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Multisystem 2 > Resp > Flashcards

Resp Flashcards

1
Q

Sinus development

Maxillary inital, prmanent

Ethmoid initial, permanent

Sphenoid initial, permanent

Frontal inital, permanent

A

birth, 4

birth, 12

<2, 12

6-8, 15-18

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2
Q

Control of respiration

Voluntary from the ___

Automatic from __ and __ pacemaker cells

Activate__ and __ spinal motor neurons

A

cerbral cortex

pons/medulla

cervical/thoracic

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3
Q

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

A

lungs
stretch/irritant

respiration

inc
dec

H+/CO2

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4
Q

Maximum exercise capacity deermined by ___

exercise requires increased ____

Proportional to ___

__ inc in hyperbolic pattern
__ inc in linear pattern

Training increases ____

A

oxygen uptake

minute ventilation

CO2 production

tidal volume
respiratory rate

maximm tidal volume

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5
Q

TLC
RV
FVC
FEV1

obsstruction asthma
COPD
restriction Obesity
weakness
Lung
A

normal, inc, dec, dec

inc, inc, dec, dec

n, n, dec, de

dec, inc, dec, dec

dec, dec, dec, dec

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6
Q

Elastic property of chest wall and lungs is ___
change in __ for change in intrapleural ___

Tendency of deformable body to return to baseline shape is ____

A

compliance
volume, pressure

recoil

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7
Q

compliance is __ in obstructive dz
elastic recoil is ____

compliance is ___ in restrictive dz
elastic recoil is ____

A

inc
dec

dec
inc

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8
Q

DLCO should be normal in __ and __ and ___

altered in __ and ___

A

asthma, obesity, weakness

COPD, IPF

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9
Q

O2 binding in lung
inc w dec ___/__, high __
___ 2/3BPG

O2 release in tissue
inc __ and ___
low ___
___ 23BPG

A

temp, CO2
pH
dec

temp, CO2
pH
inc

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10
Q

Resonant percussion, vibratory TF, auscultation is vesicular

lung is ___

A

normal

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11
Q

percussion is dull, TF is inc, auscultation is dec/bronchial

dx is ___

A

lobar consolidation

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12
Q

percussion is dull, TF is dec, auscultation is dec

dx is

A

pleural effusion

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13
Q

percussion is inc, TF is dec, auscultation is dec

dx is ___

A

pneumothorax

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14
Q

<2 yrs old, particularly 2-6m
copius rhinorrhea
wheezing, retractions, tachypnea

dx is ___
caused by ____

A

bronchiolitis

RSV

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15
Q

unimunized
high fever, drooling.distress

dx is ____
caused by ___

A

epiglotitis

Hib

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16
Q

<3 YO, acute progressive cough
inspiratory stridor

dx is _____
caused by ___

A

laryngotracheitis

parainfluenza virus

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17
Q

<6m or teenager
mild cough, becomes paroxysmal
gradually resolves

dx is ____
caused by -___

A

pertussis

bordetella pertussis

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18
Q

newborn
chronic, croup like cough
inspiratory stridor, no RDS

dx is __

caused by inc ___

A

tracheomalacia

proportion of mucous membreans

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19
Q

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 __/__

A

bacterial infection
penicillin binding proteins
beta lactamses

moraxella, staph, strep

fever/pain/irritability
opacity, mobility
bulging/redness

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20
Q

if ear pain, low grade fever, irritable, rhinorrhea

tympanic membrane is clear

dx is ____
tx w ____

A

OM w effusion

ibuprofen

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21
Q

asx
tachypnea, poor feeding, FTT
crecendo/decrescendo murmur at RUSB

dx is ___
can be due to __/__/__ valve

A

aortic stenosis

bicuspid/unicsupid/dysplastic

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22
Q

upper airway noisy breathing
cyanosis w feeding
imrpoves w crying

dx is ____
presents w ____

A

choanal atresia

midface growth abnorm

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23
Q

Premature, sudden RDS
hypoxia

Dx is ___
inc ___

A

PTX

transpulm pressure

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24
Q

Worse w agitation, tachypnea, cyanosis
harsh systolic murmur RVOT obstruction

dx is ____
4 components

A

tetralogy of fallot

VSD/overriding aorta/RVH/PS

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25
Q

RDS w feeding
aspiration

dx is ____
failed __ of ____

A

TEF

lateral septation of forgeut

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26
Q

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

A

surfactant
compliance
inflammation, injury, PE

nasal flaring, retractions

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27
Q

Dx neonatal RDS
__ infant
Xray shows diffuse __ appearance and ___

prevent w ___ at 23-34 w GA
tx w ____

A

premature
reticulogranular, air bronchograms

CS
surfactant

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28
Q

pt around 6m of age w recurrent infections
esp P jirovecci

dx is ___

A

SCID

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29
Q

freq infections over lifespan
PNA/sinusitis/malabsorption
bacteria such as staph aureus, Pseudo, B cepacia

