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Board Review - C - Respiratory > Resp II > Flashcards

Resp II Flashcards

1
Q

V/Q

A

apex zone 1 - high V/Q
zone 2 - Pa greater than PA greater than Pv
base zone 3 - low V/Q

both ventilation and perfusion greater at base of lung than apex

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2
Q

exercise and V/Q

A

apical vasodilation - decreased V/Q

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3
Q

ideal V/Q

A

1

apex = 3
base = 0.6
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4
Q

TB infection

A

thrive high O2

apex of lung

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5
Q

V/Q = 0

A

shunt - airway obstruction

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6
Q

V/Q = infinite

A

blood flow obstruction

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7
Q

CO2 transport in blood

A

HCO3 - 90%
carbamino Hb - HbCO2 - 5%
-bound to Hb at N terminus of globin - favor taut
dissolved CO2 - 5%

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8
Q

CO2 bound to Hb

A

to N terminus of globin

favor taut
-O2 unloading

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9
Q

lung CO2 and O2

A

in lung

  • O2 of Hb - prevent dissociation H+ from Hb
  • equilbrium shift to CO2 formation
  • CO2 released in lungs

haldane effect

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10
Q

bohr effect

A

peripheral tissue

-elevated H+ - shift curve right - unload O2

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11
Q

chloride shift

A

into RBC

exchange for HCO3

high Cl in RBC in venous blood

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12
Q

high altitude

A

low PaO2 - ventilation - low PaCO2
-resp alkalosis

increased EPO production
increased 2,3 BPG production - Hb release more O2

acetazolamide - augment bicarb excretion from kidney

chronic hypoxic pulmonary vasoconstriction - right ventricle hypertrophy

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13
Q

rhinosinusitis

A

MCC - viral URI

may lead to secondary bacterial infection
-strep pneumo, h. flu, m. catarrhalis

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14
Q

epistaxis

A

nose vleed

anterior nostril - kiesselbach plexus

life-threatening - posterior segment - sphenopalatine a - branch of maxillary artery

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15
Q

DVT

A

virchow triad

  • stasis
  • hypercoag
  • endo injury
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16
Q

homan sign

A

pain dorsiflex calf - DVT

17
Q

lines of zahn

A

interdigitating area pink and red - in thrombi formed before death

with pulmonary embolus

distinguish pre-post mortem clots

18
Q

hypoxemia, neuro abnormal, petechial rash

A

triad - fat emboli

19
Q

air emboli

A

nitrogen bubble - precipitate ascending diver

tx - high pressure O2

20
Q

obstructive lung disease

A

air trap in lung
-elevated RV and decreased FVC

very low FEV1
low FVC
low FEV1/FVC ratio**

V/Q mismatch

chronic - cor pulmonale

chronic bronchitis
emphysema
asthma
bronchiectasis

21
Q

blue bloater

A

chronic bronchitis

hyperplasia mucus gland
-reid index more than 50% thickness

productive cough more than 3 months for more than 2 years

hypoxemia - shunting

CO2 retention - hypercapnia

secondary polycythemia

22
Q

pink puffer

A

emphysema

enlarge air space, less recoil, more compliance

destruction of alveoli wall
-more elastase activity

barrel chested
-exhale through pursed lips

23
Q

centriacinar

A

smoking

24
Q

panacinar

A

a1 antitrypsin

25
Q

curschmann spiral

A

shed epithelium - form whorled mucus plug

-with asthma

26
Q

charcot leyden crystals

A

eosinophilic, hexagonal, double point, needle like crystals

from breakdown of eosinophils in sputum

with asthma

27
Q

bronchiectasis

A

chronic necrotizing infection of bronchi

dilated airways
and hemoptysis

association - kartagener, smoking, CF, allergic aspergillosis

28
Q

restrictive lung disease

A

decreased lung volume
decreased FVC and TLC

FEV1/FVC ratio greater than 80%

lots of causes:

  • ARDS, NRDS
  • poor breathing
  • pneumoconiosis
  • sarcoidosis
  • idiopathic pulmonary fibrosis
  • goodpasture
  • wegener
  • langerhans cell histiocytosis
  • hypersens pneumonitis
  • drug toxicity - bleo, busulfan, amiodarone, methotrexate
29
Q

obstructive vs. restrictive lung disease

A

obstructive - higher lung volume

  • FEV1 - larger decrease
  • result in decreased FEV1/FVC ratio

restrictive - lower lung volume
-FEV1/FVC ratio - increased

both - FEV1 and FVC decreased - but obstructive has larger decrease FEV1

normal FEV1/FVC ratio = 80%

30
Q

hypersensitivity pneumonitis

A

mixed type 3 and 4 HS

-to env antigen

31
Q

pneumoconiosis

A

coal workers, silicosis, asbestosis

risk cor pulmonale

caplan syndrome - RA and pneumoconiosis with intrapulmonary nodules

32
Q

asbestosis

A

pleural plaques - pathognomonic

risk of cancer - bronchogenic cancer greatest
-also mesothelioma

affect lower lobe

33
Q

berylliosis

A

aerospace and manufacturing industry

granulomas form - respond to steroid

affect upper lobes

34
Q

coal workers pneumoconiosis

A

coal dust
-macro with carbon

black lung disease
-anthracosis

affect upper lobe

35
Q

silicosis

A

sand blasting, foundries, mines

macro - release fibrogenic factor - fibrosis occurs

silica - disrupt phagolysosome - impair macros

more susceptible to TB

risk for bronchogenic carcinoma

eggshell calcifications

Board Review - C - Respiratory (3 decks)

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