Respiratory Flashcards by Mary Nolastname

Methemoglobin

oxidized form (Fe3+), doesn't bind O2 as well
increased affinity for cyanide

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Nitrate poisoning

oxidize to Fe3+

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cyanide poisoning

use nitrates to oxidize hemoglobin to methemglobinemia and bind cyanide
allows cytochrome oxidase to function
thiosulfate to bind cyanide and renal excrete

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carboxyhemoglobin

Hg bound to O2, left shift

decreased oxygen unloading

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Primary Pulmonary Hypertension gene

BMPR2 gene

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fat emboli

long bone fratures

liposuction

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alveolar hyperventilation

hypocapnia

paCO2= BMR/alv vent

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Tb med that requires acidic environment

pyrazinamide

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N-acetylcysteine mechanism in CF treatment

reduces intermolecular disulfide bridges

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histo of true vocal cords

stratified squamous

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mycolic acids

long, branched, saturated Fatty acids

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PE (changes in O2, etc)

hypoxemia
hyperventilation
resp alkalosis

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CO poisoning (O2 values)

Normal Po2 (dissolved O2)
decreased O2 saturation
decreased O2 content

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Anemia (O2 values)

Normal PO2
Normal O2 sat
decreased O2 content

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Polycythemia (O2 values)

Normal Po2
Normal O2 sat
increased O2 content

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P02

dissolved oxygen

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percent saturation of O2

O2 per gram of Hb

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O2 content

dissolved + O2 attached to Hb

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diaphragm perforation at T8

IVC

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diaphragm perforation at T10

esophagus, vagus nerve

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diaphragm perforation at T12

aorta, thoracic duct, azygous vein

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V/Q of Zero

airway obstruction

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V/Q of infinity

blood flow obstruction

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Response to High Altitude

increase ventilation
increased EPO
increased BPG
increased mitochondria
increased renal excretion of bicarb

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hypertrophy of mucous glands

bronchitis

increased elastase

emphysema

anthracosis location

coal mine | upper lobes

silicosis location

sandblasting, mines | upper lobes

asbestosis location

lower lobes

tracheal dviation towards side of lesions

atelectasis, spontaneous pneumo

tracheal deviation AWAY from side of lesion

tension pneumothorax

L-myc

small cell carcinoma of lung

Kluchitsky cells

small, dark blue cells | small cell carcinoma of lung

keratin pearls and intracellular bridges

squamous cell carcinoma of lung

psammomma bodies

mesothelioma

theophylline

inhibits phosphodiesterase and causes bronchodilation | blocks adenosine

montelukast, zileuton

anti-leukotrienes

zileuton

5 lipooxygenase inhibitor | inhibts arachidonic acid to leukotrienes

guaifenesin

thins resp secretions

bosentan

treats pulmonary arterial hypertension comp antagnst of endothelin-1 receptor decreases PVR

dextromethorphan

anti-tissuive, antagnoizes NMDA glutamate receptors

dextromethorphan overdose

naloxone

pseudoephedrine/phenylephrine

alpha-agonists

Potter Syndrome

pulmonary hypoplasia limb deformities oligohydroaminos/renal agenesis

high sweat chloride concentrations more negative nasoepithelial surface increased sodium absorption

theophyelline side effects

seizures | tachyarrythmias

neutrophil chemotaxis caused by

leukotriene B4

peak of exercise, you have

CO2 content in mixed venous blood

increased ESR due to which cytokines

TNF alpha IL-1 IL-6

Flucytosine

targets fungal DNA and RNA synthesis

Capsofungin

targets fungal cell wall

Amph B

binds ergosterol

Nystatin

binds ergosterol

Azoles

inhibit ergosterol synthesis

Central Receptors

medulla | monitor Co2, PH

Peripheral Receptors

carotid and aortic bodies | monitor, O2 (and CO2 and pH)

carotid body sends signals via

glossopharyngeal n

aortic body sends signals via

vagus nerve

chronic COPD and supplemental O2

only hypoxia stimulates resp center

particles 10-15

UR trapping

particles 2.5-10

mucociliary transport

particles <2

macrophages/phagocytosis

low PVR

FRC

high PVR

TLC | RV

airway resistance highest in

medium sized bronchi (due to turbulent airflow)

bronchiole epithelium

pseudostratified to simple colmnar | lose cilia in alveoli

CFTR -type of protein

ATP gated

PO2

inspired - 160 trachea - 150 alveolar - 104 venous - 40

Pco2

trachea - 0 alevolar - 40 venous - 45

tb drug activated by catalse-peroxidase

isoniazid

stages of pneumonia

congestions, red hep, grey hep, resolution

intraalveloar wall destruction

emphysema

lung abscess

release of lysosomal enzymes

Reid index

chronic bronchitis | thickness of mucous gland/bronchial wall

lung - hyperacute injury

blood vessel spasm

lung - acute injury

vascular damage

lung - chronic rejection

small airways/bronchiolitis obliterans

increased work of breathing

pulmonary fibrosis

relative polycythemia

excessive diuretics, dehydration

primary vs secondary polycythemia

1 - low EPO | 2 - high EPO

tryptase released from

mast cells

long term outcomes of COPD

low PO2, high PCO2 --> cerebral vasodilation (decrease in cerebral vascular resistance)