dx is ___
__ defect causing thickened ___

A

CF

ion channel, airway secretiions

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30
Q

PNA/sinusitis in male
infections w encapsulated orgs

dx is ___

A

XLA

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31
Q

chronic allergic rhinitis
recurrent sinusitis/otitis
autoimmune cx like transfusion rxn

dx is ___
deficient in ____

A

IgA def

IgA prodxn

32
Q

alcohol assc cancers (3)

arsenic (5) b/k/l/l/s

asbestos assc cancer 2

Beryllium assc cncer

cadmium assc cancer

chromium assc cancer

A

H./N/lng

bladder/kidney, liver/lung/skin

lung/mesothelioma

lung

lung

lung

33
Q

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 __

A

bladder/cervix/colon/H/N/kidney/lung/pnancres

H/N, lung, prostate, skin, stomach

lung

lung, angiosarcoma

34
Q

dyspnea, reduced FEV1, cough, coryza, SpO2 is normal

intercostal retractions

dx is ___
treat w ___
test w ___

A

asthma
albuterol
spirometry

35
Q

well controled asthma has nighttime sx less than __ per m
albuterol used ___

poorly controlled has nighttime sx greater than __ per w
albuterol used ____

A

1
less than 2d/w

1
multiple times daily

36
Q

<7, wheezing, nighttime cough, episodic SOB

dx is ___
dynamic ___ from __ infalmm of airways

A

asthma
airflow limitation
eosinophilic

37
Q

recurrent bacterial infections
IC/CF pt
chronic productive cough/SOB

dx is ___
__ and ___ of major bronchilole walls after ____

A

bronchiectasis

dilated/destroyed, recurrent infections

38
Q

adult > 50
gradual SOB/cough
smoker

dx is ____
distortion of ___ from progrssive ___

A

PF
Pulmonary architectre
fibrosi

39
Q

adult >40
>20 py smoking
dyspnea, cough, productive

dx is ____
progressive __ from enhanced ___

A

COPD
airflow limitation
inflammatory response

40
Q

acute PE < 2 ya
progressive SOB
exercise intolerance

dx is ___

A

Pulm HTN from recurrent thromboemboism

41
Q

daytime sleepiness
fatigue, snoring

dx is ___

test w __
looking for __/__ on AHI> 5/hr

tx w ___ and ___

Wl cannot __ but __ can

A

OSA

polysomnography
apnea/hypopnea

CPAP, weight loss

resolve apnea, CPAP

42
Q

otitis media, sinusitis, pediatric PNA

gram positive batceria

tx w ___

A

amoxicillin

43
Q

uncomp PNA and COPD exacerbation
tick born dz
nongonoccal uretrhtisis

good for gram positive
atypical
chlamydia

tx w ___

A

doxycycline

44
Q

dual therapy for PNA and meningitits

good for gram +/-

tx w ___

A

cefotaxime

45
Q

nosocomial PNA, skin/soft tissue infections

good for MRSA/VRE

tx w ____

A

linezolid

46
Q

MCC of pneumo 5-40 YO
diffuse interstitial pattern

could be __ or ___

A

mycoplasma

chlamydophila

47
Q

spread by inhalation of aerosols

PNA is ___

A

legionella

48
Q

HC assc PNA
multiple comorbids

usually ___

such as K/E/P

A

gram neg rods

klebsiella, escheria, pseudo

49
Q

gradual fever, coguh, SOB, hypoxia

IC pt

PNA w ____

A

pneumocystis

50
Q

primary sx of TB
xray shows __ and ___

reactivation sx
xray shows ___ and ___
some __/___

A

fever
hilar AN, pleural effusion

cough, WL, fatigue, F/NS
upper lobe infiltrate/cavity
hilar AN/PE

51
Q

HIV + person
recent contact w TB
CXR consistent w TB
immunosupression

PPD should be ___

A

> 5

52
Q

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 ___

A

> 10

53
Q

screen pt for lung cancer criteria

annual ___

CM: H/I/D/C

A

55+ w 30+ py smoking hx
low dose CT

hemoptysis, infection, SOB, cough

54
Q 
lung cancer fx
hyponatremia via \_\_
fatigable limb weakness via \_\_\_\_
ab directed against \_\_\_
plethora/facial edema, SOB, distendedd neck veins via \_\_\_

