Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Step 1 notes > respiratory > Flashcards

respiratory Flashcards

1
Q

respiratory tree histology:

from bronchiloes - terminal bronchiloes - respiratory bronchiloes: histological transition?

SMCs extend to where?

A

histological transition: pseudostratified ciliated columnar cells extend to the begining of terminal bronchiloes , then become cuboidal cells

SMCs extend to where: end of terminal bronchiloes

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

surfactant:

made by?
成分？
begin at gestational age? mature at?

which value in amniotic fluid indicates fetal lung maturity

A

made by: type II pneumocytes

成分: mix of lecithins (卵磷脂), the most important one is dipalmitoylphosphatidylcholine 二棕榈酰磷脂酰胆碱

begin at gestational age: wk 26
mature at wk 35

which value in amniotic fluid indicates fetal lung maturity: lecithin : sphingomyelin > 2

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

compliance:

define:
↓ in?
↑ in?

A

define: change in lung volume for a given pressure change (可以理解为肺部往外张的力量）

↓ in： pulmonary fibrosis, pneumonia, edema

↑ in: emphysema

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

Oxygen-Hb dissociation curve: right shift means? 哪些因素导致右移？

A

right shift means： ↑ O2 load (需要氧气的时候）

哪些因素导致右移: BAT ACE

BPG
Altitude 
Temperature ↑
Acid
CO2
Exercise
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

methemoglobin:

affinity to O2?
Cx
Rx

A

高铁血红蛋白

oxidized form of Hb (Ferric = Fe3+; Ferrous = Fe2+ [just the 2 of us])

methemoglobin has ↓ affinity to O2, but ↑ affinity to cyanide 氰化物

Cx: cyanosis, chocolate-colored blood

Rx: Methylene blue

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

CO2 transportation to the lung?

哪几种途径？

A
  1. HCO3- (95%)
  2. bind to the N-terminus of glob in (Not heme !!!)
  3. dissolved CO2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Rhinosinusitis:

MCC
MC location

A

MCC:

  • S. pneumoniae
  • H. influenzae
  • M. catarrhalis 粘膜炎莫拉菌 [Moraxella catarrhalis is a fastidious, nonmotile, Gram-negative, aerobic, oxidase- positive diplococcus]

MC location: maxillary sinuses

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

DVT:

“Virchow triad”

Sign “Homan sign”

Rx?

A

“Virchow triad”: stasis, hypercoagulability, endothelial damage (e.g.. smoking)

Sign “Homan sign” -calf pain

Rx:
1. prevention and acute management: heparin

  1. long-term prevention for recurrence: warfarin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Pulmonary embolism:

types?
How to diff PE formed before vs. after death?

A

types: FAT BAT

How to diff PE formed before vs. after death: Zahn area (间隔的pink and red zone) formed only before death

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

COPD:

定义
包括哪些疾病？
patho:
肺功能变化：RV, TV, FVC, FEV1?

A

定义：obstruction of air flow, - air trapping in the lung - airways close at high volume

包括哪些疾病:

  1. chronic bronchitis
  2. emphysema
  3. asthma
  4. bronchiectasis 支气管扩张

patho:
肺功能变化：RV ↑, TV ↓, FVC （forced vital capacity, 能呼吸的最大体积）↓, FEV1 （第一分钟能呼出的体积） ↓↓↓

hallmark: FEV1/FVC ↓

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

Chronic bronchitis:

patho:
病理变化用什么指标测量？
Cx

A

patho:

The major contributor of the wall thickening in bronchitis is the mucous gland enlargement (hyperplasia)

病理变化用什么指标测量:
Reid index (thickness of gland layer/total thickness of bronchial wall) > 50%  [normal < 40%]

Cx: productive cough > 3 m per year, for 2 yrs

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

Emphysema:

外观
分型，各自的association

变化： recoil, compliance, elastase activity

肺功能变化：Total lung V, FVC, FEV1, diffusion capacity

A

外观: “pink puffer”, barrel-shaped chest

变化：elastase activity ↑ - recoil ↓ , compliance ↑,

分型，各自的association:

  1. centriacinar: smokinh
  2. panacinar - a-antitrypsin deficiency (most important player: neutrophils)

肺功能变化：Total lung V ↑, FVC ↓, FEV1 ↓↓↓, diffusion capacity ↓

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

Asthma:

Patho2个特点？

Challenge test for Dx

which type of hypersensitivity?

