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Board Review - C - Respiratory > Resp III > Flashcards

Resp III Flashcards

1
Q

NRDS

A

low surfactant
-alveolar collapse - ground glass on CXR

L:S ratio less than 1.5

risk of PDA, retinopathy, IV hemorrhage, bronchopulmonary dysplasia

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2
Q

risk fx NRDS

A

premature
maternal diabetes - fetal insulin increase
C-section - less release of glucocorticoids

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3
Q

tx NRDS

A

maternal steroid before birth

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4
Q

ARDS

A

acute onset resp failure
-B/L opacities

causes - shock, sepsis, gastric aspiration, acute pancreatitis

diffuse alveoli damage - protein rich - leak to alveoli

formation of intraalveolar hylaine membrane

tx - mechanical ventilation with low tidal volume
-tx underlying cause

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5
Q

sleep apnea

A

repeated stop breathing more than 10 sec during sleep

daytime sleepiness

nocturnal hypoxia
-systemic/pulm HTN, arrhythmia, sudden death

see EPO release - erythropoiesis

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6
Q

obstructive sleep apnea

A

res effort against obstructed airway

with obesity and loud snoring

excess pharyngeal tissue

tx - weight loss, CPAP, surgery

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7
Q

central sleep apnea

A

no resp effort - CNS injury/toxicity

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8
Q

pulmonary HTN

A

greater than 25mmHg at rest

get arteriolosclerosis, medial hypertrophy, intimal fibrosis

death - decompensated cor pulmonale

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9
Q

pulmonary arterial HTN

A

idiopathic

  • heritable - BMPR2 - inactivated
  • normally inhibit vasc smooth m proliferation

bad prognosis

also with cocaine, amphetamine use, HIV, CT disease, portal HTN, cngenital heart disease

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10
Q

pulmonary HTN with left heart disese

A

systolic/diastolic dysfxn - and valvular disease

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11
Q

pulmonary HTN due to lung disease or hypoxia

A

destruction parenchyma - COPD

hypoxemia vasoconstriction
-sleep apnea/living at altitude

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12
Q

chronic thromboembolic PH

A

recurrent microthrombi

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13
Q

tension pneumo

A

trachea away from side of lesion

hyperresonant on percussion

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14
Q

atelectasis

A

bronchial obstruction

tracheal deviation toward side of lesion

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15
Q

transudate

A

low protein content

increased hydrostatic P and low oncotic P

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16
Q

exudate

A

high protein content

malignancy, pneumona, collagen vasc disease, trauma

drained - risk infetion

17
Q

chylothorax

A

lymphatic pleural effusion

milky appearing - high triglycerides

thoracic duct injury

18
Q

primary spontaneous pneumothorax

A

rupture apical bleb or cyst

-tall thin young male

19
Q

secondary spontaneous pneumothorax

A

barotrauma

or diseased lung - bulla in emphysema/infection

20
Q

traumatic pneumothorax

A

rib fx or penetrating trauma

21
Q

tension pneumo

A

when air enter and cannot exit - trachea deviate away from affected side

22
Q

lobar pneumonia

A

strep pneumo

legionella
klebsiella

intraalveolar exudate - consolidation to lobe

23
Q

bronchopneumonia

A

strep pneumo
staph aureus
h. flu
klebsiella

acute inflammatory infiltrate

  • bronchioles to adjacent alveoli
  • patch often with more than 1 lobe
24
Q

interstitial pneumonia

A

atypical

virus - influenza, CMV, RSV, adenovirus

mycoplasma
legionella
chlamydia

diffuse patchy inflammation - interstitial areas at alveolar walls

diffuse more than 1 lobe

25
Q

lung abscess

A

aspiration - loss consciousness, alcoholic, epileptic

air fluid level

anaerobe infection - bacteriode, fusobacterium, peptostreptococcus

or staph aureus

26
Q

mesothelioma

A

malignancy of pleura
-asbestosis

pleural thickening

see psammoma bodies

27
Q

pancoast tumor

A

superiro sulcus tumor

pancoast syndrome - horners, SVC syndrome, sensorimotor deficit, hoarseness

28
Q

SVC syndrome

A

facial plethora - JVD, edema upper extremities

with malignancy - pancoast tumor

or thrombosis from indwelling catheters

HA, dizzy, risk of aneurysm and rupture cranial arteries

29
Q

lung cancer

A

leading cause of cancer death

cough, hemoptysis, bronchial obstruction, wheezing, coin lesion, etc.

30
Q

lung cancer mets

A

adrenal
brain
bone
liver

31
Q

lung mets

A

more common than primary neoplasm

from breast, colon, prostate, baldder

32
Q

hoarseness

A

recurrent laryngeal n compression - with lung cancer

33
Q

oat cell carcinoma

A

small cell

central location

paraneoplastic

  • ACTH - cushing
  • SIADH
  • Abs - presynaptic Ca - lambert eaton
  • amplify myc

tx - cannot operate

  • aggressive - mets before diagnosis
  • chemotherapy
34
Q

kulchitsky cell

A

neuroendocrine neoplasm cells of small cell carcinoma

chromogranin positive

35
Q

non-small cell cancer of lung

A
  • adenocarcinoma - peripheral
  • SCC - central
  • large cell - peripheral
  • bronchial carcinoid
36
Q

adenocarcinoma of lung

A

peripheral

MC lung cancer nonsmokers - except mets

activation KRAS, EGFR, LK

hypertrophic osteoarthropathy - clubbing

CXR - hazy infiltrate

good prognosis

glandular pattern - stains with mucin

bronchioalveolar subtype - thick alveolar walls

37
Q

SCC of lung

A

central located

hilar mass from bronchus

cavitation
cigarettes
hyperCa - produce PTHrP

keratin pearls
intercellular bridges

38
Q

large cell carcinoma of lung

A

peripheral

anaplastic undifferentiated

poor prognosis

less response to chemo
-remove with surgery

secrete B-hCG

pleomorphic giant cells

39
Q

bronchial carcinoid tumor

A

good prognosis

sx - mass effect

secrete serotonin - flushing, diarrhea, wheezing

nests endocrine cells

chromogranin positive

Board Review - C - Respiratory (3 decks)

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