hamartoma

benign lung tumor | hyaline cartilage, fat, smooth muscl

popcorn calcifications

hamartoma

neonatal O2 supplementation consequences

retinal damage (upregulated VEGF)

cough reflex

internal laryngeal nerve

gag reflex

glossopharyngeal nerve

adenocarcinoma of lung

peripheral

large cell carcinoma of lun

peripheral | galactorrhea, gynecomastia

vagal stimulation of lungs

M3/Ach receptors increase smooth muscle constriction increase mucous secretions (increase work of breathing)

hypoxemia - normal A-a gradient

high altitude | hypoventilation

hypoxemia - increase A-a gradient

V/Q mismatch diffusion limitation RtoL shunt

rifampin

inhibits DNA dependent RNA synthesis | red urine

birefringent particles

silica

cromolyn

inhibits mast cell cegradation

toxo prophylaxis

tmp-smx

mac prophylasis

azithromycin

histo prophylaxis

itraconazole

Ethambutol mofa

inhibits arabinosyl transferase | carbohydrate polymerzation in cell wall synthesis of myocbacteria

Cheyne-Stokes breathing

cycles of hyperventilation and apnea cardiac - chf neuro - tumor, TBI, stroke

primary PAH

increase endothelin decrease NO and prostacyclin vascular smooth muscle proliferation

other causes of PAH

LHF chronic hypoxia (sleep apnea, COPD) chronic TE HIV

bronchioalveolar carcinoma

tall, columnar cells that secrete mucosa

eosinophilia and cytokine association

IL-5

increased ca in

TB Sarcoid HL NHL

sqaumous metaplasia in pancreatic ducts

vit a def

rifampin monotherapy

menigococcal exposure

green sputum color

myeloperoxidase (heme)

isoniazid mofa

inhibits mycolic acid synthesis

inotropes

increase CONTRACTILITY | increase ca current

chronotropes

increase SA NODE firing rate (increase HR) | increase Na and Ca

dronotropes

increase conduction velocity thru AV NODE | increase Ca current

Clara cells

produce part of surfactant, site of p450 stuff

S viridans treatment

penicillin

Norcardia

GP+, weakly acid fast | lung and brain abscesses

thiazide diuretics - urine

Na-cl

Loop diuretics - urine

Na, Cl K and Ca | loops lose Ca

toxins that increase cAMP

pertussis | vibrio

largest effect on LDL

HMG-CoA Reductase

largest effect on triglycerides

fibrates

largest effect on increasing HDL

niacin

Niacin mofa

inhibits lipolysis in adipose tissue

niacin ae

red face hyperglycemia (acanthois nigrans) hyperuricemia

bile acid resins

prevent intestinal reabsorption of bile | can have cholesterol gallstones

cholesterol gallstones from which meds

bile acid resins | fibrates

ezetimbie

prevents cholesterol reabsorption | increase LFTs

fibrates mofa

upregulate LPL | myositis, hepatotoxicty, cholesterol gallstones

Hmg Coa reducatse AE

hepatotoxicity | rhabdomyolysis

ARDS caused by a virus

hantavirus, association with rodents

vaginal bacteria

lactobailli (faculative anaerobes)

medial rotator of arm

subscapularis

preeclampsia at 20 weeks is suggestive of

molar pregnancy

BRCA1 and 2 located on which chromosome

17 | 13

medical abortion, mifepristone often co adminstered with

oxytocin-like drug

direct acting sympathomimetics

less receptor binding in CNS

treatment for carcinoid tumors

ocretide

carcinoid tumors originate in

liver

Salmeterol

LA B2 agonist

Albuterol

SA B2 agonist

peaked T wavers

hyperkalemia

Chlamydia psittaci

birds

stimulate lipoprotein lipase by activation of PPAR-alpha protein

fibrates

young patient, CHF symptoms, especially after URI

coxsackie B

degeneration of anterior horns and corticospinal tracts

ALS

degeneration of anterior horns

polio

degeneration of anterior white commisure

syringomyelia

degerneration of posterior columns and corticospinal tracts

pernicious anemia

degeneration of posterior columns

syphilis

mittelschmerz

ovulation pain

estradiol

ovaries

estrone

adipocytes

androstenedione

adrenal cortex

Fitz-Hugh-Curtis syndrome

PID, perihepatitis

dilated airways

bronchiectasis

2nd line after statins for cholesterol

cholestyramine (binds bile acids)

Mobitz type II heart block caused by defect in

his-purkinje system