Pulmonary Correlates Flashcards
Lung zone at base of lungs, apex of lungs and during exercise
Lung base: zone 2 and 3
Apex of lung: zone 3
Exercise: zone 3 in all lung areas
Shift to the left of the O2 Hgb dissociation curve
Carbon monoxide and fetal hemoglobin
Controls inspiratioj; sends inspiratory ramp signal
Dorsal respiratory group of the medulla
Controls both respiration and expiration; overdrive mechanism in exercise
Ventral respiratory group of the medulla
Limits inspiration and increases respiratory rate
Pneumotaxic center of the pons
Stimulates respiration and decreases respiratory rTe
Apneutic center of the pons
Made up of the VRT and DRG in the ventral medulla; excited by H from blood CO2. Adapts within 1-2 days
Central hemoreceptors
Found in carotid bodies (CN IX) and aortic bodies (CN X). Activated when PO2 less than 70 mmHg to a lesser extent CO2
Peripheral chemoreceptors
Benign ovarian tumors with ascites and pleural effusion
Meig’s syndrome
Dutch hypothesis vs British hypothesis
Dutch: contends asthma and COPD are variations of the same basic disease
British: contends that asthma and COPD are fundamentally different diseases
TB virulence factor
Cord factor
TB prevents macrophage-lysosomal fusion
Sulfatides
Marker for TB infection
PPD
Pathologic sign of primary TB
Ghon’s focus
Ghon’s focus and hilar lymphadenopathy
Ghon’s complex
Radiologic sign of primary TB
Ranke complex
Pathologic sign of secondary TB
Simon’s focus
Most common site of extrapulmonary TB
Lymph nodes
Physiologic abnormality of Asthma
Airway hyperresponsiveness
Pathogenesis behind asthma
Imbalance favoring TH2 production over TH1 leading to increased IL1, IL5 resulting to increased eosinophils
Putative mediators of asthma
SRS-A ( made up of leukotriene C4, D4, E4)
Whorls of shed epithelium in mucus plugs seen in asthma
Curschmann spirals
Crystalloid made up of eosinophils membrane protein seen in both asthma and amoebiasis
Charcot- Leyden crystals
Most common allergens to trigger asthma
Dermatophagoides species (dust mites)
Mechanism of exercise-induced asthma
Hyperventilation
Most effective bronchodilators in current use
B2 agonist
Most common side effects of B2 agonists
Muscle tremor and palpitations
Most common side effects of anticholinergics
Dry mouth
Most common side effct of theophylline
Nausea, vomiting, headaches
Drugs that have been shown to be safe in pregnancy and without teratogenic potential
Short acting B2 agonist, ICS, theophylline
Pathogenesis behind emphysema
Imbalance between protease (elastase) and anti protease (alpha 1 anti trypsin)
Most common form of severe A1 anti trypsin deficiency
PiZ
Accounts for essentially all the reduction in PaO2 that occurs in COPD
Ventilation- perfusion mismatching
Major site of increased resistance in most individual in most individuals in COPD
Small airways of less than 2 mm diameter
Type of emphysema most frequently associated with cigarette smoking
Centriacinar emphysema. Centri = cigarette
Type of emphysema usually observed in patient with alpha 1 AT deficiency
Panacinar emphysema
Type of emphysema associated with spontaneous pneumothorax
Distal acinar emphysema
Major physiologic change in COPD resulting from both small airway obstruction and emphysema
Airflow limitation
The only pharmacologic therapy demonstrated to unequivocally decrease mortality rates
Supplemental O2
Bacteria frequently implicates in COPD exacerbations
Strep. Pneumonia, H. Influenza, M. Catarrhalis
Most common pathogenesis of pneumonia
Aspiration
Most common cause of nosocomial pneumonia and pneumonia in cystic fibrosis patients
Pseudomonas aeruginosa
Most common viral cause of atypical pneumonia and bronchiolitis in children
Respiratory syncytial virus (RSV)
Most common cause of pneumonia in AIDS patients
Pneumocystis jiroveci
To be adequate for culture, sputum sample must have
Per LPF more than 25 neutrophils and less than 10 squamous epithelial cells
Imaging modality of choice for confirming the diagnosis of bronchiectasis
Chest CT
Most common cause of viral croup/ laryngotracheobronchitis in infants
Parainfluenza
Leading cause if transudative pleural effusion
LV failure and cirrhosis
Leading cause of exudative pleural effusion
Bacterial pneumonia, malignancy, viral infection, pulmonary embolism
Most common cause if chylous pleural effusiom
Malignancy
Most common lesions in the anterior mediastinum
Thymoma, lymphomas, teratomatous neoplasms, thyroid masses
Most common masses in middle mediastinum
Vascular masses, lymph node enlargement from metastases or granulomatous disease, pleuropericardial and bronchogenic cysts
Most common masses in posterior mediastinum
Neurogenic tumors, meningocele, meningomyeloceles, gastroenteric cysts, esophageal diverticula
Tracheal deviation in spontaneous pneumothorax
Ipsilateral
Tracheal deviation in tension pneumothorax
Contralateral
Usual cause of death from Pulmonary Embolism
Progressive right heart failure
Most common ECG abnormality in PE
T wave inversion in leads V1 to V4
Top 3 causes of ARDS
Gram-negative sepsis, gastric aspiration, severe trauma
Short term morphology of ARDS
Waxy hyaline membrane
Long term morphology of ARDS
Intra-alveolar fibrosis
Histologic manifestation of ARDS
Diffuse alveolar damage
Pulmonary wedge pressure in ARDS
Less than 18 mmHg
Lung zones
Zone 1: no blood flow
Zone 2: intermittent blood flow
Zone 3: continuous blood flow
