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USMLE STEP1 📚👩🏻‍⚕️ > Respiratory 🫁 > Flashcards

Respiratory 🫁 Flashcards

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USMLE® Step 1 flashcards
1
Q

Intrapleural pressure

A

Always negative created by opposing Forces between lung and chest wall

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2
Q

Intrapleural pressure and transmural pressure

A

Same amount , different charges
IPP = - 7
IMP = + 7

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3
Q

Normal Intrapleural difference

A

5-15 mmhg
> than 15mmhg or less than 5 mmhg = pathological
Tension Pneumothorax ( become less negative )
Stab wound

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4
Q

Compliance mean

A

Distensibility
Extensibility
Decrease Surface tension
Surfactant ~ Compliance

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5
Q

Increase compliance similar to

A

Old used socks with loose elastic band
C = V/P ( meaning more volume ,loose pressure )
COPD ( get air in , can’t get air out bc pressure is not enough to push/exhale air out)
Expiration
Saline filled lung ( liquid )

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6
Q

Increase Elastic recoil ( tight sock after washing )

A

Collapse
Increase surface tension
Increase elastin
Lung Can’t expand well
Lung fibrosis

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7
Q

Lung fibrosis disease type

A

Restrictive lung disease
Normals or increase FEV1/FVC
All LFT decrease ( bc can’t get the air in&raquo_space; TLC, FRV,FVC all reduced )

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8
Q

Neonatal respiratory syndrome

A

Lack or reduced surfactant in baby
Rx- cortisol to increase surfactant
Insulin is surfactant antagonist
(Therefore , baby with diabetic mother are at higher risk for NRDS)

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9
Q

Decrease compliance

A

Restrictive
NRDS
Chest wall disease ( MG/ dumchenne/GBS) -Extrinsic
Lung fibrosis ( Intrinsic )

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10
Q

How to differentiate COPD and Asthma , Dx test ?

A

Give Bronchodilator
Improve - Asthma ( reversible )
Not improved - COPD ( irreversible damage due to smoking )

Methacholine challenge test
Asthma - symptoms worsened

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11
Q

A-a gradient

A

Different Intrinsic and Extrinsic restrictive lung disease

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12
Q

Work of breathing = work of inspiration
How about expiration ?

A

Expiration do not require active work , only passive exhalation of air after inspiration ( pressure force air out)
In OLD, abdominal Ms breathing to get air out&raquo_space; increase work of breathing > resp fatigue > ICM retraction >barrel chest

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13
Q

Chocolate color blood

A

Methemoglobinemia

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14
Q

Rx for Methemoglobinemia

A

Methylene blue
Vit C

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15
Q

Causes of Methemoglobinemia ( Fe2+ to Fe3+)

A

Dapsone
Anasthestic
Nitrates

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16
Q

Pancoast tumor
Impair blood drainage from head and neck
Headaches / dizziness
JVP distension
Dx
Risk of what condition ?

A

SVC syndrome
Aneurysm
Intracranial arteries rupture

17
Q

H1 blocker uses?

A

Gen. 1 : allergy , motion sickness , gestational emmesis
Gen 2 : Allergy , less Cns toxicity

18
Q

Tumor at the Apex of the lung
Risk of nearby structures compression ( SVC, Stellate ganglion , Brachial plexus ,phrenic nerves )

A

Pancoast tumor

19
Q

SCLC significances ?

A

Affects
1.Neuro : LEMG , encephalitis , cerebellar degeneration)
2.Endocrine : ACTH - cushion / SIADH
Myc-oncogenes mut

20
Q

Most common lung cancer

A

Adenocarcinoma
Happen to non-smoker
Female
Bronchoalveolar
Tall Columnar cells
Stain mucin +

21
Q

SCC location

A

Remember “C”
Central , Ca2+ , Cavitation ,Cig
Hilar- bronchus
His- Keratin pearls

22
Q

LCC (lung)

A

Large -giant cells
Mostly smokers
Increase b-HCG -gynecomastacia

23
Q

ComplicTion of Lung Ca
SPHERE

A

S- SVC $
P-Pancoast Tumor
H- Horner $ (stellate Ganglion compression)
E-endocrine neoplastic
R- recurrent laryngeal n compression
E- effusion ( pleural / pericardial)

24
Q

Multiple Mets lesion on the lung

A

More common in 2mets than 1 lung Ca
Mostly from breast /colon /bone/ bladder

25
Q

Alcoholic
Choking +
Aspiration Oropharyngeal content +
Air fluid level + on CXR
DX?
Expect to see in Which side of lung?

A

Lung abscess ( pus )
Aerobes or s aureus
Right lung ( more vertical )
Sitting -RLL
supine- RUL

26
Q

Course/natural Hx of pneumonia ?

A

D 1-2 : Congestion ( Bac + Exudate ) -consolidation
D3-4: Red Hepatization - WBC migration + fibrin + Exu
D5-7: Gray -Fibrin ,lyses RBC , WBC
D8+ : Resolution -Macrop enzymatic digestion of exudate

USMLE STEP1 📚👩🏻‍⚕️ (13 decks)

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