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1
Q

Clara cells

A

nonciliated cells in bronchioles that secrete component of surfactant and act as reserve cells. also degrade toxins

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2
Q

where aspirated objects go when upright vs supine

A

upright - lower portion of RLL

supine - superior portion of RLL

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3
Q

spatial relation of each pulm art to bronchus

A

RALS - right anterior, left superior

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4
Q

innervation of diaphragm

A

phrenic nerve (C3,4,5)

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5
Q

eqn for physiologic dead space in lungs

A 
Vd = Vt * (PaCO2-PeCO2)/PaCO2
PaCO2 = arterial
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6
Q

at what lung volume is inward pull of lung and outward pull of chest wall balanced so that the pressure in the lungs is atmospheric?

A

FRC

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7
Q

which form of hemoglobin has higher affinity for O2 - taut or relaxed?

A

relaxed

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8
Q

5 things that dec Hgb affinity for O2

A

inc Cl, H, CO2, 2,3BPG, temp

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9
Q

methemoglobin

A

oxidized Hgb, inc affinity for cyanide

nitrites can cause it to form

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10
Q

tx for methemoglobinemia

A

methylene blue

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11
Q

tx of CN poisoning

A

give nitrites to make methemoglobin > binds CN and stops damage, use thiosulfate to bind CN forming thiocyanate > renally excreted

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12
Q

which way does Hgb binding curve shift when affinity dec?

A

right

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13
Q

which substances are diffusion limited vs perfusion limited in lung?

A

diffusion - O2 (in emphysema, fibrosis), CO

perfusion - O2 (in health), CO2, N20

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14
Q

nl pulm art pressure

A

10-14 mmHg

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15
Q

cause of primary pulm HTN

A

inactivating mutation of BMPR2 gene

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16
Q

cor pulmonale

A

right heart failure due to inc pulm resistance

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17
Q

alveolar gas eqn

A 
PAO2 = PIO2 - PaCO2/R
usually = 0.2*(770-20)-PaCO2/0.8 = 150 - PaCO2/0.8
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18
Q

nl A-a gradient

A

10-15 mmHg

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19
Q

causes of hypoxemia w/ inc A-a gradient

A

V/Q mismatch, diffusion limitation, R>L shunt

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20
Q

why does TB like the apex?

A

thrives in high O2 and apex has high V/Q ratio

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21
Q

haldane effect

A

oxygenation of Hgb > inc dissoc of H from Hgb > drives buffer system to favor production of CO2 > CO2 released from RBCs and exhaled

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22
Q

bohr effect

A

inc H from tissue metabolsim shifts Hgb dissociation curve to right and causes unloading of O2 into tissues

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23
Q

Virchow’s triad

A

stasis, hypercoag, endothelial damage

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24
Q

Homan’s sign

A

sign of DVT

dorsiflexion of foot causes calf pain

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25
triad of hypoxemia, neuro abnlties, and petechial rash points to
fat embolism
26
best imaging choice for PE
CT pulm angiography
27
spirometry hallmark of obstructive lung dz
dec FEV1/FVC ratio
28
Reid index
thickness of gland : thickness of bronchial wall | >50% in chronic bronchitis
29
2 types of emphysema and what are they assoc w/
centriacinar (upper lobes) - smoking | panacinar (lower lobes)- alpha 1 antitrypsin def
30
Curschmann's spirals
mucus plugs w/ shed epithelium seen in asthma
31
Charcot-Leyden crystals
make from breakdown of eos in sputum in asthma
32
inc ACE and Ca caused by what dz
sarcoidosis
33
3 pneumoconioses - who gets them and what lobes do they affect?
anthracosis - coal miners, upper silicosis - foundries, sandblasting, mines. upper asbestosis - shipbuilding, roofing, plumbing. lower
34
"eggshell" calcification of hilar LNs
silicosis
35
golden brown fusiform rods resembling dumbbells found in lung tissue
asbestos bodies
36
calcified pleural plaques
asbestosis
37
causes of ARDS
trauma, sepsis, shock, gastric aspiration, uremia, acute pancreatitis, amniotic fluid embolism
38
path process corresponding to ARDS
diffuse alveolar damage
39
formation of intraalveolar hyaline membranes assoc w/
ARDS
40
in what pulm condition do you find fremitus?
consolidation (lobar PNA, pulm edema)
41
leading cause of cancer death
lung CA
42
MC lung tumor
metastasis
43
where does lung CA metastasize to?
adrenals, brain, bone, liver
44
2 types of lung CA not assoc w/ smoking
bronchioloalveolar, bronchial carcinoid
45
MC type of lung CA in nonsmokers
adenoCA
46
mutation assoc w/ lung adenoCA
k-ras
47
bronchioloalveolar lung CA
type of adenoCA, limited to alveolar walls (appear thickened), excellent prognosis
48
3 assoc findings w/ SCC of lung
cavitation, hyperCA (from PTH-rp), keratin pearls
49
small cell lung CA - prognosis, assoc mutations, what cell started it
very poor myc oncogenes Kulchitsky cells
50
Kulchitsky cells
neuroendocrine cells that can turn into small cell lung CA
51
extra pulm manifestations of small cell lung CA
make ACTH, ADH, or ab against presynaptic Ca channels (Lambert Eaton syndrome)
52
large cell lung CA - prognosis
highly undifferentiated, poor prognosis. treated surgically
53
pancoast tumor
apical lung CA that causes Horner's syndrome by interfering w/ cervical sympathetic plexus
54
bugs that cause bronchoPNA
strep pneumo, staph aureus, h flu, klebsiella
55
type of hypersensitivity for hypersensitivity pneumonitis
3/4
56
chylothorax
lymphatic pleural effusion. milky appearing fluid w/ inc TGs
57
what happens to cause spontaneous pneumothorax?
rupture of apical blebs
58
theophylline mech
inhib PDE > dec cAMP hydrolysis | blocks action of adenosine
59
corticosteroids used for asthma
beclomethasone, fluticasone
60
1st line therapy for chronic asthma control
inhaled corticosteroids
61
zileuton mech
5-lipoxygenase pathway inhib > block conversion of arachidonic acid to leukotrienes
62
omalizumab
anti-IgE, used in asthma resistant to inhaled steroids and LABAs
63
n-acetylcysteine - uses
mucolytic in asthma, antidote for acetaminophen overdose
64
bosentan - mech, use
antagonist to endothelin-1 receptors > dec pulm vasc resistance pulm HTN

EBSE (18 decks)

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