Resp Flashcards
Sinus development
Maxillary inital, prmanent
Ethmoid initial, permanent
Sphenoid initial, permanent
Frontal inital, permanent
birth, 4
birth, 12
<2, 12
6-8, 15-18
Control of respiration
Voluntary from the ___
Automatic from __ and __ pacemaker cells
Activate__ and __ spinal motor neurons
cerbral cortex
pons/medulla
cervical/thoracic
Automatic Control of respiration
signal location
vagal affarents from ___
__/__ receptors inhibit inspiration
Muscle/joint receptors, as movement stimulates __
Carotid/aortic chemoreceptors
CO2/H+ __ conc activates impulses to medulla
O2 ___ conc activates impulse to medulla
Medlla chemoreceptors
__/indirect __ inc conc stimulates respiration
lungs
stretch/irritant
respiration
inc
dec
H+/CO2
Maximum exercise capacity deermined by ___
exercise requires increased ____
Proportional to ___
__ inc in hyperbolic pattern
__ inc in linear pattern
Training increases ____
oxygen uptake
minute ventilation
CO2 production
tidal volume
respiratory rate
maximm tidal volume
TLC
RV
FVC
FEV1
obsstruction asthma COPD restriction Obesity weakness Lung
normal, inc, dec, dec
inc, inc, dec, dec
n, n, dec, de
dec, inc, dec, dec
dec, dec, dec, dec
Elastic property of chest wall and lungs is ___
change in __ for change in intrapleural ___
Tendency of deformable body to return to baseline shape is ____
compliance
volume, pressure
recoil
compliance is __ in obstructive dz
elastic recoil is ____
compliance is ___ in restrictive dz
elastic recoil is ____
inc
dec
dec
inc
DLCO should be normal in __ and __ and ___
altered in __ and ___
asthma, obesity, weakness
COPD, IPF
O2 binding in lung
inc w dec ___/__, high __
___ 2/3BPG
O2 release in tissue
inc __ and ___
low ___
___ 23BPG
temp, CO2
pH
dec
temp, CO2
pH
inc
Resonant percussion, vibratory TF, auscultation is vesicular
lung is ___
normal
percussion is dull, TF is inc, auscultation is dec/bronchial
dx is ___
lobar consolidation
percussion is dull, TF is dec, auscultation is dec
dx is
pleural effusion
percussion is inc, TF is dec, auscultation is dec
dx is ___
pneumothorax
<2 yrs old, particularly 2-6m
copius rhinorrhea
wheezing, retractions, tachypnea
dx is ___
caused by ____
bronchiolitis
RSV
unimunized
high fever, drooling.distress
dx is ____
caused by ___
epiglotitis
Hib
<3 YO, acute progressive cough
inspiratory stridor
dx is _____
caused by ___
laryngotracheitis
parainfluenza virus
<6m or teenager
mild cough, becomes paroxysmal
gradually resolves
dx is ____
caused by -___
pertussis
bordetella pertussis
newborn
chronic, croup like cough
inspiratory stridor, no RDS
dx is __
caused by inc ___
tracheomalacia
proportion of mucous membreans
acute otitis media
usually ____ of middle ear
orgs
S pneumo- resistance via __
Hib ressitance via __
possible M/S/S
acute onset __/__/___
middle ear effusion w __/impaired ___
inflammation shows __/__
bacterial infection
penicillin binding proteins
beta lactamses
moraxella, staph, strep
fever/pain/irritability
opacity, mobility
bulging/redness
if ear pain, low grade fever, irritable, rhinorrhea
tympanic membrane is clear
dx is ____
tx w ____
OM w effusion
ibuprofen
asx
tachypnea, poor feeding, FTT
crecendo/decrescendo murmur at RUSB
dx is ___
can be due to __/__/__ valve
aortic stenosis
bicuspid/unicsupid/dysplastic
upper airway noisy breathing
cyanosis w feeding
imrpoves w crying
dx is ____
presents w ____
choanal atresia
midface growth abnorm
Premature, sudden RDS
hypoxia
Dx is ___
inc ___
PTX
transpulm pressure
Worse w agitation, tachypnea, cyanosis
harsh systolic murmur RVOT obstruction
dx is ____
4 components
tetralogy of fallot
VSD/overriding aorta/RVH/PS
RDS w feeding
aspiration
dx is ____
failed __ of ____
TEF
lateral septation of forgeut
Neonatal RDS
__ def leads to high surface tension
dec __ leads to atalectasis and hypoxia
Lung __ and epithelial cell __ leads to ___
CM: tachypnea, N/R, cyanosis
PTX and air leaks
surfactant
compliance
inflammation, injury, PE
nasal flaring, retractions
Dx neonatal RDS
