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Step 1 > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Where do cartilage and goblet cells, psuedostratified cilia, smooth muscle extend to?

A

cartilage and goblet cells: end of bronchi

psuedostratified cilia, SM: terminal bronchioles

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2
Q

Type 1 vs Type II pneumocytes

A

Type I: squamous, thin, gas exchange

Type II: surfactant

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3
Q

What is surfactant made of?

A

Lecthins, dipalmitoylphosphatidylcholine

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4
Q

When does the lung begin to produce surfactant?

A

35 wks

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5
Q

What nerve, nerve roots supply diaphragm?

A

phrenic nerve; C3, 4, 5

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6
Q

What levels do IVC, esophagus, aorta perforate diaphragm?

A

T8: IVC
T10: esophagus
T12: aortic hiatus

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7
Q

What is IRV?

A

Air that can still be breathed in after normal breath

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8
Q

What is typical TV?

A

500ml

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9
Q

What is ERV?

A

Air that can still be breathed out after normal breath

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10
Q

What is IC?

A

IRV+TV

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11
Q

What is FRC?

A

RV+ERV

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12
Q

What is RV

A

Air in lung after maximal respiration; cannot be measured on spirometry

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13
Q

what is VC

A

TV+IRV+ERV; maximum volume gas expired after maximal inspiration

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14
Q

Formula for physiologic dead space

A

Vd=Vt-PaCO2-PECO2/PaCO2

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15
Q

What is equation, normal value for alveolar ventillation?

A

normal- 3500ml

VA=(Vt-Vd)xRR

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16
Q

How do T and R forms of Hb differ in affinity for O2

A

T (taut)- low affinity, tissues

R(relaxed)- high affinity, respiratory tract

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17
Q

Explain how cyanide is treated (and relation to Hb)

A

1) Nitrites oxidize Hb to methemoglobin, bind cyanide

2) thiosulfate binds cyanide, excreted by kidney

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18
Q

What is methemoglobin? How treat?

A

Oxidized (Ferric, Fe3+) Hb- lower O2 affinity

treat with methylene blue

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19
Q

Formula for O2 content of blood

A

1.39xHbxSatO2+0.003xPO2

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20
Q

What is resistance and compliance of pulmonary circulation?

A

Low resistance, high compliance

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21
Q

In what states (2) is O2 diffusion limited?

A

emphysema, fibrosis

22
Q

Formula for alveolar gas exchange

A

PAO2=150-PaCO2/0.8

23
Q

Normal A-a gradient

24
Q

What is hypoxemia vs hypoxia?

A

Hypoxemia: decr arterial O2
Hypoxia: decr O2 delivery to tissues

25
Q

How does V/Q compare at base/apex of lungs

A

Apex- wasted ventilation (V/Q=3)

Base- wasted perfusion (V/Q=0.6)

26
Q

Haldane vs Bohr effects

A

Haldane- lungs, CO2 released from RBC

Bohr- tissues, incr H+, O2 released

27
Q

Which sinuses most commonly infected?

A

Maxillary sinuses

28
Q

What does Reid index >50% indicate?

A

Chronic bronchitis

29
Q

What is associated with centriacinar vs panacinar emphysema?

A

centriacinar- smoking (upper lobes)

panacinar- a1 antitrypsin (lower lobes)

30
Q

What does exhalation through purse lips indicate

31
Q

What are Curshmann spirals and Charcot-Leyden crystals associated with? Describe both

A

Curshmann- shed epithelium forms mucus plugs

CL- formed from breakdown of eosinophils

32
Q

What causes bronchiectasis?

A

chronic necrotizing infection of bronchi

33
Q

Restrictive lung disease with bilateral hilar LAD, noncaseating granulomas

A

sarcoidosis

34
Q

What reactions mediate hypersensitivity pneumonitis

A

Type III/IV mixed, birds

35
Q

What is the underlying pathology of Goodpasture?

A

Autoimmune attack of type IV collagen (alveoli + glomeruli)

36
Q

Assoc with calcified pleural plaques, ferruginous bodies

A

Asbestosis

37
Q

Which lobes are affected by asbestosis, Coal, silicosis?

A

Asbestosis, coal: lower lobes

Silicosis: upper lobes

38
Q

What is associated with eggshell calcifications of hilar lymph nodes?

39
Q

What is associated with formation of intra-alveolar hyaline membrane

40
Q

FEV1/FVC in obstructive vs restrictive disease?

A

normal=80%

obstructive 80%

41
Q

What is BMPR2 associated with?

A

primary pulmonary hypertension

42
Q

What type of lung cancer is not associated with smoking?

A

Bronchial carcinoid

43
Q

Central lung cancer

A

squamous cell, small cell

44
Q

What type of lung cancer is associated with hypercalcemia?

A

squamous cell

45
Q

What are neuroendocrine kulitchsky cells

A

small dark blue cells, small cell lung cancer

46
Q

What type of lung cancer shows pleiomorphic giant cells

A

large cell

47
Q

What type of lung cancer is Chromogranin A+

A

bronchial carcinoid

48
Q

What paraneoplastic syndromes are associated with small cell?

A

ACTH, ADH, Lambert-Eaton

49
Q

What oncogene is assoc with smal cell lung cancer?

50
Q

Presents with JVD, upperextremity edema, facial plethora

A

SVC syndrome

51
Q

What are most likely cause of spontaneous vs tension pnuemothorax

A

spontaneous- accum air, usually rupture of apical blebs

tension- trauma or infxn, deviation of trachea

52
Q

Transudate vs exudate

A

Transudate- low protein, exudate high protein

Step 1 (34 decks)

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