Respiratory Flashcards
Methemoglobin
oxidized form (Fe3+), doesn't bind O2 as well increased affinity for cyanide
Nitrate poisoning
oxidize to Fe3+
cyanide poisoning
use nitrates to oxidize hemoglobin to methemglobinemia and bind cyanide
allows cytochrome oxidase to function
thiosulfate to bind cyanide and renal excrete
carboxyhemoglobin
Hg bound to O2, left shift
decreased oxygen unloading
Primary Pulmonary Hypertension gene
BMPR2 gene
fat emboli
long bone fratures
liposuction
alveolar hyperventilation
hypocapnia
paCO2= BMR/alv vent
Tb med that requires acidic environment
pyrazinamide
N-acetylcysteine mechanism in CF treatment
reduces intermolecular disulfide bridges
histo of true vocal cords
stratified squamous
mycolic acids
long, branched, saturated Fatty acids
PE (changes in O2, etc)
hypoxemia
hyperventilation
resp alkalosis
CO poisoning (O2 values)
Normal Po2 (dissolved O2)
decreased O2 saturation
decreased O2 content
Anemia (O2 values)
Normal PO2
Normal O2 sat
decreased O2 content
Polycythemia (O2 values)
Normal Po2
Normal O2 sat
increased O2 content
P02
dissolved oxygen
percent saturation of O2
O2 per gram of Hb
O2 content
dissolved + O2 attached to Hb
diaphragm perforation at T8
IVC
diaphragm perforation at T10
esophagus, vagus nerve
diaphragm perforation at T12
aorta, thoracic duct, azygous vein
V/Q of Zero
airway obstruction
V/Q of infinity
blood flow obstruction
Response to High Altitude
increase ventilation increased EPO increased BPG increased mitochondria increased renal excretion of bicarb
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
CF
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