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EBSE > Resp > Flashcards

Resp Flashcards

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
Q

triad of hypoxemia, neuro abnlties, and petechial rash points to

A

fat embolism

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26
Q

best imaging choice for PE

A

CT pulm angiography

27
Q

spirometry hallmark of obstructive lung dz

A

dec FEV1/FVC ratio

28
Q

Reid index

A

thickness of gland : thickness of bronchial wall

>50% in chronic bronchitis

29
Q

2 types of emphysema and what are they assoc w/

A

centriacinar (upper lobes) - smoking

panacinar (lower lobes)- alpha 1 antitrypsin def

30
Q

Curschmann’s spirals

A

mucus plugs w/ shed epithelium seen in asthma

31
Q

Charcot-Leyden crystals

A

make from breakdown of eos in sputum in asthma

32
Q

inc ACE and Ca caused by what dz

A

sarcoidosis

33
Q

3 pneumoconioses - who gets them and what lobes do they affect?

A

anthracosis - coal miners, upper
silicosis - foundries, sandblasting, mines. upper
asbestosis - shipbuilding, roofing, plumbing. lower

34
Q

“eggshell” calcification of hilar LNs

A

silicosis

35
Q

golden brown fusiform rods resembling dumbbells found in lung tissue

A

asbestos bodies

36
Q

calcified pleural plaques

A

asbestosis

37
Q

causes of ARDS

A

trauma, sepsis, shock, gastric aspiration, uremia, acute pancreatitis, amniotic fluid embolism

38
Q

path process corresponding to ARDS

A

diffuse alveolar damage

39
Q

formation of intraalveolar hyaline membranes assoc w/

A

ARDS

40
Q

in what pulm condition do you find fremitus?

A

consolidation (lobar PNA, pulm edema)

41
Q

leading cause of cancer death

A

lung CA

42
Q

MC lung tumor

A

metastasis

43
Q

where does lung CA metastasize to?

A

adrenals, brain, bone, liver

44
Q

2 types of lung CA not assoc w/ smoking

A

bronchioloalveolar, bronchial carcinoid

45
Q

MC type of lung CA in nonsmokers

A

adenoCA

46
Q

mutation assoc w/ lung adenoCA

A

k-ras

47
Q

bronchioloalveolar lung CA

A

type of adenoCA, limited to alveolar walls (appear thickened), excellent prognosis

48
Q

3 assoc findings w/ SCC of lung

A

cavitation, hyperCA (from PTH-rp), keratin pearls

49
Q

small cell lung CA - prognosis, assoc mutations, what cell started it

A

very poor
myc oncogenes
Kulchitsky cells

50
Q

Kulchitsky cells

A

neuroendocrine cells that can turn into small cell lung CA

51
Q

extra pulm manifestations of small cell lung CA

A

make ACTH, ADH, or ab against presynaptic Ca channels (Lambert Eaton syndrome)

52
Q

large cell lung CA - prognosis

A

highly undifferentiated, poor prognosis. treated surgically

53
Q

pancoast tumor

A

apical lung CA that causes Horner’s syndrome by interfering w/ cervical sympathetic plexus

54
Q

bugs that cause bronchoPNA

A

strep pneumo, staph aureus, h flu, klebsiella

55
Q

type of hypersensitivity for hypersensitivity pneumonitis

A

3/4

56
Q

chylothorax

A

lymphatic pleural effusion. milky appearing fluid w/ inc TGs

57
Q

what happens to cause spontaneous pneumothorax?

A

rupture of apical blebs

58
Q

theophylline mech

A

inhib PDE > dec cAMP hydrolysis

blocks action of adenosine

59
Q

corticosteroids used for asthma

A

beclomethasone, fluticasone

60
Q

1st line therapy for chronic asthma control

A

inhaled corticosteroids

61
Q

zileuton mech

A

5-lipoxygenase pathway inhib > block conversion of arachidonic acid to leukotrienes

62
Q

omalizumab

A

anti-IgE, used in asthma resistant to inhaled steroids and LABAs

63
Q

n-acetylcysteine - uses

A

mucolytic in asthma, antidote for acetaminophen overdose

64
Q

bosentan - mech, use

A

antagonist to endothelin-1 receptors > dec pulm vasc resistance
pulm HTN

EBSE (18 decks)

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