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First Aid > Pulmonary > Flashcards

Pulmonary Flashcards

1
Q

errors at embryonic stage of lung development

A

tracheoesophageal fistula

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2
Q

respiration is possible at how many weeks

A

25

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3
Q

5 phases of lung development

A
  1. embryonic
  2. pseudoglandular
  3. canalicular
  4. saccular
    5 alveolar
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4
Q

pulmonary hypoplasia is associated with….

A

congenital diaphragmatic hernia and Potter sequence

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5
Q

bronchogenic cysts caused by….

A

abnormal budding of foregut and dilation of terminal or large bronchiole

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6
Q

club cells

A

located in small airways, secrete component of surfactant, degrade toxins

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7
Q

surfactant synthesis begins at…

A

week 26, matures at week 35

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8
Q

neonatal respiratory distress syndrome

A
  • surfactant deficiency leading to collapse
  • risks: maternal diabetes, C-section (less stress)
  • problems: NEC PDA
  • treat with steroids
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9
Q

treatment with neonatal O2 can cause

A
  • retinopathy of prematurity
  • BPD
  • intraventricular hemorrhage
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10
Q

L/S ratio

A

greater than 2 is healthy, low is predictive for NRDS

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11
Q

airway smooth muscle extends to….

A

terminal bronchioles

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12
Q

cartilage and goblet cells extend to….

A

end of bronchi

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13
Q

cilia extend to…..

A

respiratory bronchioles

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14
Q

number of lobes on each side

A

left has less lobes (2) and lingula

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15
Q

RALS

A

right anterior, left superior, relationship of pulmonary artery to bronchus

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16
Q

more likely to aspirate in what side…

A

right, more vertical

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17
Q

spinal level of things entering the abdomen

A

T8 - IVC
T10 - esophagus, vagus
T12 - aorta, thoracic duct, azygos vein

I 8, 10 eggs at 12

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18
Q

inspiratory reserve volume

A

volume you can still breath in after tidal

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19
Q

expiratory reserve volume

A

volume you can still breath out after tidal

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20
Q

functional residual capaticy

A

volume left after normal respiration

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21
Q

inspiratory capacity

A

what can be breathed in after normal exhale

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22
Q

calculation for physiologic dead space

A

Taco, paco, peco paco

Vd = Vt * (PaCO2 - PeCO2/PaCO2)

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23
Q

lung is most balanced at…

A

FRC, PVR is at a minimum here

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24
Q

elastic recoil

A

tendency for a lung to collapse inward

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25
Q

compliance

A

change in lung volume for a change in pressure, inversely proportional to wall stiffness

surfactant increases compliance

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26
Q

hysteresis

A

lung inflation curve follows different curve than deflation due to need to overcome surface tension

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27
Q

things that shift hemoglobin curve

A

shift curve right = more offloading

- CO2, acid, 2,3BPG, temperature

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28
Q

oxygen affinity to hemoglobin

A

deoxygenated = less affinity

more oxygenation = more affinity

29
Q

treatment for methemoglobinemia

A

vitamin C or methylene blue

30
Q

methemoglobin

A

iron is in Fe3+ leading to decrease oxygen affinity

- cyanosis and chocolate color blood

31
Q

causes of methemoglobin

A

nitrites and benzocaine

32
Q

carbon monoxide

A

binds reversibly to hemoglobin at much higher affinity

33
Q

why does fetal Hb have higher affinity for O2

A

due to low affinity for 2,3 BPG

34
Q

3 components of oxygen content of blood

A

hemoglobin level, hemoglobin saturation, dissolved oxygen

35
Q

low oxygen in lungs causes vaso….

A

constriction, shunt blood to better perfused areas

36
Q

lungs are normally (perfusion/diffusion) limited

A

perfusion limited - can only be increased with additional blood flow

37
Q

states of diffusion limited problems

A

emphysema, fibrosis, CO poisoning - oxygen does not have time to get to hemoglobin

38
Q

DLCO

A

measure of diffusion using CO

39
Q

alveolar gas equation

A

PAO2 = PIO2 - (PaCO2/0.8)

40
Q

increased A-a gradient occurs in….