__ infant
Xray shows diffuse __ appearance and ___
prevent w ___ at 23-34 w GA
tx w ____
premature
reticulogranular, air bronchograms
CS
surfactant
pt around 6m of age w recurrent infections
esp P jirovecci
dx is ___
SCID
freq infections over lifespan
PNA/sinusitis/malabsorption
bacteria such as staph aureus, Pseudo, B cepacia
dx is ___
__ defect causing thickened ___
CF
ion channel, airway secretiions
PNA/sinusitis in male
infections w encapsulated orgs
dx is ___
XLA
chronic allergic rhinitis
recurrent sinusitis/otitis
autoimmune cx like transfusion rxn
dx is ___
deficient in ____
IgA def
IgA prodxn
alcohol assc cancers (3)
arsenic (5) b/k/l/l/s
asbestos assc cancer 2
Beryllium assc cncer
cadmium assc cancer
chromium assc cancer
H./N/lng
bladder/kidney, liver/lung/skin
lung/mesothelioma
lung
lung
lung
Tobacco cancers B/C/C/H/N/L/P
pesticides assc cancer H/N/L/P/S/S
radon assc cancer
PVC assc cancer __ and __
bladder/cervix/colon/H/N/kidney/lung/pnancres
H/N, lung, prostate, skin, stomach
lung
lung, angiosarcoma
dyspnea, reduced FEV1, cough, coryza, SpO2 is normal
intercostal retractions
dx is ___
treat w ___
test w ___
asthma
albuterol
spirometry
well controled asthma has nighttime sx less than __ per m
albuterol used ___
poorly controlled has nighttime sx greater than __ per w
albuterol used ____
1
less than 2d/w
1
multiple times daily
<7, wheezing, nighttime cough, episodic SOB
dx is ___
dynamic ___ from __ infalmm of airways
asthma
airflow limitation
eosinophilic
recurrent bacterial infections
IC/CF pt
chronic productive cough/SOB
dx is ___
__ and ___ of major bronchilole walls after ____
bronchiectasis
dilated/destroyed, recurrent infections
adult > 50
gradual SOB/cough
smoker
dx is ____
distortion of ___ from progrssive ___
PF
Pulmonary architectre
fibrosi
adult >40
>20 py smoking
dyspnea, cough, productive
dx is ____
progressive __ from enhanced ___
COPD
airflow limitation
inflammatory response
acute PE < 2 ya
progressive SOB
exercise intolerance
dx is ___
Pulm HTN from recurrent thromboemboism
daytime sleepiness
fatigue, snoring
dx is ___
test w __
looking for __/__ on AHI> 5/hr
tx w ___ and ___
Wl cannot __ but __ can
OSA
polysomnography
apnea/hypopnea
CPAP, weight loss
resolve apnea, CPAP
otitis media, sinusitis, pediatric PNA
gram positive batceria
tx w ___
amoxicillin
uncomp PNA and COPD exacerbation
tick born dz
nongonoccal uretrhtisis
good for gram positive
atypical
chlamydia
tx w ___
doxycycline
dual therapy for PNA and meningitits
good for gram +/-
tx w ___
cefotaxime
nosocomial PNA, skin/soft tissue infections
good for MRSA/VRE
tx w ____
linezolid
MCC of pneumo 5-40 YO
diffuse interstitial pattern
could be __ or ___
mycoplasma
chlamydophila
spread by inhalation of aerosols
PNA is ___
legionella
HC assc PNA
multiple comorbids
usually ___
such as K/E/P
gram neg rods
klebsiella, escheria, pseudo
gradual fever, coguh, SOB, hypoxia
IC pt
PNA w ____
pneumocystis
primary sx of TB
xray shows __ and ___
reactivation sx
xray shows ___ and ___
some __/___
fever
hilar AN, pleural effusion
cough, WL, fatigue, F/NS
upper lobe infiltrate/cavity
hilar AN/PE
HIV + person
recent contact w TB
CXR consistent w TB
immunosupression
PPD should be ___
> 5
recent immigration
IVDU HIV neg
high risk setting
high risk for acitve dz siicosis L/L WL gastrectomy child younger than 4
PPD should be ___
> 10
screen pt for lung cancer criteria
annual ___
CM: H/I/D/C
55+ w 30+ py smoking hx
low dose CT
hemoptysis, infection, SOB, cough
lung cancer fx hyponatremia via \_\_ fatigable limb weakness via \_\_\_\_ ab directed against \_\_\_ plethora/facial edema, SOB, distendedd neck veins via \_\_\_
dx is ____
SIADH
LEMS
voltage gated Ca channels
SVC syndrome
SCLC
lung cancer fx
Hypercalcemia via ___
Horner syndrome/shoulder pain via ___
tumor located in ___
dx is ___
pancoast syndrome
superior sulcus
NSCLC
high probabilyt of PE
tx options
begin ___
image via ____ and __ if -
heparin
CT angiography, Doppler US
PF:serum protein < ___
PF: serum LDH < ___
Pleral fluid LDH < ___
