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First Aid > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Which type of pneunomycte proliferates during lung damage?

A

Type II

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2
Q

What is the most important lecithin?

A

Dipalmitoylphosphatidylcholine

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3
Q

What week does surfactant production begin? End?

A

begin = 26

end = 35

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4
Q

What does RALS mean?

A

relation of pulmonary artery to bronchus at right and left side

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5
Q

What are the five cause of an O2-Hb right shift?

A

Cl-

H+

temperature

CO2

23BPG

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6
Q

What is the function of nitrites in treating Cyanide poisoning? Purpose of thiosulfate?

A

nitrites = Hb into Methemoglobin (Fe3+) which binds cyanide

thiosulfate = thiosulfate = water soluble

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7
Q

How many mL’s of O2 can be bound in one dL?

A

20.1

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8
Q

What does PA mean?

A

partial pressure of gas in alveolar air

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9
Q

What does Pa mean?

A

partial pressure of gas in pulmonary blood

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10
Q

Name an organism that thrives in high O2 of the lung? Where would this organism be found?

A

TB

apex of lung

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11
Q

What is the triad of a fat emboli?

A

hypoxemia

petechiae

neurological abnormalities

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12
Q

What is the test of choice for a PE?

A

CT pulmonary angiography

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13
Q

What is the unique location where lung cancer likes to metastisize?

A

adrenal glands

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14
Q

What is Stewart-Treves Syndrome?

A

lymphatic malignancy associated with persistent lymphedema

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15
Q

What is the hallmark of bronchitis?

A

hyperplasia of mucus secreting glands in the lung

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16
Q

What is the Reid Index? What does the Reid Index have to be to diagnose chronic bronchitis?

A

thickness of lung glands/total thickness

greater than 50%

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17
Q

What type of emphysema is associated with smoking? What lobes?

A

centriacinar

upper

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18
Q

What type of emphysema is associated with α1 anti-Trypsin activity? What lobes?

A

panacinar

lower

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19
Q

What is the hallmark of asthma?

A

hypertrophy of lung smooth muscle

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20
Q

What are the two histological findings of Asthma?

A

Curschmann spirals

Charcot-Leyden Crystals

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21
Q

What are Curshmann Spirals composed of?

A

mucus plugs with whorls of shed epithelium

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22
Q

What are Charcot-Leyden Crystals composed of?

A

major basic protein from eosinophils

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23
Q

What is pulsus paradoxus?

A

drop in systolic pressure upon inhalation

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24
Q

What is Bronchiectasis?

A

necrotizing infection of bronchi that leads to permanent dilation

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25
Q

Name two diseases that cause Bronchiectasis?

A

Kartagener

Cystic Fibrosis

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26
Q

Name an infective disease that causes Bronchiectasis?

A

Aspergillosis

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27
Q

Is sarcoidosis a caseating or noncaseating granuloma?

A

noncaseating

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28
Q

What two lab values would be increased during Sarcoidosis?

A

ACE and Ca2+

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29
Q

What are the three pneumoconioses?

A

anthracosis

silicosis

asbestosis

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30
Q

What four drugs are known to cause lung fibrosis?

A

busulfan

bleomycin

amiodarone

methotrexate

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31
Q

Would ARDS be a restrictive or obstructive disease?

A

restrictive

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32
Q

Would pulmonary Langgerhans Cell Histiocytosis be a restrictive or obstructive lung disease?

A

Obstructive

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33
Q

Hypersensitivity Pneumonitis may occur as a result to exposure to what two allergens?

A

Farmers

birds

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34
Q

How does sarcoidosis present in the eye?

A

anterior uveitis

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35
Q

What is Caplan Syndrome?

A

rheumatoid arthritis and pneumoconiosis

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36
Q

What part of the lung does asbestos effect?

A

base

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37
Q

What part of the lung does asbestos effect?

A

lower

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38
Q

What part of the lung do silica and coal effect?

A

upper

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39
Q

Which pneumoconioses increases risk to TB?

A

Silicosis

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40
Q

Which pneumoconioses increases risk of bronchogenic carcinoma?

A

silicosis

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41
Q

Below what ratio of lecithin:sphingomyelin is predictive or NRDS?

A

1.5

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42
Q

Other than drugs, what keeps a PDA open?

A

Hypoxemia

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43
Q

What are the two consequences of supplemental O2 during NRDS?

A

Bronchogenic dysplasia

retinopathy

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44
Q

What increases the risk of NRDS?

