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FA organs HY > Respiratory > Flashcards

Respiratory Flashcards

1
Q

What ends at the Bronchi before Bronchioles?

A

Cartilage

Goblet cells

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2
Q

What Extends to terminal bronchioles?

A

Pseudostratified CILIATED columnar

Smooth muscle

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3
Q

Non ciliated cells that secrete components of surfactant and degrade toxins?

A

Clara cells

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4
Q

FRC= ?

A

FRC = RV + ERV

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5
Q

VC = ?

A

VC = TV + IRV + ERV

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6
Q

Physiological dead space equation?

A 
Vd= Vt x (Paco2 - Peco2)/ Paco2 
Vt= tidal volume 
Pa= arterial 
Pe= Expiratory
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7
Q

Taut vs Relaxed Hb?

A 
Taut = Low affinity for O2 in Tissue 
Relaxed = High affinity for O2 Respiratory
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8
Q

Pt on Nitroprusside gets Oxidized Hb that has high affinity for Cyanide, Rx?

A

Methemoglobin = Methylene blue

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9
Q

Perfusion vs Diffusion limited exchange?

A 
Perfusion = Gas equilibrates along capillary (O2, CO2, N2O)
Diffusion = Does NOT equilibrate (CO + O2 in emphysema)
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10
Q

CO diffusion measures?

A

Alveolar- Capillary interaction
Emphysema = Dec SA
Fibrosis = Inc Thickness

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11
Q

During normal exercise Increased BF does NOT overwhelm O2 diffusion Unless?

A

Fibrosis = then O2 is Diffusion Limited

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12
Q

Pulmonary HTN (> 25mmHg):
Primary
Secondary

A

1 = BMPR2 mutation = Inc Vascular sm. musc Prolif
2nd = COPD (parenchyma destruction) + Recurrent thromboemboli (dec Cx Area of vasculature)
Autoimmune (Intimal Fibrosis )
Left-Right shunt = Endothelial injury = atherosclerosis
Altitude/sleep apnea = Hypoxic vasoconstriction

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13
Q

Pulmonary Vascular resistance= ?

A

PVR = [P (pul art) - P (left atrium)] / CO

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14
Q

O2 content = ?

O2 delivery?

A

O2 content = (O2 binding capacity x %sat) + dissolved O2
*1 g Hb = binds 1.34 mL O2 -> [Hb = 15]
**O2 content == 20 mL
O2 delivery = CO x content

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15
Q

Dec Hb causes?

A

Dec O2 content
Normal O2 sat
Normal Po2

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16
Q

Alveolar gas equation? Normal PAo2 vs Pao2?

A

PAo2 = PIo2 - (Paco2/ R)
*** PAo2== 150 - (Paco2 / 0.8) **
PAo2= 100
Pao2 = 95

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17
Q

A-a gradient is normally? Elevated in ?

A

A-a gradient = 10-15

Elevated A-a = Hypoxemia (shunt, V/Q mm, Fibrosis)

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18
Q

Pt with hypoxemia but A-a gradient= 12?

A

High Altitude
Hypoventilation = Barbiturates / Brain injury
URT obstruction = Epiglotitis
Obesity

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19
Q

Pt with Hypoxia?

A

Dec CO
Hypoxemia
Anemia
CO poisoning

20
Q

Pt with Hypoxemia and A-a gradient = 33?

A

V/Q mismatch = ARDS/ PE
Diffusion limited = Fibrosis/ Edema / pneumonia
Right-Left shunt

21
Q

Pt with Hypoxemia + A-a gradient 33 and 100% O2 does not correct hypoxemia?

A

Right - Left Shunt

22
Q

V/Q mismatch @ lung zones:
Apex
Base
Exercise

A

Apex–> V/Q= 3 (wasted Ventilation= dead space)
Base –> V/Q= 0.6 (wasted perfusion= Shunt)
Exercise –> inc CO = Inc Perfusion @ apex = V/Q= 1

23
Q 
V/Q = 0
V/Q = infinity
A 
V/Q= 0 = SHUNT (Not corrected by 100% O2)
V/Q= infinity = Dead space = 100% O2 corrects issue
24
Q

What 3 forms are CO2 carried in blood?

A 
Bicarbonate= 90%
Carbaminohemaglobin = 5% (bound to N terminus of GLobin not Heme)
Dissolved = 5%
25
Q

Signs and symptoms of Pul embolus?

A

Sudden onset dyspnea
Chest pain
Tachypnea

26
Q

Triad for Fat embolus?

A

Hypoxemia
CNS abnormalities
Petechial rash

27
Q

What defines Chronic bronchitis?

A

Productive cough > 3 mo/ yr for >2years

**Hypertrophy of mucus secreting cells (Reid index>50%)

28
Q

What interleukins are involved in Asthma?

A

IL-4 ==> IgE
IL-5 ==> Eosinophils
LT C/D4

29
Q

What are the findings seen in Asthma sputum/biopsy?

A

Smooth Muscle hypertrophy
Curschmann spirals = shed epithelium
Charcot-Leyden crystals= Eos breakdown

30
Q

What is seen in a pt with hx of Sandblasting?

A

Silicosis
“Eggshell calcifications” @ UPPER lobe
TB

31
Q

pt who works for the Aerospace industry has fibrosis and Noncaeseating granulomas?

A

Berylliosis

32
Q

Infant with NRDS is treated with O2 can develop?

A

Retinopathy of prematurity
Bronchopulmonary dysplasia
**BOTH due to ROS

33
Q

What are RFs for NRDS?

A

Prematurity
Maternal DM = Insulin inhibits surfactant production
C-section = dec Cortisol release

34
Q

What hormones are responsible for Surfactant production?

A

Cortisol

Thyroxine

35
Q

What is the treatment for ARDS?

A

Mechanical ventilation
NO
Steroids
Antibiotics

36
Q

What is seen in ARDS?

A

Diffuse alveolar damage
Intra-alveolar hyaline membrane
PMN induced damage via ROS

37
Q

Pt with decreased breath sounds, dullness to percussion, and decreased tactile fremitus?

A

Pleural effusion

38
Q

Pt with decreased breath sounds and hyperresonant to percussion?

A

Pneumothorax

39
Q

Pt with bronchial breath sounds, dullness to percussion, and Increased tactile fremitus?

A

Consolidation

40
Q

Difference btwn Effusion and Consolidation?

A 
Effusion = NO Fremitus/ Dec
Consolidation= INC Fremitus
41
Q

What two types of lung cancers are NOT associated with smoking?

A

Bronchioloalveolar

Bronchial Carcinoid

42
Q

Female nonsmoker presents with clubbing of the finger, hemoptysis, and hazy CXR. What mutation is most likely caused her disease?

A

Adenocarcinoma ==> MC in females / Non smokers

** activating k-ras / EML4-ALK (TK) **

43
Q

Malignant carcinoma that grows along the alveolar walls?

A

Bronchioalveolar

44
Q

What are the characteristics of SCC of lung?

A 
Cavitations
Central 
Smokers 
Hypercalcemia (PTHrP)
Keratin pearls / Intercellular bridges
45
Q

Characteristics of Small cell lung cancer?

A 
Central 
ACTH/ ADH / Eaton lambert 
myc Amplification 
NO Surgery = Chemo only 
Neuroendocrine
46
Q

pt with a “popcorn calcification” on CXR and biopsy shows cartilage and adipose tissue?

A

Hamartoma

47
Q

Farmer’s lung and Bird feeders lung have what Pathophysiology?

A

Type 3 HS == Immune complex

FA organs HY (11 decks)

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