Pulmonary Flashcards

1
Q

aging and its effects on pulmonary function

A
  • decrease in chest wall compliance
  • increase lung compliance due to loss of elastic recoil
  • dilation of alveolar ducts is homogenous
  • increase in residual volume
  • total lung capacity= unchanged
  • decrease in forced vital capacity
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2
Q

what test to use to test for asthma

A

methacholine challenge test- muscarinic cholinergic agonists that acts by inducing bronchial smooth muscle contraction and increasing bronchial mucus production

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3
Q

findings of idiopathic pulmonary fibrosis

A

progressive exertional dyspnea, dry cough, restrictive profile, interstitial fibrosis with cystic air space enlargement, patchy involvement with dense fibrosis , “honeycomb” changes

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4
Q

why does supplemental oxygen administration in patients with COPD lead to oxygen-induced hypercapnia and thus lead to confusion and depressed consciousness?

A

reversal of hypoxic pulmonary vasoconstriction–> increases physiologic dead space as blood is shunted away from well-ventilated alveoli

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5
Q

hypoxia stimulates _________ production from the renal cortex

A

erythropoietin–> to stimulate erythrocyte production

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6
Q

________ deficiency is associated with reddish-pink, periodic acid-Schiff-positive granules

A

alpha-1 antitrypsin (AAT)

associated with panacinar emphysema

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7
Q

signs of sarcoidosis

A

accumulation of CD4+ cells, noncaseating granulomas in parenchyma and hilar lymph nodes, dyspnea, enlarged mediastinal and hilar lymph nodes on x-ray, high ACE levels, hypercalcmia

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8
Q

______ is a competitive antagonist of endothelin receptors used for pulmonary arterial hyptertension

A

Bosentan

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9
Q

electrical stimulation of the ______ nerve increases the opening of the orophyngeal airway to decrease obstructive sleep apnea episodes

A

hypoglossal

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10
Q

side effect of inhaled glucocorticoids/ corticosteroids (1st line for chronic asthma)

A

oral thrush/ oropharyngeal candidiasis

*use a spacer and rinse mouth after use to reduce risk

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11
Q

leukotriene B4

A

stimulates neutrophil migration to sites of inflammation

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12
Q

immune response to pulmonary tuberculosis infection to control it

A

CD4+ TH1 lymphocytes and macrophages

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13
Q

why do lung infarction only rarely develops as a complication of pulmonary embolism?

A

lung is supplied by dual circulation from the pulmonary and bronchial systems (collateral circulation)

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14
Q

how does pulmonary emboli usually appear on the lung?

A

multiple wedge-shaped hemorrhagic lesions in the periphery of the lung

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15
Q

IV drug users are at risk for developing septic pulmonary emboli as a complication of __________

A

tricuspid valve endocarditis

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16
Q

which has a more significant effect on cerebral blood flow: pCO2 or pO2?

A

pCO2

CO2 causes cerebral vasodilation, so decreases CO2 like with asthma, then decreased cerebral blood glow and lead to dizziness, weakness, and blurred vision

17
Q

peripheral chemoreceptors found in __________________ are the primary sites for sensing arterial PaO2 and are stimulated by hypoxemia

A

carotid and aortic bodies

18
Q

antibiotic good for lung abscess, oral infections and aspiration pneumonia

A

Clindamycin

19
Q

Vitamin ___ maintains orderly differentiation of specialized epithelia, including mucus-secreting columnar epithelia of the ocular conjuctiva, respiratory and urinary tracts, and pancreatic and other exocrine ducts

20
Q

primary cell lines that are increased in stable COPD

A

neutrophils, macrophages, and CD8+ T lymphocytes

*secrete enzymes and proteases that perpetuate both alveolar destruction of emphysema and mucus hypersecretion found in chronic brochitis

21
Q

complication of using concentrated oxygen therapy for neonatal respiratory distress syndrome

A

retinopathy of prematurity

major cause of blindness

22
Q

ventilation/perfusion scan finding for pulmonary embolism

A

perfusion defect with ventilation defect

23
Q

Cystic fibrosis is an autosomal ______ disease caused by mutations in the _________ gene

A

recessive; CF transmembrane conductance regulator (CFTR)

*CFTR protein=transmembrane ATP-gated Cl- channel

24
Q

Chyne-Stokes breacthing

A

cyclic breathing in which apnea is followed by gradually increasing then decreasing tidal volumes until the next apneic period

  • associated with advanced congestive heart failure
25
what is the Reid index? like how is it measured?
ratio of the thickness of the mucous gland layer in the branchial wall submucosa to the thickness of the bronchial wall between the respiratory epithelum and bronchial cartilage---> does not include the cartilage part for chronic bronchitis
26
arterial blood gas changes associated with high altitudes
hypoxemia--> reduced PaO2--> triggers chemoreceptors in carotid bodies--> hyperventilation--> decrease PaCO2--> respiratory alkalosis--> compensation would decrease bicarb
27
Pancoast tumor (key findings)
*key: shoulder pain and Horner's syndrome superior sulcus tumor arise at lung apex
28
4 major causes of hypoxemia
alveolar hypoventilation, ventilation-perfusion mismatch, diffusion impairment, and right-to-left shunting A-a gradient is normal with alveolar hypoventilation- distinguishes it from others
29
fat embolism syndrome: the classic triad
acute-onset neurologic abnormalities, hypoxemia, and petechial rash
30
fat embolism syndrome caused by
severe long bone and/or pelvic fratures fat globules dislodges from bone marrow and travel to lung--> can cause ARDS
31
normal A-a oxygen gradient
5-15 mm Hg, with older people having a higher gradient
32
untreated obstructive sleep apnea can lead to (2 things)
pulmonary hypertension and right heart failure
33
why is it thought that small cell carcinoma of the lung have a neuroendocrine origin?
tumor cells express neuroendocrine markers and have neurosecretory granules in the cytoplasm
34
adverse effects of theophyline (asthma drugs that causes bronchodilation by inhibiting phosphodiesterase)
seizures and tachyarrhythmias (do not usually case QT prolongation) seizures=major cause of morbidity and mortality in theophylline intoxication