A

insulin

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45
Q

What decreases the risk of NRDS?

A

glucocorticoids

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46
Q

What mm of Hg would signal pulmonary HTN?

A

> 25 mm Hg

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47
Q

What gene is Primary Pulmonary HTN associated with?

A

BMPR2

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48
Q

What is the normal function of BMPR2?

A

inhibit smooth muscle function

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49
Q

What is a Pancoast tumor?

A

tumor in apex of lung

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50
Q

Which four cancers commonly metastisize to the lung?

A

bladder, colon, breast, prostate

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51
Q

What are four sites lung cancer commonly metastisizes to?

A

Adrenal, Brain, Bone, liver

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52
Q

Are adenocarcinomas central or peripheral?

A

peripheral

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53
Q

What type of lung cancer most often appears in non-smokers?

A

adenocarcinoma

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54
Q

What three oncegenes is lung adenocarcinoma associate with?

A

KRAS/EGFR/ALK

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55
Q

Which lung cancer is associated with clubbing?

A

Adenocarcinoma

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56
Q

Which type of lung cancer grows along the alveolar septa?

A

Bronchioloalveolar subtype

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57
Q

Is squamous cell carcinoma central or peripheral?

A

central

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58
Q

Which lung cancer subtype produces a cavitation?

A

squamous

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59
Q

Cigarette smoking most often causes what type of lung cancer?

A

squamous

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60
Q

Which type of lung cancer is associated with hypercalcemia? Why?

A

squamous

releases PTHrp

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61
Q

What are the two histological findings of squamous cell lung cancer?

A

keratin pearls/whorls

intercellular bridges

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62
Q

Which type of lung cancer often arises from the bronchi?

A

squamous

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63
Q

Is small cell lung cancer central or peripheral?

A

central

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64
Q

What are the three PNP products released by small cell lung cancer?

A

ADH

ACTH

Antibodies to L-type Ca2+ channels (EL)

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65
Q

L-myc is implicated during the pathogenesis of what type of lung cancer?

A

small cell

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66
Q

What cell type is small cell lung cancer derived from?

A

Kulchitsky

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67
Q

Is a Large Cell Lung Carcinoma central or peripheral?

A

peripheral

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68
Q

What is the prognosis of Large Cell Lung Carcinoma?

A

poor

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69
Q

What does Large Cell Lung Carcinoma look like on histology?

A

pleomorphic giant cells

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70
Q

Which lung cancer would stain positive for Chromogranin A?

A

Carcinoid

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71
Q

Pancoast tumor can cause what two syndrome?

A

SVC Syndrome

Horner Syndrome

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72
Q

Which bacteria is the most common to superimpose itself on a viral lung infection?

A

Staph. aureus

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73
Q

Lobar pneumonia. Name three bacteria on differential.

A

S. pneumoniae

Legionella

Klebsiella

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74
Q

Legionella pneumonia would be associated with what common source?

A

aerosolized water

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75
Q

What four bacteria are known to cause bronchopneumonia?

A

S. pneumoniae

S. aureus

H. influenzae

Klebsiella

76
Q

Does interstitial pneumoniae present quickly or indolently?

A

indoldent

77
Q

Which three bacteria are known to cause Interstitial Pneumoniae?

A

Mycoplasma

Legionella

Chlamydia

78
Q

What type of pneumoniae do viruses cause?

A

interstitial

79
Q

What three viruses are known to cause interstitial pneumoniae?

A

RSV

Influenza

Adenovirus

80
Q

Which three bacteria are implicated in aspiration pneumonia?

A

Bacteroides

Fusobacterium

Peptococcus

81
Q

Is transudate protein rich or protein poor?

A

protein poor

82
Q

Would a pleural effusion with transudate or exudate be at an increased risk of infection?

A

exudate

83
Q

What person does a spontaneous pneumothorax arise in?

A

tall, thin young man

84
Q

What is the common name for 2nd generation histamine blockers?

A

“-adine”

85
Q

Why are 2nd generation histamine blockers less sedating?

A

less penetration into CNS

86
Q

What are the two expectorants?

A

Guaifensein

N-acetylcysteine

87
Q

What is the antidote for dextromethorphan?

A

naloxone

88
Q

What receptor does dextromethorphan antagonize?

A

NMDA

89
Q

What drug functions similarly to salmeterol?

A

formoterol

90
Q

Does theophylline produce bronchoconstriction or bronchodilation?

A

dilation

91
Q

What is the MOA of theophylline?