must have ___
effusion is __
common cx
inc hydrostatic pressure H/C
dec oncotic pressure
H/N/C/M
.5
.6
200
all
transudate
HF, constrictive pericarditis
hypoalbuminemia, nephrotic sx, cirrhosis, mal
PF: serum protein > .5
PF: serum LDH >.6
Plerual fluid LDH >200
if have ____
PE is ___
seen w I/N/C/P/H
any
exudative
infection/neoplasm/CVD/pulm infarct/hemothorax
movement of interstitial fluid into pleural space
PE is ___
exudative
Empyema is ___
__ into pleural space
fluid is __, with high __ or positive ___
tx ___
exudative
bacteria
acidic, LDH, culture
chest tube
Chylothroax is ____
__/__ of thoracic duct
can result from ___ such as thoracic surgery or severe chest trauma
or ___ such as L/L/met ccancer
pleural fluid TG > ____
exuative
obstruction/disrupton
trauma
malignancy
110
idiopathyic multisystem granulomatous dz
dx is ____
CM: F/W/N
Dry ___, bilateral __
skin shows ____
hyper___ as granuloma produces ____
Lofgren syndrome F B E Arhritis, usually in \_\_\_
sarcoidosis
fever, wl, night sweats
cough, hilar LN
EN
Ca, calcitriol
fever
bilateral hilar LN
EN
ankle
PaO2 <60
SOB, cyanosis, confusion, delirium, tachycardia, tachypnea
RF is _____
hypoxemic
hypoxemic V/Q mismatch
P/C w blood flow but poor ventilation
good ventiltion, poor perfusion ____
intrapulmonary shint like __/___
PNA/COPD
PE
PNA/AVM
Hypoxemic rf
diffusion defect
thickened alveolar membrane like ____
fluid filled aveoli like P/E/A
ILD
PNA, edema, atalectaiss
PaCO2 >50
SOB, HA, hyperemia, hypopnea, apnea, asterixis
__ RF
hypoventilation pulm dz liek \_\_/\_\_\_ CNS dz like H\_\_/H\_\_/E\_\_ NM dz like \_\_ or \_\_\_ Sedation\_\_ chest wall dysfxn \_\_\_ O
hypercarbic
COPD/asthma head trauma/herniation/enceph GB/ALS opioids scoliosis obesity hypovent syndrome
Resp acidosis retains ___
acute has HCO3 inc __ for each __ inc pCO2
metaolic compensation begins ____
CNS depressin like S/I/T/I/B
chronic: HCO3 inc __ for each __ inc PCO2
inc renal excretion of ___ in 24hrs
NM causes G/M/M/A
resp casues C/I/P
CO2
1, 10
immediately
sedation, ischemia, trauma, infect, tumor
4, 10
NH4
GB/MS/MG/ALS
COPD/ILD/PE
Resp alkalosis loses ___ via hyperventilation
CM: P, a
acutely A/P S S/P/C S
chronic H H P C
CO2
paresthesias, anxiety
anxiety/pain
stroke
salicylates, prg, catecholamines
sepsis
hyperT
hypoxia
preg
cirrhosis
ARDS
most common etiology
also A/P/severe ___
PaO2/FiO2
__ infiltration causing __ infiltrate
inc ___ resulting in PE
__ daage w pneumcyte destxn/fibrosis
loss of __ creates surfactant def
sepsis
aspiration/pna/traua
200
pulm infiltrates
HF
PMN, alveolar infalm
lung perm
epithelial
t2P
CO poison
___ indoors
malfxn ___
CM occurs in ___
HA/lighthead/confusion/CP/SOB
__ appearnace to skin
evaluate
pulse ox/ABG is ____
measure ___
manage w ___
burning heat source
heating system
multiple members
cherry red
normal
carboxyhemogolobin
supplemental o2
Barotrauma- complication of ___
___: compression air in lungs
comps P/H
__ oxerexpansion of air in lungs
comps A/P
scuba
descent
PE/hemorrhage
ascent
alveolar rupture/PTX
Decompression sickness
descent loads tissues w __
ascent liberates __ leading to vessel ___
CM: J/P/P
nitrogen
gas bubbles
obstruction
joint pain, paresthesias, PG embolis
High altitude sickness
hypoxic stress inc ___
__/__ edema
Tx __ and hyperbaric __
precent w __/___
blood flow
cerebral/pulm
descnet, O2
acclimitazation, acetazolamide
20 yr after asbesots
progressive SOB
multinodular/reticular findings + pleural plaques
dx os___
direct toxic effects of __ and ___ activation
asbestosis
fibers, inflamm
hr/day after exposre
F, chills, cough, malaise, SOB
diffuse reticular opacity
dx is ____
caused by ___ such as animals/farming/dust
hypersensitivity Pneumonitis
inhalaltional antignes
nonprod cough, cp, SOB
constitutional sx
patchy alveolar opacities on CXR
dx ____
can be __/__ or result of ___
COP
post infect, drug induced, CTD
prog cough, SOB x 3m
bibasilar crackles
diffuse reticular opacitieis
dx is ___
___ and __ influences
IPF
genetic, environmental