Rx:

A

Patho2个特点：Curschmann spirals, Charcot-Leyden crystals

Challenge test for Dx: (in pts suspect for asthma - family history for 过敏性鼻炎，异位性皮炎， but spriometry can’t catch it): methacholine challenge test, or histamine, cold air, exercise

which type of hypersensitivity: type I (IgE-mediated)

Rx:

  1. alpha1 agonist (bronchidilator - albuterol)
  2. glucoticoids: flunisolide 氟尼缩松，9-去氟肤轻松
    - 1st line for prevention and control of acute attack;

if aerosol: ask pt to rinse oral cavity and use spacer (prevent Candiditis)
3. theophylline [ˌθiə`filin] 茶碱 (PDE, ↑ cAMP)

  1. drugs to inhibit mast cell degrunulation: Cromolyn, nedocromil
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

bronchiectasis

Patho
Associated diseases

A

支气管扩张

Patho: chronic necrotizing infection - permanent dilated airways

Associated diseases: Kartagener syn, CF, aspergillosis infection

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

Restrictive lung disease:

define:
change in 肺功能：lung volumes (TLV, FVC), FEV1/FVC ratio

分类标准

A

define: restricted lung expansion (限制性肺病，无法在吸气时膨胀）

change in 肺功能：
↓ lung volumes (TLV, FVC),
FEV1/FVC ratio > 80% (注意：obstructive 肺病中 FEV1/FVC ratio ↓; normal = 80%）

分类标准：

  1. 肺外因素引起，normal A-a gradient
  2. 肺自身因素引起，↑ A-a gradient
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

hypersensitivity pneumonitis:

which type of hypersensitivity?
Cx?
人群？

A

which type of hypersensitivity： mixed III/IV

Cx: dyspnea, cough, chest tightness, headache

人群: farmers and those who exposed to birds

17
Q

pneumoconioses, or pneumoconiosis [ˌnju:məuˌkɔni`əusis]：

包括？
↑ for ?

A

尘肺,

包括
1） silicosis [ˌsilikəusis] 矽肺， 石末沉着病 2）asbestosis [ˌæsbestəusis] 石棉沉着病
3) coal worker’s pneumoconiosis

↑ for cor pulmonale (肺心病) and Caplan syn

18
Q

asbestosis [ˌæsbes`təusis]

associated 职业？
累及肺叶？
特征性病灶 （pathognomonic）？
associated with ↑ incidence for?

A

石棉沉着病

associated 职业: building (insulation里含大量石棉）， roofing, plumbing

累及肺叶: lower lobes

特征性病灶 （pathognomonic）: “Ivory white” calcified pleural plaques - but not pre-cancerous

associated with ↑ incidence for: bronchogenic carcinoma, mesothelioma 间皮瘤

19
Q

coal worker’s pneumoconiosis

Patho?
which immune cells play the major role?
累及肺叶？

A

“black lung disease”

anthracosis[ænθrə`kəusis]
炭末沉着病，炭肺：煤尘沉着于肺所致的一种常见无症状的肺尘埃沉着病，存在于多数城市居民中；大量煤尘积聚可致煤矿工人肺尘埃沉着病

which immune cells play the major role: macrophage

累及肺叶: upper

20
Q

silicosis：

associated 职业？
累及肺叶？
特征性病灶 ？
which immune cells play the major role?
associated with ↑ incidence for?
A

矽肺

associated 职业： foundries (金属铸造厂）， mines, sandblasting

累及肺叶: upper [diff with asbestosis]

特征性病灶 : “eggshell” calcification of hilar lymph nodes

which immune cells play the major role: macrophage

associated with ↑ incidence for: TB, bronchogenic carcinoma

21
Q

NRDS (neonatal respiratory distress syn):

Patho
how to predict
心脏risk?
supplemental O2 may cause?

risk factors?
Rx

A

Patho: surfactant deficiency - alveolar collapse

how to predict: lecithin : sphingomyelin ratio < 1.5 in 羊水

心脏risk：PDA

supplemental O2 may cause: retinopathy, bronchopulmonary dysplasia

risk factors: prematurity, maternal DM, C-dection

Rx: maternal steroids before birth, artificial surfactant for infants

22
Q

ARDS (acute respiratory distress syn):

Cause
Patho 特征
major players
XR表现

A

Cause： trauma, sepsis, shock, acute pancreatitis, amniotic fluid embolism

Patho 特征: protein-rich leakage into alveoli, thickened hyaline membranes

major players: neutrophils

XR表现: near-complete opacification, obscured cardiomediastinal sihouette

23
Q

PH (pulmonary hypertension):

normal pulmonary a pressure? 肺动脉高压诊断指标？

Primary (PPH): 好发人群？gene mutation? Dx? Rx?

Secondary

Course?

