Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Neo Review > Respiratory > Flashcards

Respiratory Flashcards

1
Q

3 factors (pathophys) leading to RDS

A

decrease lung volume
decrease FRC
decrease compliance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

A chest x-ray may show hyperinflation, prominent perihilar vascular markings, edema of interlobar septae, or fluid in the fissures. What is diagnosis?

A

TTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Adenosine leads to increased or decreased apnea?

A

leads to increased apnea
caffeine competitive antagonist for adenosine, and less apnea when caffeine is used

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

airway resistance is comprised of what 3 components?

A

Chest wall resistance (25%), airway resistance (55%), lung tissue resistance (20%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

At what embryological stage would CDH occur?

A

Before 10th week
due to failure of pleuro-peritoneal closure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

At what embryonic stag is lung considered viable?

A

Cannicular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Does airway resistance increase or decrease with postnatal age?

A

Increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

does high or low PcO2 lead to increase IVH risk?

A

both do

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

name 5 ways caffeine helps

A

decreases hypoxic depression of breathing
decreases periodic breathing
improves CO2 sensitivity
increased diaphragmatic activity
increases minute ventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How is oxygen content determined?

A

can be calculated by adding amount of O2 bound to hgB ot the amount of dissolved O2 in blood

(1.34 ml O2/ghb x hgb (g/dl) x 02 sat ) + (.002 x paO2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How is surfactant synthesized?

A

Predominantly Choline incorporation pathway, induced by steroids, cAMP or beta agonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Meconium aspiration releases which chemical vasoconstrictors?

A

endothelin-1, thromboxane A2 and prostaglandin E2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Name 3 physical factors of lung development

A

Lung Fluid: Promotes growth through chronic stretch (due to pressure)
Fetal breathing (increased pressure when coupled from upper airway contractions)
Peristaltic airway contractions (pressure on distal buds)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

name 5 things that can cause pulmonary hypoplasia

A

Renal agenesis
urinary outlet obstruction
loss of amniotic fluid (PPROM)
CDH
Large pleural effusions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

name some factors associated with delayed lung maturation

A

Diabetes, Rh isoimmunoization with hydrops, 2nd born twin, c-section

mediated by insulin, androgens, and transforming growth factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

New BPD vs old BPD

A

new BPD interferes with luing development

old BPD is caused by direct injury to lungs

new BPD have decrease in alveolar septation, and microvascular development
(arrest of pulmonary alveolarization, with increased alveolar deimateres and fewer alveoli)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

pressure controlled ventilation what happens when compliance increases?

A

Tidal volume increases, PIP, stays same

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Volume targeted ventilation what happens when compliance increases

A

pressure drops (PIP), and TV stays same

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What abnormalities might you see in Pseudoglandular phase of lung development, if something is amiss?

A

BRANCHING ABNORMALITIES OF LUNG

bronchogenic cysts
CDH
Congenital lobar emphysema
Cystic adenomatoid malformations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are 5 variables that impact distribution of surfactant

A
  1. gravity (position of lung)
  2. volume of instillation
  3. Speed of instillation
  4. Surfactant type and properties
  5. Fluid volume in lung
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what are benefits of permissive hypercapnia?

A

need for less MV
less lung injury
direct protective effect of lung
neuroprotection
ensures maximal respiratory drive
less danger of hypocapnia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the hydrophilic surfactant proteins

A

Sp-A Tubular Myelin
sp-D Surfactant lipid homeostasis (host defense)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the hydrophobic Surfactant proteins?

A

SP-B Type II surface tension reduction
SP-C tension reduction film stability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What information does the alveolar-arterial (A-a) gradient provide?

