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S1 First aid > pulmo > Flashcards

pulmo Flashcards

1
Q

what causes a rigth shift in the oxy. diss. curve?

A

co2, h+, 2,3bp and temp increase

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2
Q

what causes a left shift in the oxy. diss. curve?

A

co2, h+, 2,3bp and temp decrease

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3
Q

epistaxis occurs?

A

kiesselbach plexus, anterior segment of the nostril

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4
Q

Mediastinis cause that is very commen?

A

histoplasma capsulatum

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5
Q

What is assci. with asthma?

A

charcot-leyden crystals

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6
Q

what guaifenesin?

A

exspectorant, thins the secretion but not the cough reflex?

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7
Q

what is phenylephrine?

A

alpha-adrenergic agonist, for nasal cogestion

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8
Q

what is dextromethorphan?

A

antitussive that antago. NMDA glutamate recepteos, mild opoidd effect

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9
Q

endothlin receptor antagonist are used?

A

antagoninizes endothlin-1 reducin pulmonary vascular resistance

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10
Q

protacycline analoges are used?

A

PGI2 (prostacycline) with direct vasodilation on pulmol and systemic, inhibilts aggregation

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11
Q

what is albuterol?

A

short acting beta 2 agonist, can cause arrhytmia

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12
Q

what are salmeterol, fometerol

A

long acting beta2 agonist, can cause tremor + arrhytmias

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13
Q

tiopropium is ?

A

competetive muscarinic antagonist, long acting

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14
Q

what is fluticasone, budisonide?

A

coticosteroids inactivate NFkapa

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15
Q

Transudate

A

Transudate is extravascular fluid with low protein content and a low specific gravity (< 1.012)

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16
Q

Adnocarcinoma

A

Most common, more Females none smoker, EGFR, KRAS, ALK mutations, location: peripheral, hist: Glands and mucine

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17
Q

SCC

A

30%, Smoker, TP53 CDKNZA, mutation, paraneoplastic: PTHrP, located: centrally, histo: Spinosom: Desmosomes (intracellular bridges), keratin whorls/pearls

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18
Q

Small cell carcinoma

A

15%, TP53 RB mutation, smokers,

Paraneoplastic: SIADH=decreased Na+, or Antibodies agianst presynatic Ca2+, ACTH=cushungs

location: centrally, Hist: small cells (kulchitsky cells—> small dark blue cells, chromogranin A, synaptophysin

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19
Q

Large cell

A

highly undiff. tumor

Hist: huge cells: Pleomorphic giant cells/Anaplastic cell with allot of cyplasm

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20
Q

Brochial carcinoid

A

carcinoid sy.: flushing, wheezing, valve fibrosis and diarrhea

Hist: well organized
trabecula/ nest of neuroendocrine cells
low mito. rate

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21
Q

Mesothelioma

A

associ. abestos, location pleural thickining

histo: (Psammoma bodis), calretinin

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22
Q

Lung cancer

complications
and metastases

A 
complications: SPHERE
Sup. vena cava
Pancoast tumor
Honer syndrome
Endocrine (paraneoplastic)
Recurrent laryngeal nerve compression (horseness)
Effusion

Metastases:

Love Affecting BONEheads and BRAINcs

Liver, Adrenal, Bone, Brain

Tumors that metas. to the lung are: Breast, Colon, Postate and bladder

23
Q

Pancoast tumor

A

superio sulcus tumor. Carcinoma that appears at the apex of the lung. causes pancoast sy. by invading/ compressing local structures
causing:

hoarseness,
horner syn. (stellate ganglion), SVC syndrome, brachiochephalic sy.,
brachial plexus sy.

24
Q

SVC

A

obstruction of the SVC impairs blood draininge frpm the head (facial plethora), jug. venous dist., upper edema

cause: malignancy (mediast. mass, pancoast tumor

Emergency: can cause ICP increase—-> headaches, dizziness, increased risk of aneurism/ rapture of the intracraneal arteries

25
Q

Rhinosinusistis

A

superior meatus—> drains spenoid, post. ethmoid

middle meatus—> drains frontal, maxillary and anterior ethmoid

inferior—> drains nasolascrimal duct

26
Q

VC

A

TV+IRV+ERV

27
Q

FRC

A

RV+ERV

28
Q

OLD

A

only: RV increases, TLC increases

FEV1 decreased

FEV1/ VC= decrease because VC is increased

decrease in elastin and therefore recoil

29
Q

RLD

A

all volumes are decrease

FEV1 decreased

FEV1/ VC= normal because all volumes are decreased

30
Q

pleural effusion

A

lung sounds decrease and the fremitus will reduce

31
Q

Consolidation

A

increased fremitus/ solid, dullness to percussion

32
Q

pulmonary edema is

A

crackels

33
Q

obstruction

A 
wheezing= obstruction of expiration
Strider= same soud on expiration/ its the upper airways
34
Q

Pulmonary Edema

A

Hydrostatic forces equation=

J=K(H-O)

O= OSI
Cirrhosis
Nephrosis
Gastrosis >= Albumen will be low

H= Clot
Cancer
Compression
Cuts
Cirrhosis
!CHF!