A

normal pulmonary a pressure： 10-14 mmHG
肺动脉高压诊断指标: > 25 mmHg

Primary (PPH):

  • 好发人群: 20 - 40 yr women
  • gene mutation: inactivation mutation of BMPR2 (which inhibit VSMC proliferation)
  • Dx: 心脏echo见coronary sinus (where LA receives blood from pulmonary, 正常看不见）
  • Rx: Bosentan (ET inhibitor) 波生坦; lung transplantation

Secondary

Course

24
Q

Sleep apnea

define
最严重的后果
Rx

A

睡眠呼吸暂停

最严重的后果: pulmonary HTN - RHF, then systemic HTN; arrhythimias , sudden death

25
Q

Lung-physical findings:

hyperresonant percussion indicates?

A

pneumothorax

26
Q

lung cancer: 1st leading cause of cancer death

CXR
CT

最常见的是其他肿瘤的肺转移（比原发多见）， 按顺序是：

肺癌的远处转移按顺序？

complication 口诀？

分类？哪些在central, 哪些peripheral? 除哪一种外都和抽烟有关？

A

CXR: “coin” lesion

CT: noncalcified nodule

最常见的是其他肿瘤的肺转移（比原发多见）， 按顺序是：breast > colon > prostate > bladder cancer

肺癌的远处转移按顺序：adrenal, brain, bone (pathological fracture), liver (jaundice, hepatomegaly)

complication 口诀: SPHERE

Pancoast syn: lung apex (supeiror sulcus), pain in the shoulder region radiates to axilla and scapula [C8, T1, T2 roots = lower branchial plexus] - MC asscoiated with small cell carcinoma

分类: LABSS
Large cell carcinoma
Adenocarcinoma
Bronchial carcinoid tumor
Squamous cell carcinoma
Small (oat) cell carcinoma

哪些在central: Squamous and
Small (oat) cell carcinoma are “S”entrap

哪些peripheral: LAB

除哪一种外都和抽烟有关: Bronchial carcinoid tumor

27
Q

adenocarcinoma:

在肺癌中发生率？
location
mutation
associated with
一个subtype (adenocarcinoma in situ): CXR
Px?
A

在肺癌中发生率: MC lung cancer in nonsmokers as well as overall [note: except for metastases; 肺癌最多还是转移】

location： peripheral

mutation: activation mutation of k-ras, ALK, EGFR

associated with: clubbing (hypertrophic osteoarthropathy)

一个subtype (adenocarcinoma in situ): bronchioloalveolar subtype: grow along alveolar septa, - apparent thickening of alveolar walls
CXR: Hazy infiltrates similar to pneumonia

Px: excellent

28
Q

Squamous cell carcinoma:

location
notes: 4C
patho见？

A

location： “S”entral

notes: 4C: cavitation, cigarrettes, hyperCalcimia, Central

patho见 “keratin pearls and intercellular bridges”

29
Q

small (oat) cell carcinoma:

location
notes: 4A
分化如何？
mutation?
patho见？
Rx
A

location: central [ “S”entral]
notes: 4A: produce ACTH, ADH, Ab against presynaptic Ca2+ channel - Lambert-Eaton myasthenia syn; Ampliferation of myc
mutation: myc

分化如何: undiff, very aggressive

patho见neuroendocrine “Kulchitsky cells” - small dark blue cells with nuclear molding, high mitotic rate, necrosis, “salt and pepper” neuroendocrine-type chromatin

Rx: inoperable, chemo

30
Q

larges cell carcinoma:

location
分化如何？
Px?
patho见？
Rx
A

location: peripheral

分化如何: highly anapestic undifferentiated

Px: poor

patho见 pleomorphic 多型的 giant cells

Rx: remove surgically, less responsive to chemo compared to small cell carcinoma

31
Q

bronchial carcinoid tumor:

Px? 转移是否多见
Cx
patho见？

A

Px: excellent

转移是否多见; no

Cx: mass effect 占位效应

patho见 nest of neuroendocrine cells; chromogranin A +
[ˌkrəuməu`ɡrænin] 嗜铬粒蛋白

32
Q

Pancoast tumor:

部位
Cx

A

部位: lung apex

Cx

33
Q

SVC (superior vena cava syn):

cause
Cx
can cause?

A

cause: malignancy and thrombosis from indwelling catheters

Cx:

  • 压迫head blood drainage : facial plethora 多血〔症〕：指肤色红润的一般术语
  • neck: jugular v distension
  • upper extremitis: edema

medical emergency, can increase intracranial pressure - headache, dizziness, ↑ risk of aneurysm/ rupture of intracranial a

Step 1 notes (22 decks)

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