A

provides information about whether the lungs are transferring oxygen from atmosphere to pulmonary circulation.
the larger the A-a gradient, the poorer O2 transfer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is a pulmonary artery sling?
anomalous origin of the left pulmonary artery from right pulmonary artery LPA supplies left lung goes posterior to trachea, and anterior to esophagus LPA aberration compresses distal trachea, and right mainstem bronchus
26
What is ABCA 3 Transporter?
ATP Binding cassette protein that helps with transport of lipids Autosomal recessive, 30-40% of all refractory acute respiratory failure abnormal accumulation of lamellar bodies in type 2 cells, and inablity to transport to surface
27
what is hyperoxia test?
determining if low O2 sats are due to Cardiac or Respiratory reasons if paO2 >100, it's respiratory
28
What is physiological deadspace, and how can it be calculated?
Anatomical dead space (gas in conducting areas of respiratory system) does not come into contact with alveoli + Alveolar dead space (air contacting alveoli without blood flow in adjacent pulmonary capillaries) can be calculated by Bohr equation
29
What is the Haldane effect
Decrease in hgb Saturation enhances removal of CO2 from oxygen increased Hgb Saturation decreases its ability to carry CO2 promotes dissociation of CO2 from hgb in oxygen rich capillaries of lungs
30
What is the most sensitive test for evaluating phrenic nerve injury?
ultrasound
31
What respiratory measurements are increased in neonates compared to adults
Respiratory Rate Residual Volume Minute Ventilation Alveolar Ventilation [(TV - dead space) x RR]
32
Where do majority of CDH take place?
They occur posteriorly and are a result of the failure of pleuroperitoneal membrane closure in utero.
33
Why is MCT formula recommended for patients with chyolothorax?
if lymphatic vasculature has been injured, the lymphatic vessels are not necessary for absorption of MCT
34
How does iNO work
increases soluble guanlyate cyclase, which increases cyclic GMP
35
What do you see in all patients with Congenital Lobar emphysema?
hyperinflation of affected lung segment
36
Best way to position infant with PIE
on affected side lateral decubtius, allows unaffected lung to oxygenate
37
Reciprocal of time constant is equal to what in flow volume curve on vent?
slope of exhalation
38
What is reciprocal of compliance?
elastance?
39
What is reciprocal of conductance?
resistance
40
How is resistance represented on flow volume curve?
Resistance is represented by the distance from the slope of the curve to the outer portion of the loop When resistance to flow is increased, the distance will increase and the loop will become wider
41
Which aortic arch derivates stick, of the 6?
3, 4, 6 pulmonary structures arise from 6th arch
42
Do antenatal steroids improve alevorization?
No, but they do increase surface area and they do increase surfactant production
43
Time constant measures what?
resistance x compliance time required for inflation for deflation by 63%
44
Embryologically where do lungs derive from
from ventral bud of esophagus
45
Type I pneumocytes differ from Type 2 pneumocytes how
Type 1 cover alveolar surface, help in gas exchange, Type 2 mainily in alveolar lining (only 10% of surface), and play role in surfactant metabolism
46
Boyle's Law
P1V1 = P2V2 as pressure of a gas decreases, the volume in that space increases
47
Chemoreceptors on medulla respond to what kind of changes?
Changes in CO2, increase in H There are no O2 sensors in medulla
48
Peripheral chemoreceptors are located where?
carotid and aortic bodies they responde to decrease in PaO2, and increase in PaC02
49
Alveolar Ventilation equation
Va= (Tidal volume- dead space) x RR
50
Va/Q >1 (the ____________ effect)
excessive ventilation and blood from that area in lung will have high PaO2 and low PaCO2 dead space effect
51
Va/Q <1 (the __________ effect)
some gas exchange, but lower than normal PaO2 and higher PaCo2 (shunt effect)
52
What kind of blood is intrapulmonary shunt
any blood that goes through systemic circulation without going through ventilated lung region.
53
What is anatomic dead space?
areas of lung, not involved in gas exchange
54
What is physiologic dead space?
WASTED VENTILATION anatomic deadspace + alveolar dead space
55
What does the Bohr equation measure?
Physiologic dead space
56
Bohr equation
[Arterial CO2- Expired CO2/(Arterial CO2) ] x tV
57
Poiseuille's law
length x viscosity /radius to 4th power
58
bronchoconstriction increases or decreases dead space?
decreases
59
What is equation for elastance?
inverse of compliance change in pressure/ Change in volume
60
hypoxemia vs hypoxia
hypoxemia is low O2 in blood (not necessarily reflective of O2 sat) hypoxia is low O2 in tissues
61
What does A-a gradient measure?
how well lugs are transferring O2 from atmosphere to pulmonary circulation?
62
Calculation of A-a gradient
63
Equation for O2 Delivery
Cardiac Output x O2 content