A

inhibits phosphodiesterase

92
Q

Which receptors does ipratropium antagonize in the lung?

A

muscarinic

93
Q

What is the transcriptional product of NFKB?

A

TNFα

94
Q

What are the two steroids used for lung inflammation?

A

Beclomethasone

fluticasone

95
Q

What are the two leukotriene receptor antagonists?

A

Montelukast

Zafirlukast

96
Q

What drug blocks the conversion of arachidonic acid to leukotrienes?

A

Zileuton

97
Q

What is the endothelin receptor antagonist?

A

Bosentan

98
Q

What is Omalizumab an antibody against? Free or receptor bound?

A

IgE

free

99
Q

Which Fc receptor does IgE bind?

A

Fc-gamma-R1

100
Q

What is the relationship of the pulmonary artery to the bronchus on the right and the left side?

A

Right = anterior

left = posterior

101
Q

What is fungal sinusitis a complication of?

A

diabetes

102
Q

What happens to the lung surface area during emphysema?

A

decreases

103
Q

What is the Haldane Effect?

A

oxygenation of Hb promotes dissociation of H+

104
Q

What is the Bohr Effect?

A

H+ dissociates O2 from Hb in peripheral tissues

105
Q

How does the majority of CO2 get back to the lungs?

A

as bicarb in RBCs

106
Q

What is the Chloride Shift?

A

exchage of HCO3 and chloride

107
Q

Would ACD cause a left shift or right shift of O2-Hb dissociation curve?

A

right

108
Q

What cells in the kidney is 1α-Hydroxylase located?

A

PCT

109
Q

What is the Homan test? What is the Homan test indicative of?

A

pain on dorsiflexion of foot

DVT

110
Q

What is Stewart-Treves Sydnrome? What causes it?

A

lymphangiosarcoma

long standing lymphadenitis

111
Q

Is Lofgren Syndrome an acute or chronic sarcoidosis?

A

acute

112
Q

What are the four symptoms of Lofgren Syndrome?

A

Hilar lymphadenopathy

fever

arthralgia

erythema nodosum

113
Q

What is almost always the cause of Langerhans Cell Histiocytosis of the lung?

A

smoking

114
Q

What are the two common presentations of Langerhans Cell Histiocytosis of the lung?

A

Pulmonary HTN

recurrent pneumothorax

115
Q

Which pneumocytes are destroyed during ARDS?

A

Type I and Type II

116
Q

What causes the k-Ras mutations in lung adenocarcinoma?

A

smoking

117
Q

What patient population is the EGFR mutation seen during lung adenocarcinoma?

A

asians

118
Q

In what populations are ALK mutations seen that lead to lung adenocarcinoma?

A

nonsmokers and young

119
Q

Which cells give rise to Bronchioalveolar Carcinoma?

A

club cells

120
Q

What three mutations are seen during Small cell carcinoma

A

Rb

p53

EGFR

121
Q

What are the three stains of small cell lung cancer?

A

chromogranin

synaptophysin

CD56

122
Q

WHat is the main virulence factor of H. influenzae?

A

IgA protease

123
Q

Kiesselbachs plexus is located at the anterior or posterior nasal septum?

A

anterior

124
Q

What is the mode of inheritance of A1AT?

A

co-dominant

125
Q

Is sleep apnea a problem of the pharynx or larynx?

A

pharynx

126
Q

Are lobular arteries in the center or periphery?

A

center

127
Q

Are lobular veins in the center or periphery?

A

periphery

128
Q

Pseudostratified ciliated columar epithelium extends all the way to what structure?

A

respiratory bronchiole

129
Q

Smooth Muscle extends all the way to what structure?

A

terminal bronchiole

130
Q

What type of epithelium is found in the respiratory bronchioles?

A

cuboidal

131
Q

Does sarcoidosis have lymphocytes in them?

A

yes

132
Q

Particles smaller than what size can make their way to the respiratory bronchiole?

A
133
Q

Alveolar macrophages relase cytokines that that to what during their phagocytic activity?

A

fibrosis

134
Q

Which part of the lung is the greatest contributor to anatomic dead space?

A

apex

135
Q

Does hemoglobin have positive or negative allostery?

A

negative

136
Q

What is bound to Hb during Carboxyhemoglobin?

A

CO

137
Q

What is a normal A-a gradient?

A

10-15

138
Q

Is the venous amount of O2 increased or decreased during cyanide poisoning?

A

increased

139
Q

Do only peripheral or central chemoreceptors respond to O2?

