PULM1 Flashcards
RESTtrictive or obstructive in ARDS
restrictive\ca
cause pul edema
atelectasis restrictive or obsturcitve
restrictive
why does asthma have an increase DLCo
due to increased pulmonary capillary blood volume
Rheumatoid arhtitis obstructive or restrictive
restritctive
which T cell increased in COPD
cd8 T cells
bronchiolitis obliterans affects the
small aireways
hypoxic vasconstriciton improves VQ mismath by
decreaseing phys shunting in poorly ventialted alveoli leading to overall more efficient gas exchagne
PUL HTN complication of
CREST syndrome
no normal PFT in hypoxic vasoconstriction
TRUE
seen in chronic lung disease or hypoventilation syndromes
destruction of vascular beds
emphysema: raisess vasculare resistance; contributing to PAH
cavitary lung lesions caused by
aggregations of activated leuklocytes
( release of proteases, NO, ROS) cause cavitary ; damage
stimulation of hypoglossal nerve does what
cause tongue to move forward slighlty; increasing AP dimater of airway
reid index is the ratio of
thickness of submucosal bronchial glands to thickness of bronchial wall bw epithelial basement membrane and bronchial cartialges
mucous glands/submucos + lp
larger diamter, shroter, and more vertically oreinted
right main bronchus
where should thoracentesist be performed
above 8th rib in midclavicular line, the 10th rib along midaxillary line, and 12th rib along posterior scapualr or paravertebral line
lower than these poitns: increase risk of penetrating abdominal structures
lung is located about 8th in mid axillary
true
staph aureus burkholderia cepacia serratia marcescens nocardia aspergillus
CGD
2 major mechanisms of hypoxemia in advanced COPD
- emphsyemaptous destructio nof alveolar capillary membrane results in impaired diffusion of O2
- airway obstruction (due to bronchial inflammation and mucus secretion) and air-trapping (due to both bronchial inflammation and emphseymeatous airway collapse ) cause vq mismatching
air trapping leads to an increase in
FRC in pt’s w copd
perpetual collapsin force on lugns caused by
alvoelar transmural pressure always being positive
ARDS assoc intersitial edema and hyaline membrane formation along w fluid filled alveoli collapse and atelectasis result in decreased lung compliance and increased work of breathing. the fluid filled, collapsed alveoli are unable to deliver oxygen despite continuing to receive adequate blood flow, resulting in Vq mismatch and hypxoia
true
ARDS incraese or decrease lung complaicen
decrease
inspissated mass green
meconium ileus
dehdyrated meceoniem
most common cause of ddeeath in hirschprung
enterocolitis
impaired fodling and glycoyslation of CFTR
Cystic fibrosis
eosinohils recruited by
IL5
decrease ERV is most focmmon dinicator of
obestiy related disease
classic triad in fat embolism syndrome
neurologic abnormality
hypoxemia
petechiae
astham has no effect on
lung compliacnce
VTE prohylaixixs
lmwh
high vq regions have large capacity to
exhale additional co2
why does hyperventialtion not significantly improve arterial oxygenation
hemoglobin is nearly fully satured w o2 in areas of normal vq ratio, there is little capacity for high vq regions to increase blood o2 content much furtehr
pulm edema affecss where in lung
lung bases
untreated OSA causes
pulmonary Hypertension
cancers located in apex of lung
superior sulcus
anterior mediastinum mass
thymoma, teratoma, thyroid cancer, terrible lymphoma
VTE vs tricuspid valve endocarditis
tricuspid valve: high grade fever, recent IV drug use; multiple infarcts
primary site of lactate clearance
liver
lactic acidosis in septic schok results from tissue hypoxia which
impairs ox phosphorylation and causes shunting of pyruvate to lactate following glycosis. tehre is a buildup of nadh
initial treatment of choice for sacrocidois
oral glucocorticoids 9prednisone)
syphillis
caseating granulomas
rash on maculopapulor involved palms and soles
OSA
resp effort
resp effort adquate THROUGHOUT
cheyne-stokes breathing seen in
advanced CHF
cyclic breathing patternr in which apnea is followed by gradually increasing then decreasing tidalvolumes until next apneic period
cheyne stokes breathing
chesst tube for drainigae of pleural effusion into 4th or 5th ics in anterior axillary or midaxillary lin traverses
serratus anterior muscle
intercostal muscles
parietal plerua
heart failure cells seen in
CHRONIC left heart failure
if acute; more likely transudate cardiogenic pulm edema
neutrophils in alveolar fluid
exduate
restoring CFTR proteins to emmbrane
lumacaftor
enhance protein function
ivacaftor (chloride transport)
whorled collagen fibers and dust laden macs
silicosis
sound vibrations travel faster and more efficeintly thorugh liquids than gases thus
increased breath sound, increased tactile fremiuts
lobar consolidiaton
pulm edema
peripheral chemoreceptors located in the
carotid and aortic bodies
in copd: what decreses
peripheral chemoreceptors.
remember not senstiive to paco2; so peripheral becomes major drive (hypoxemia)
peripiheral chemoreceptors are primarily responsbile for sensingpao2; and can be suppressed with oxygen administraiton
lung apices extend above
clavicle and first rib
ansa cervacilis
arise from c1, c2, c3 nerve roots and innervates sternohyoid, sternothyroid, omohyoid
penetrating trauma to neck above cricoid cartialage can injure this nerve
leakage of protein-rich fluid in alveolar airspaces
lobar pneumonia; happens in congestion
neutrophils respond to bacterial components by releasing cytokines that increase permeability of pulmonary capillary endothelium
excesssive fibroblast proliferation and ecm matrix depsotion
idopathic pulmonary fibrosis
absolute vs relative
erythrocytosis
absolute has a true increase in RBC mass
Relative Has a normal rBC mass
relative erytrhocytosis due to dehydration or
excessive diruessis
normal RBC mass
causes lung abscess formation driven by
neutrophil recuritment and activation leading to release of cytotoxic granules that kill bacteria but also cause liquefying necorsis of surrounding tissue
decrease chest wall compliance
increases work of breathing
UTI: sepsis leads to what pulm
ARDS
wedge shaped areas of hemorraghic necrosis caused
by pulmonary embolism
SVC sydnroem caused by
anterior mediastinal mass
