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Internal Medicine Platinum > Pulmonary Correlates > Flashcards

Pulmonary Correlates Flashcards

1
Q

Lung zone at base of lungs, apex of lungs and during exercise

A

Lung base: zone 2 and 3
Apex of lung: zone 3
Exercise: zone 3 in all lung areas

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2
Q

Shift to the left of the O2 Hgb dissociation curve

A

Carbon monoxide and fetal hemoglobin

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3
Q

Controls inspiratioj; sends inspiratory ramp signal

A

Dorsal respiratory group of the medulla

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4
Q

Controls both respiration and expiration; overdrive mechanism in exercise

A

Ventral respiratory group of the medulla

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5
Q

Limits inspiration and increases respiratory rate

A

Pneumotaxic center of the pons

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6
Q

Stimulates respiration and decreases respiratory rTe

A

Apneutic center of the pons

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7
Q

Made up of the VRT and DRG in the ventral medulla; excited by H from blood CO2. Adapts within 1-2 days

A

Central hemoreceptors

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8
Q

Found in carotid bodies (CN IX) and aortic bodies (CN X). Activated when PO2 less than 70 mmHg to a lesser extent CO2

A

Peripheral chemoreceptors

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9
Q

Benign ovarian tumors with ascites and pleural effusion

A

Meig’s syndrome

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10
Q

Dutch hypothesis vs British hypothesis

A

Dutch: contends asthma and COPD are variations of the same basic disease
British: contends that asthma and COPD are fundamentally different diseases

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11
Q

TB virulence factor

A

Cord factor

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12
Q

TB prevents macrophage-lysosomal fusion

A

Sulfatides

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13
Q

Marker for TB infection

A

PPD

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14
Q

Pathologic sign of primary TB

A

Ghon’s focus

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15
Q

Ghon’s focus and hilar lymphadenopathy

A

Ghon’s complex

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16
Q

Radiologic sign of primary TB

A

Ranke complex

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17
Q

Pathologic sign of secondary TB

A

Simon’s focus

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18
Q

Most common site of extrapulmonary TB

A

Lymph nodes

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19
Q

Physiologic abnormality of Asthma

A

Airway hyperresponsiveness

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20
Q

Pathogenesis behind asthma

A

Imbalance favoring TH2 production over TH1 leading to increased IL1, IL5 resulting to increased eosinophils

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21
Q

Putative mediators of asthma

A

SRS-A ( made up of leukotriene C4, D4, E4)

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22
Q

Whorls of shed epithelium in mucus plugs seen in asthma

A

Curschmann spirals

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23
Q

Crystalloid made up of eosinophils membrane protein seen in both asthma and amoebiasis

A

Charcot- Leyden crystals

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24
Q

Most common allergens to trigger asthma

A

Dermatophagoides species (dust mites)

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25
Q

Mechanism of exercise-induced asthma

A

Hyperventilation

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26
Q

Most effective bronchodilators in current use

A

B2 agonist

27
Q

Most common side effects of B2 agonists

A

Muscle tremor and palpitations

28
Q

Most common side effects of anticholinergics

A

Dry mouth

29
Q

Most common side effct of theophylline

A

Nausea, vomiting, headaches

30
Q

Drugs that have been shown to be safe in pregnancy and without teratogenic potential

A

Short acting B2 agonist, ICS, theophylline

31
Q

Pathogenesis behind emphysema

A

Imbalance between protease (elastase) and anti protease (alpha 1 anti trypsin)

32
Q

Most common form of severe A1 anti trypsin deficiency

A

PiZ

33
Q

Accounts for essentially all the reduction in PaO2 that occurs in COPD

A

Ventilation- perfusion mismatching

34
Q

Major site of increased resistance in most individual in most individuals in COPD

A

Small airways of less than 2 mm diameter

35
Q

Type of emphysema most frequently associated with cigarette smoking

A

Centriacinar emphysema. Centri = cigarette

36
Q

Type of emphysema usually observed in patient with alpha 1 AT deficiency

A

Panacinar emphysema

37
Q

Type of emphysema associated with spontaneous pneumothorax

A

Distal acinar emphysema

38
Q

Major physiologic change in COPD resulting from both small airway obstruction and emphysema

A

Airflow limitation

39
Q

The only pharmacologic therapy demonstrated to unequivocally decrease mortality rates

A

Supplemental O2

40
Q

Bacteria frequently implicates in COPD exacerbations

A

Strep. Pneumonia, H. Influenza, M. Catarrhalis

41
Q

Most common pathogenesis of pneumonia

A

Aspiration

42
Q

Most common cause of nosocomial pneumonia and pneumonia in cystic fibrosis patients

A

Pseudomonas aeruginosa

43
Q

Most common viral cause of atypical pneumonia and bronchiolitis in children

A

Respiratory syncytial virus (RSV)

44
Q

Most common cause of pneumonia in AIDS patients

A

Pneumocystis jiroveci

45
Q

To be adequate for culture, sputum sample must have

A

Per LPF more than 25 neutrophils and less than 10 squamous epithelial cells

46
Q

Imaging modality of choice for confirming the diagnosis of bronchiectasis

A

Chest CT

47
Q

Most common cause of viral croup/ laryngotracheobronchitis in infants

A

Parainfluenza

48
Q

Leading cause if transudative pleural effusion

A

LV failure and cirrhosis

49
Q

Leading cause of exudative pleural effusion

A

Bacterial pneumonia, malignancy, viral infection, pulmonary embolism

50
Q

Most common cause if chylous pleural effusiom

A

Malignancy

51
Q

Most common lesions in the anterior mediastinum

A

Thymoma, lymphomas, teratomatous neoplasms, thyroid masses

52
Q

Most common masses in middle mediastinum

A

Vascular masses, lymph node enlargement from metastases or granulomatous disease, pleuropericardial and bronchogenic cysts

53
Q

Most common masses in posterior mediastinum

A

Neurogenic tumors, meningocele, meningomyeloceles, gastroenteric cysts, esophageal diverticula

54
Q

Tracheal deviation in spontaneous pneumothorax

A

Ipsilateral

55
Q

Tracheal deviation in tension pneumothorax

A

Contralateral

56
Q

Usual cause of death from Pulmonary Embolism

A

Progressive right heart failure

57
Q

Most common ECG abnormality in PE

A

T wave inversion in leads V1 to V4

58
Q

Top 3 causes of ARDS

A

Gram-negative sepsis, gastric aspiration, severe trauma

59
Q

Short term morphology of ARDS

A

Waxy hyaline membrane

60
Q

Long term morphology of ARDS

A

Intra-alveolar fibrosis

61
Q

Histologic manifestation of ARDS

A

Diffuse alveolar damage

62
Q

Pulmonary wedge pressure in ARDS

A

Less than 18 mmHg

63
Q

Lung zones

A

Zone 1: no blood flow
Zone 2: intermittent blood flow
Zone 3: continuous blood flow

Internal Medicine Platinum (4 decks)

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