pulmonary

Question 1

pleural effusion

Answer 1

bacterial translocation from alveoli into pleural space

Question 2

empyema

Answer 2

accumulation of pus in pleural space

Question 3

methemeglobin

Answer 3

Fe2+ to Fe3+, unable to bind O2, only ppO2 is normal, causes cyanosis, decreased O2 content of arterial blood, decreased O2 delivery to tissues

Question 4

CO poisoning

Answer 4

• headache
  -dizziness
• competitively binds to heme with higher affinity than O2
  -carboxyhemoglobin

Question 5

tuberculosis

Answer 5

• fever, night sweats, maybe pericarditis but no heart murmur

Question 6

Legionella

Answer 6

• pneumonia with diarrhea
• grows on cysteine and iron agar - buffered charcoal yeast
• confusion, headache
• treat with macrolide/fluoroquinolones
• oxidase positive

Question 7

diaphragm innervation

Answer 7

C3-C5, phrenic nerve

Question 8

most common lung cancer

Answer 8

adenocarcinoma

Question 9

pancoast tumor

Answer 9

at the superior sulcus. Can cause Horner syndrome

Question 10

Most commonly injured in thoracic procedures

Answer 10

Thoracic duct (lymph nodes are on it, could cause pleural effusion, ex lymph node removal)

Question 11

markers for small cell lung cancer

Answer 11

• chromogramin, synaptophysin, NCAM
• sheets of small blue cells with scant cytoplasm
• associated with smoking
• centrally located
• neuroendocrine tumor secreting ADH

Question 12

theophylline intoxication

Answer 12

watch for seizures and tachyarrythmias

Question 13

transudative effusion

Answer 13

• can be caused be heart failure
• increased hydrostatic pressure causes leakage of fluid from pulmonary capillaries
• fluid shoes low protein, low lactate dehydrogenase

Question 14

exudative effusion

Answer 14

• inflammatory disruption of vascular permeability in lungs
• fluid shows high protein, high lactate

Question 15

asthma on histology

Answer 15

charchot leyden crystals and kershman spirals

Question 16

cancer associated with Lambert eaton

Answer 16

associated with small cell lung cancer

Question 17

Pulmonary embolism ____ physiologic dead space

Answer 17

Increases

Question 18

Pulmonary actinimycosis usually caused by

Answer 18

Aspiration pneumonia

Question 19

sarcoidosis

Answer 19

hypercalcemia, non caseating granulomas, activated macrophages, hilar lymphadenopathy, erythema nodosum

Question 20

BMPR2 gene

Answer 20

Familial pulmonary hypertension - leads to vascular smooth mm hypertrophy

Question 21

Damage to alveolar capillary interface causing leakage of fluid and hyaline membrane

Answer 21

ARDS

Question 22

Neonatal respiratory distress syndrome

Answer 22

Decreased pulmonary surfactant

Question 23

Lecithin

Answer 23

Higher than sphingoyelin, made of phosphotidle choline

Question 24

Oxygen in neonatal respiratory distress syndrome

Answer 24

Causes free radical damage, can cause blindness

Question 25

Most common cause of cancer mortality

Answer 25

Lung cancer

Question 26

Keratin pearls with intracellular bridges

Answer 26

Squamous cell carcinoma

Question 27

Most common lung tumor in non smokers

Answer 27

Adenocarcinoma

Question 28

pleural effusion

Answer 28

increased hydrostatic pressure and increased rate of fluid flow to the pleural space

Question 29

croup inflammation of the

Answer 29

trachea - causes barking cough

Question 30

Traumatic pneumothorax

Answer 30

Has crepitus

Question 31

mesothelioma stains positive for

Answer 31

cytokeratin

Question 32

Asthma, bronchiectasis, eosinophilia, elevated IgE

Answer 32

Allergic bronchopulmonary aspergillosis

Question 33

shift of trachea to the right

Answer 33

left pneuothorax

Question 34

cilia ends where in the lungs

Answer 34

terminal bronchioles

Question 35

positive end expiratory pressure

Answer 35

PEEP helps treat ARDS by opening collapsed alveoli to reduce intrapulmonary shunting and increase functional residual capacity

Question 36

leukotrienes

Answer 36

vasoconstriction, increased vascular permeability and bronchospasm

Question 37

stimulates broncodilation via blockade of binding of acetylcholine to muscarinic receptors

Answer 37

ipratropium, mostly used in COPD

Question 38

5 lipoxygenase inhibitor that reduces production of leukotrienes

Answer 38

Ziluteon

Question 39

ARDS affects which cell type?

Answer 39

type 1 pneumocytes

Question 40

COPD

Answer 40

increase airway resistance and increased lung compliance

Question 41

Most common mutation if A1AT deficiency

Answer 41

PiZ

Question 42

A1AT deficiency also affects the

Answer 42

Liver - protein accumulation in endoplasmic reticulum

Question 43

Emphysema does not have

Answer 43

Mucus

Question 44

IL 5

Answer 44

Eosinophilia

Question 45

Curshman and Charcot Leyden

Answer 45

Asthma

Question 46

exudative effusion light criteria

Answer 46

bacterial of > 6.0

Question 47

restrictive lung disease

Answer 47

everything is down except for ratio

Question 48

used for long term asthma control

Answer 48

inhaled corticosteroid - fluticasone

Question 49

harsh systolic ejection murmur that disappears with episodes of cyanosis

Answer 49

tetralogy of fallot

Question 50

findings in tetralogy of fallot

Answer 50

1. Right ventricular outflow obstruction 2. ventricular septal defect

Question 51

septic shock

Answer 51

widespread vasodilation leading to decreased SVR, increased cardiac index, decreased CVP (r sided preload)

Question 52

cardiogenic shock

Answer 52

decreased cardiac index, increased PCWP, increased CVP(r sided preload), increased SVR, decreased SV02

Question 53

brionchiolitis obliterans

Answer 53

progressive scarring of the small airways - can happen in chronic lung transplant rejection. Reduced FEV1, normal FVC

Question 54

failure of primitive foregut to separate from airway

Answer 54

esophageal atresia and tracheoesophageal fistula, can present with polyhydrammios due to inability to swallow fluid; significant drooling, coughing, cyanosis with feeds due to reflux/aspiration of breastmilk into lungs; x ray shows a stomach bubble