dx is ____

A

SIADH
LEMS
voltage gated Ca channels
SVC syndrome

SCLC

55
Q

lung cancer fx
Hypercalcemia via ___
Horner syndrome/shoulder pain via ___
tumor located in ___

dx is ___

A

pancoast syndrome
superior sulcus

NSCLC

56
Q

high probabilyt of PE

tx options
begin ___
image via ____ and __ if -

A

heparin

CT angiography, Doppler US

57
Q

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

A

.5
.6
200
all

transudate

HF, constrictive pericarditis

hypoalbuminemia, nephrotic sx, cirrhosis, mal

58
Q

PF: serum protein > .5
PF: serum LDH >.6
Plerual fluid LDH >200
if have ____

PE is ___
seen w I/N/C/P/H

A

any

exudative
infection/neoplasm/CVD/pulm infarct/hemothorax

59
Q

movement of interstitial fluid into pleural space

PE is ___

A

exudative

60
Q

Empyema is ___

__ into pleural space

fluid is __, with high __ or positive ___

tx ___

A

exudative

bacteria

acidic, LDH, culture

chest tube

61
Q

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 > ____

A

exuative

obstruction/disrupton

trauma

malignancy

110

62
Q

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 \_\_\_
A

sarcoidosis

fever, wl, night sweats

cough, hilar LN
EN
Ca, calcitriol

fever
bilateral hilar LN
EN
ankle

63
Q

PaO2 <60

SOB, cyanosis, confusion, delirium, tachycardia, tachypnea

RF is _____

A

hypoxemic

64
Q

hypoxemic V/Q mismatch
P/C w blood flow but poor ventilation

good ventiltion, poor perfusion ____

intrapulmonary shint like __/___

A

PNA/COPD
PE

PNA/AVM

65
Q

Hypoxemic rf

diffusion defect
thickened alveolar membrane like ____
fluid filled aveoli like P/E/A

A

ILD

PNA, edema, atalectaiss

66
Q

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
A

hypercarbic

COPD/asthma
head trauma/herniation/enceph
GB/ALS
opioids
scoliosis
obesity hypovent syndrome
67
Q

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

A

CO2
1, 10
immediately
sedation, ischemia, trauma, infect, tumor

4, 10

NH4
GB/MS/MG/ALS

COPD/ILD/PE

68
Q

Resp alkalosis loses ___ via hyperventilation

CM: P, a

acutely
A/P
S
S/P/C
S
chronic
H
H
P
C
A

CO2

paresthesias, anxiety

anxiety/pain
stroke
salicylates, prg, catecholamines
sepsis

hyperT
hypoxia
preg
cirrhosis

69
Q

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

A

sepsis
aspiration/pna/traua

200
pulm infiltrates
HF

PMN, alveolar infalm

lung perm

epithelial

t2P

70
Q

CO poison
___ indoors
malfxn ___

CM occurs in ___
HA/lighthead/confusion/CP/SOB
__ appearnace to skin

evaluate
pulse ox/ABG is ____
measure ___

manage w ___

A

burning heat source
heating system

multiple members
cherry red

normal
carboxyhemogolobin

supplemental o2

71
Q

Barotrauma- complication of ___

___: compression air in lungs
comps P/H

__ oxerexpansion of air in lungs
comps A/P

A

scuba

descent
PE/hemorrhage

ascent
alveolar rupture/PTX

72
Q

Decompression sickness

descent loads tissues w __
ascent liberates __ leading to vessel ___

CM: J/P/P

A

nitrogen
gas bubbles
obstruction

joint pain, paresthesias, PG embolis

73
Q

High altitude sickness
hypoxic stress inc ___

__/__ edema
Tx __ and hyperbaric __
precent w __/___

A

blood flow

cerebral/pulm
descnet, O2
acclimitazation, acetazolamide

74
Q

20 yr after asbesots
progressive SOB
multinodular/reticular findings + pleural plaques

dx os___

direct toxic effects of __ and ___ activation

A

asbestosis

fibers, inflamm

75
Q

hr/day after exposre
F, chills, cough, malaise, SOB
diffuse reticular opacity

dx is ____

caused by ___ such as animals/farming/dust

A

hypersensitivity Pneumonitis

inhalaltional antignes

76
Q

nonprod cough, cp, SOB
constitutional sx
patchy alveolar opacities on CXR

dx ____
can be __/__ or result of ___

A

COP

post infect, drug induced, CTD

77
Q

prog cough, SOB x 3m
bibasilar crackles
diffuse reticular opacitieis

dx is ___

___ and __ influences

A

IPF

genetic, environmental

Multisystem 2 (14 decks)

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