A

peripheral

140
Q

In which two situations does O2 become diffusion limited?

A

exercise

alveolar damage

141
Q

What are the three perfusion limited gases?

A

N2O/CO2/O2

142
Q

What is the diffusion limited gas?

A

CO

143
Q

What is the equation for Pulmonary Vascular Resistance?

A

Pressure in pulm. artery = left atria pressure/CO

144
Q

Is ventilation higher at the base of the lung or apex?

A

base

145
Q

Is perfusion higher at the base of the lung or apex?

A

base

146
Q

What is the phrase for pulmonary fibrosis on Xray?

A

“bilateral reticulonodular opacities”

147
Q

Is Pulmonary FIbrosis greater in apex or base of lungs?

A

base

148
Q

What percent of CO2 is transported as HCO3?

A

90%

149
Q

Do restrictive lung diseases breath at a high or low rate?

A

high

150
Q

Do obstructive lung diseases breath at a high or low rate?

A

low

151
Q

Which nerve mediates the cough reflex?

A

internal laryngeal nerve

152
Q

Would a PE more likely go to base or apex of lung?

A

base

153
Q

Which two drugs can cause Pulmonary HTN?

A

cocaine and amphetamines

154
Q

Which heart structure can be visible during Pulmonary HTN?

A

coronary sinus

155
Q

Which tumor marker may be released by Large Cell Carcinoma of lung?

A

B-HCG

156
Q

A bacterial lung abscess is caused by which two types of bacteria?

A

S. aureus or anaerobes

157
Q

Does panacinar emphysema affect the upper or lower lobes?

A

upper

158
Q

Does centriacinar emphysema affect the upper or lower lobes?

A

lower

159
Q

What is the Hering-Bruer reflex?

A

stretch receptors in the lungs inhibit further inspiration

160
Q

What does J Receptor stand for?

A

Juxtacapillary

161
Q

Does obstructive atelectasis cause the trachea to deviate to or from the obstruction?

A

towards

162
Q

How does obstructive atelectasis look on CXR?

A

unilateral opacification

163
Q

Can aspiration pneumonia have giant cells?

A

yes

164
Q

What type of atelectasis would present post-operatively within one hour with a fever?

A

resorption

165
Q

What are the three first generation H1 blockers?

A

Diphenhydramine

Dimenhydrinate

Chlorpheniramine

166
Q

Does Guaifenesin thin secretions or break up mucus plugs?

A

this

167
Q

Does N-acetylcysteine thin secretions or break up mucus plugs?

A

break up plugs

168
Q

What is the toxicity of Bosentan?

A

hepato

169
Q

What are the two toxicities of Iliprost and epoprostenol?

A

jaw pain and flushing

170
Q

Which artery in the posteriior nasal septum can cause life threatening bleeding?

A

sphenopalatine

171
Q

What is the toxicity of Ziluteon?

A

hepato

172
Q

What are the three toxicities of NRDS regarding oxygen administration?

A

Retinopathy

Intra-ventricular hemorrhage

Bronchopulmonary dysplasia

173
Q

Would Retinopathy of Prematurity have increased or decreased vasculation? Why?

A

increased

hypoxia induces VEGF

174
Q

What does thyroxine do to surfactant production?

A

increase

175
Q

What are the two new tests for surfactant production in kids?

A

FOAM stability

surfactant/albumin

176
Q

Which cell mediates the fibrosis of asbestosis?

A

macrophages

177
Q

What type of calcifications for pneumoconioses?

A

eggshell

178
Q

What type of pneumoconioses can present with Birefringment Crystals?

A

Silicosis

179
Q

What type of pneumoconioses can increase the risk of bronchogenic carcinoma?

A

silicosis

180
Q

Which procedure can cause a loss of peripheral chemoreceptors?

A

bilateral carotid endarterectomy

181
Q

Does silicosis affect the upper or lower lungs?

A

upper

182
Q

Are lines of Zahn found in a stasis clot or an embolus?

A

embolus

183
Q

What is the time frame for bronchitis?

A

greater than three months for longer than two years

184
Q

Would DLCO be increased or decreased during Emphysema?

A

decreased

185
Q

Would Hypersensitivity Pneumonitis be a restrictive or obstructive pattern?

A

restrictive

186
Q

What type of hypersensitivity is Hypersensitivity Pneumonitis?

A

three and four

187
Q

What occurs in G1 of the cell cycle? What three drugs act here?

A

duplication of cellular content

carmustine/cisplatin/lomustine

First Aid (21 decks)

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