Resp

Question 1

Causes of MetHb

Answer 1

sulfa
dapsone
nitrites
benzocaine

Question 2

relation of PA to bronchus

Answer 2

RALS
Right = ant
Left = superior

Question 3

Deadspace volume

Answer 3

1) find out the alveolar volume
VT * PECO2 = VA * PaCO2
[because P1V1 = P2V2; because PaCO2=PACO2]

2) do VT = VD + VA to find VD

Remember physiological VD = anatomical deadspace + alveolar deadspace
*alveolar dead space is NOT NOT NOT NOTNOT VA

Question 4

@FRC, PIP =

Answer 4

-5

intraalveolar P = 0

Question 5

Small A-V O2 gradient

Answer 5

cyanide poisoning (because not using the O2)
.: severe lactic acidosis
burnt almond smell

Question 6

O2 content =

Answer 6

(O2 binding capacity * %saturation) + dissolved O2

Question 7

Perfusion limited

Answer 7

O2 (healthy lung) * get close to diffusion in heavy exercise
CO2
N20

Question 8

Diffusion limited

Answer 8

unhealthy lung (emphysema, fibrosis)
CO

Question 9

PVR =

Answer 9

PVR = Ppulm atrery - Pleft atria / CO

Question 10

AGE: PAO2 =

Answer 10

PAO2 = PIO2 - PaCO2/RQ
[RQ = CO2 made/O2 consumed]

use this to compare PAO2 to PaO2
if gap is big, then there may be a R-L shunt, V/Q mismatch, diffusion problem

Question 11

exercise blood gas changes

Answer 11

PaO2 = SAME
PaCO2 = SAME

venous CO2 increased
venous O2 decreased

Question 12

Bacterial superimposed infections on rhinosinutisis

Answer 12

s. pneumoniae
h. flu
m. catarrhalis

Question 13

Virchow’s triad

Answer 13

Venous stasis
Hypercoaguability
Endothelial damage

Question 14

Inhibitors of elastase:

Answer 14

PMN = A1AT
macro = TIMP

Question 15

pulsus paradoxus in:

Answer 15

cardiac tamponade, pericarditis, croup, asthma, OSA

Question 16

Hypersensitiyivty pneumonitis: who, s/s, histo

Answer 16

farmer/bird people

s/s = dyspnea, cough, tight chest, headache

histo = type III and IV (non-caseating granulomas in alveoli)

Question 17

pneumoconiosis complications

Answer 17

cor pulmonale

Caplan syndrome: RA + intrapulmonary nodules

Question 18

lobe and pneumoconiosis

Answer 18

Lower = asbestos

Uppers = beryliosis, coal workers, silliosis

Question 19

Ivory white calcified supra diaphragmatic and pleural plaques

Answer 19

Asbestosis

Question 20

Job and pneumoconiosis:

• roofer, plummer, shipbuilder
• aerospace + manufacturing
• coal
• foundries, sandblasting, mines

Answer 20

• roofer, plummer, shipbuilder: asbestosis
• aerospace + manufacturing: berylliosis
• coal: CWP
• foundries, sandblasting, mines: sillicosis

Question 21

ferruginou bodies

Answer 21

asbestosis

ogden-brown, dumbbells in alveolar septum

Question 22

eggshell calcification of hilar LNs

Answer 22

Sillicosis

also risk of TB (P-L and macrophage dysfunction) and bronchogenic carcinoma

Question 23

NRDS complications and rx complications

Answer 23

PDA, metabolic acidosis, necrotizing enterocolitis

Rx = R, I, B

Question 24

PCWC in ARDS

Answer 24

NORMAL!!!! normal PVR but edema

Question 25

plexiform lesions

Answer 25

tufts of capillaries after long term P.HTN

Question 26

causes of 1' P.HTN

Answer 26

BMPR-2 inactivating mutations, long-term appetite suppressants//amphetamines/cocaine, HIV, CT disease, portal HTN, congenital heart disease, schistosomiasis

Question 27

increase remits via:

Answer 27

consolidation only!!!! (pneumonia or pulmonary oedema) | also bronchial breath sounds with late inspiratory crackles

Question 28

how do you know pleural effusion is chylothorax?

Answer 28

milky with high TGs

Question 29

pancoast tumour/syndrome

Answer 29

invades sympathetic chain causing: - SVC syndrome - horners - sensotimotor deficits - hoarseness

Question 30

SVC syndrome

Answer 30

- blockage of venous blood form from head/neck/upper limb - MC via malignancy (pancoast) or catheter thrombosis, also mediastinal mass blocking SVC *just remember if not hoarse, no shoulder pain, no eye problems, it is SVC alone without pan coast

Question 31

Small cell

Answer 31

``` ACTH, SIADH, Lambert-Eaton Amplification L-myc Kulchinsky (small blue) Chemo neuroendocrine i.e. chromogrannin, synaptophysin [carcinoid also positive for these] ```

Question 32

AdenoCA

Answer 32

activating mutation in: KRAS, EGFR, ALK clubbing (hypertrophic osteoarthropathy Glandular, mucin +

Question 33

"thickening of alveolar septa"

Answer 33

bronchioalveolar subtype of ACA; clara cells, good Px

Question 34

squamous cell

Answer 34

cavitation hypercalcemia (PTHrp) Keratin pearls, intercellular bridges ERB-B1

Question 35

large cell

Answer 35

anaplastic .: surgery pedomorphic giant cells b-HCG