A

shunting, V/Q mismatches, fibrosis (impaired diffusion)

41
Q

hypoxia causes

A

low cardiac output, hypoxemia, anemia, CO poisoning

42
Q

hypoxemia causes (normal A-a)

A

hypoventilation, high altitude

43
Q

hypoxemia causes (high A-a)

A

V/Q mismatch, diffusion limitation, shunt

44
Q

V/Q based on area of lung

A

highest at top, lowest at bottom

45
Q

V/Q = 0

A

airway obstruction

46
Q

V/Q is very large

A

blood blockage, shunt, if not at 100%, oxygen can help

47
Q

three forms of CO2 in blood

A
  1. bicarb
  2. bound to Hb at N terminus of globin
  3. dissolved
48
Q

Haldane effect

A

oxygenation of Hb promotes dissociation of H+ leading to CO2 formation

49
Q

Bohr effect

A

In tissues with more H+, curve is shifted left leading to oxygen offloading

50
Q

d-dimer

A

used to rule out DVT

51
Q

lines of Zahn

A

areas of pink - platelets and fibrin vs RBCs found in thrombi before death - distinguish between pre and postmortem thrombi

52
Q

fat emboli association

A

bone fractures, liposuction

53
Q

caplan syndrome

A

rheumatoid arthritis and pneumoconiosis with intrapulmonary nodules

54
Q

asbestosis

A
  • higher risk of carcinoma
  • prussian blue stain
  • risk of pleural effusions
  • dumbell rods
55
Q

berylliosis

A
  • noncaseating granulomas
  • effects upper lobes
  • aerospace and manufacturing
56
Q

coal workers

A
  • coal
  • black lung
  • anthraosis (asymptomatic condition)
57
Q

silicosis

A
  • fibrosis
  • disrupt phagolysosomes and impair macrophages
  • eggshell calcifications
58
Q

mesothelioma

A
  • psammoma bodies
  • cytokeratin and calretinin are usually positive
  • no smoking
59
Q

ARDS

A
  • diagnosis of exclusion (must be acute)
  • sepsis, pancreatitis, pneumonia, aspiration, trauma, shock
  • endothelial damage, permeability, leakage into alveoli
  • hyaline membranes
  • neutrophilic substances toxic
60
Q

etiologies of pulmonary hypertension

A
  • primary
  • left heart failure
  • lung disease
  • chronic microemboli
  • multifactorial
61
Q

tracheal deviation in pleural effusion vs ateletctasis vs tension pneumothorax

A

effusion - away from side of lesion
atelectasis - toward side of lesion
pneumothorax - away (air pushes it)

62
Q

cryptogenic organizing pneumonia

A
  • noninfectious
  • inflammation of bronchioles
  • caused by chronic inflammation or drugs (amiodarone)
63
Q

treatment of lung abscess

A

clindamycin

64
Q

pancoast tumor

A

carcinoma in apex of lung that causes symptoms by invading cervical chain

65
Q

SVC syndrome

A
  • impaired blood drainage from head
  • JVD, upper extremity edema
  • malignancy and thrombosis
  • risk of aneurysm rupture
66
Q

SPHERE complications of lung cancer

A 
S - SVC syndrome
P - pancoast tumor
H - horners syndrome
E - endocrine - paraneoplastic
R - recurrent nerve compression
E - effusions
67
Q

small cell cancer

A
  • ACTH, SIADH, Lamber-Eaton
  • myc oncogenes
  • neuroendocrine cells
  • chromogranin A, enolase positive
68
Q

lung adenocarcinoma

A
  • peripheral

- hazy infiltrates

69
Q

squamous cell

A
  • central, smoking
  • hypercalcemia
  • keratin pearl and intercellular bridges

First Aid (16 decks)

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