K= Inlammation: Infec. or Cancer
!ACI!

35
Q

Pulmonary Edema

cardiogenic

A

1 Cariogenic:
Transudate: protein are low, cells are low
Hydrostatic cause increase in PCWP ( estimates the left atrial pressure/ brach of the pulmonary artery) CHF symp. dyspne on exsurgen, parox. dyspnoe, orthopnea, JVD, per. edema
Hist: Hemoseriderin laden marophages

36
Q

noncardiogenic effusion

A

hyaline membrane around the alveoli

Exudative effusion (increased protein and increased cells): Cause is leaky capillaries

ALI=ARDS=DAD=hyaline membrane

no CHF/ no volume overload

ALI: occurs in SIRS:
Septic Shock, Pancreatisis, Transfusion related Lung Injury

SIRS—>vasodil—> neutro. fibro,macro—–>hyline membranes—-> collagen

37
Q

Pleural Effusion

A

horizontal minicus on x-ray, Transudate: (H)ydrostatic, (O)ncotic
Exudate: K (vascular permeability), Cancer, Inf.

38
Q

pneumothorax

A

vertical lung shadow on x-ray: large simple

39
Q

tensionpneumo

A

the collpased lung and shift of organs

hypotension, obstruction of the IVC=JVD, tracheal divation

40
Q

Asthma

A

rev. airway remod.

41
Q

COPD

A

irrv. Ephysem, Bronchitis

42
Q

Brochitis

A

conducting airways

Path: inflam. of the Large Airways

43
Q

Bronchitis

A

conducting airways

Path: inflam. of the Large Airways
Old, Smoker
chronic productive cough > 3months, 2yrs
Cyanosis, pulm. HTN, CHF, peri. edema, JVD
"blue bloaters"

Hist: Hypertrophy +hyperplasia of submucosal glands =Reed index

Reed in index> 40%= mucosal hyperplasia

44
Q

Emphysema

A

Path: Alveoli, loss of elastin/septa=loss of recoil
pt: smoker=centriacinar Apixes
prologe exp. phase, purged lips, intercoastal hypertrophy, cachexia, icreased AP diamether XR: Hyperinflation, Chronic CO2 retainers, Ph normal, co2 elevated, increased bicarb

1Inflammation: Debris—>PMN–>Proteases—> decrease elastin

2) Antitryprotease=Panacinar lower lobes
Alpha1 anti D.—–> cirrhosis and emphysema

((((3)Apoptosis?= loss of septa
VFGF-endothelial
Rtp80l- mTor

NRF2 oxidant stress))))))

pink puffer

45
Q

Astma

A

rev. broncho, typeI, IGE, Mast, Eo

Wheeze, Dyspnea, Cough, low O2

1) Early Phas=Bonchocontriction
Histamine=vasodilation
leukotriane= brochcontriction
Vagus—>M3—->Brochcon.

2late Phase=Mucus
Th2:---->IL4 class switch IgE
---->IL5 eosiniphiles( Chorcot layden Cry) summoning (MBP)--->epithelial detashments
---->IL13 Mucous (Plug= Cruschmann spirals)

Air Remodeling:
Submocosal Hyperplasia and trophy, goble hyplasia, smooth muscle hypertrophy
leading to subbasement fibrosis

46
Q

pulmonary hypertension

A

10-14mmhg, above 25 is hypertension

47
Q

Pulmonary arterial hypertension

Class1

A

2° PAH—- intimal thickining, fibroblast prol, collagen–collapse of the lumen

iPAH—Plexoform lesions, BMRP-2
Young weman

Treament works only for iPAH (of fibro. prolif): PDE-5 inhib, Entholin inhitors Bosentan, Epoprostal inhibits procyclin

48
Q

Class 2

A

LV dysfunction

will lead to pulmonary venous HTN, 
venous medial thickening,
arterialization,
CHF SxS, Pulmonary Edema
hemosideren macrophages
49
Q

Class 3

A

Hypoxic Lung D.

Medial thickining+Hyperplasia, OLD, RLD, OSA

50
Q

Classs 4

A

CTE, Chronic Thrombpembolic

Hx:DVT/PE

V/A scan

51
Q

RLD diff.

A

DLCO (assess the diff barrier)

DLCO is normal: mucular or Obesity
DLCO is low: fibrotic: ILD=DPLD
IPF Asbestosis etc

52
Q

Idiopathic pulm fibrosis

A

Path: progressive firo. in the septa, never smoke

HRCT: subpelural fibrosis, lower lobes, Honey combing

histo: usu intersti. pneumonia, subpleural fibrosis, progressive sparing of central alveoli

53
Q

Hypersensitivity pneumonitis

A

typeII/III hyper. due to enviro. antigen seen in farmers and those exposed to birds

S1 First aid (20 decks)

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