64
Fick Principle
O2 consumption in blood is difference between O2 delivered to tissues (arterial blood) and blood returning form tissues (venous blood)
65
O2 consumption equation
VO= 1.34 x (hgb) (arterial O2 sat - venous O2 sat)
66
If O2 delivery is decreased to tissue, how will body compensate?
Increase O2 extraction (less venous O2) Recruiting more capillaries
67
What is Haldane effect
Changes im CO2 binding to Hb based on amount of O2
68
Haldane effect on tissues
O2 is removed from Hb, thus greater amount of CO2 can bind to Hb
69
Haldane effect on lungs
binding of O2 to hb in alveolar capillaries increases CO2 unloading from capillary to alveoli.
70
Co2 elimination is dependent on
Alveolar minute ventilation (Resistance, compliance, time constant) Diffusion across alveolar capillary membrane ( distane between alveoli and capillaries)
71
What decreases if you increase PEEP
TV will decrease, but if you increase PIP by same TV remains same TV decreases because you reduce pressure gradient
72
which manipulation of vent parameter will increase O2 and decrease PcO2
increasing flow
73
Benefits of VV ECMO?
spares carotid artery lower risk of arterial emboli
74
Benefits of VA Ecmo
provides respiratory and cardiac support can use femoral vessels
75
HFJV requires ________ time for gas to get OUT of lungs?
MORE
76
HFOV requires __________ time for gas to get IN to lungs
MORE
77
Why are majority of infants asymptomatic with pneumomediastinum?
because air is seldom under tension
78
What causes a pulmonary hemorrhage
acute increase in capillary hydrostatic pressure (From L to R shunting of PDA, or vasoconstriction from illness)
79
How to manage pulmonary hemorrhage
increase PEEP, to impede pulmonary blood flow
80
What is more worrisome, inspiratory stridor, biphasic stridor or Expiratory Stridor?
Expiratory stridor (region narrows during expiration) Tracheomalacia, tracheal stenosis Vascular rings, mediastinal mass
81
How do you diagnose vascular ring?
barium swallow (might show indentation in esophagus)
82
LHR < 1.0 good or bad prognosis in CDH
bad
83
How do you distinguish between Pneumothoraces and Congenital Lobar emphysema on xray?
both have hyperinflated lobe and mediastinal shift, but in CLE, lung markings will extend to the periphery
84
Most affected lob in Congenital Lobar Emphysema
left upper lobe > right middle lone> right upper lobe
85
How do CPAMs differ from bronchopulmonary sequestrations?
blood supply from pulmonary circulation CPAMS also have communication with tracheo-broncial tree
86
What types of CPAM have most favorable prognosis
Types 1 and 4 (2 and 3 usually associated with other morbidities, syndromes TEF etc)
87
What leads to lymphagneictasia?
failure of lymphatic vessel regression at 20 weeks gestation, or lymphatic obstruction
88
Is Extralobar or intralobar sequestration more common in neonates?
extralobar, but overall intralbor more common in general population
89
where are majority of extralobar sequestrations located?
mainly left side between lower lobe and diaphragm
90
Prognosis of Alveolar-capillary dysplasia
poor, respiratory failure in first 48 hours
91
Pulmonary veins are misaligned, and inadequate vascularization of alveoli with decreased number of capillaries adjacent to alveoli
Alveolar-capillary dysplasia
92
What does Guanyl Cyclase do?
with NO increases cyclic GMP
93
In what CHD legion might you see WPW
Ebstein's anomaly
94
What happens when there is an increase in resistance (either CLD >>>> or RDS) without a concomitant decrease in compliance, what happens to time constant?
time constant increases and takes longer for lung to empty
95
If a ventilator does not allow for sufficient time for expiration what happens
lungs will have long time constant, and gas trapping occurs
96
Where are most intrapulmonary sequestrations located?
posterior basal segment, mainly in left lung blood supply by anomalous usually from aorta
97
What is immediate goal in treatment of of hyperammonemia?
to remove ammonia hemodialysis allso IV sodium benzoate and sodium phenylacetate will remove glycine and glutamate from body
98
In Methemglobinemia what happens to Hgb?
Iron changes from ferrous (reduced) state to ferric (oxidized) state, decreasing ability of hemoglobin to bind O2.
99
What happens during an intrathoracic obstruction? (kind of sound)
Region narrows during expiration, expiratory stridor tracheomalacia, tracheal stenosis, external compression (vascular ring)
100
What happens during laryngeal obstruction? (kind of sound)
region is fixed in size, larynx is narrowest part of airway, so this is the most common type of stridor layrngomalacia, vocal cord paralysis
101
With surfactant surface tension is greater in expiration or inspiration?
Lowest at expiration, highest at inspiration
102
What are side effects of therapeutic hypothermia?
platelet dysfunction, decreased surfactant, pulmonary hypertension, vasoconstriction

Neo Review (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions