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Respiratory Flashcards

1
Q

Dx of asthma

A

Methacholine –> M3 stimulation

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2
Q

Aspirin induced asthma Tx

A

LT receptor blockers - Zafirlukast, Montelukast

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3
Q

Restrictive lung disease

A
  1. Fibrosis
  2. ARDS
  3. Sarcoid
  4. Pneumoconioses
  5. Goodpasture’s
  6. Wegener’s
  7. Drugs - bleomycin, amiodarone, busulfan
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4
Q

Obstructive lung diseases

A

Asthma, COPD

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5
Q

FVC dec
RV, TLC, FRC dec
FEV1/FVC normal or inc

A

Restrictive lung disease

  • think of it as a small lung volume problem
  • DCLO DEC
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6
Q

FVC normal
RV, TLC, FRC in
FEV1/FVC dec

A

Obstructive lung disease

  • can’t get the air out = learn to function at higher lung capacity
  • DLCO INC
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7
Q

Spherules

A

Coccidoides immitis

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8
Q

Cells that produce surfactant

A

Type II pneumocytes

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9
Q

Calculate dead space

A

tidal volume x PACO - PECO / PACO

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10
Q

Calculate pulmonary vascular resistance

A

P-pul artery - P-l atrium / CO

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11
Q

Hypoxemia w/ normal A-a gradient

A

High altitude
Hypoventilation
= there is no impaired delivery of O2 to the blood

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12
Q

Hypoxemia w/ INC A-a gradient

A

V/Q mismatch
Diffusion limited - fibrosis
R–>L shunt

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13
Q

Hypoxia (dec O2 delivery to tissue) w/ normal A-a gradient

A

Dec CO
Hypoxemia
Anemia

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14
Q

Hypoxia w/ INC A-a gradient

A

CN

CO

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15
Q

V/Q of apex

A

3 = wasted ventilation

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16
Q

V/Q of base

A

0.6 = wasted perfusion

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17
Q

V/Q = 0

A

SHUNT blood

Airway obstruction

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18
Q

V/Q = infinity

A

DEAD space
BF obstruction
100% O2 improves PO2

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19
Q

1 rhinitis

A

adenovirus

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20
Q

Nasal polyps

A

Aspirin-intolerant asthma*

CF

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21
Q

Chinese adult w/ pleomorphic keratin+ cells in a background of lymphocytes, cervical LA

A

Nasopharyngeal CA

- EBV*

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22
Q

Single in adults or multiple in kids growth on vocal cord

A

Laryngeal papilloma

- HPV 6,11

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23
Q

Pneumonia in nursing home & diabetics

A

Kleb

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24
Q

Pneumonia in alcoholics

A

Kleb

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25
Q

Pneumonia exacerbation of COPD

A 
H. influenzae
#1 = Moraxella
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26
Q

Cold agglutinin +, Eaton agar

A

Mycoplasma pneumoniae

Tx = erythromycin

27
Q

Post-transplant pneumonia

28
Q

Hypertrophy of bronchial mucous glands, Reid index >50%, productive cough for 3+ months for >2yrs

A

Chronic bronchitis “blue bloaters”

- infection & cor pulmonale

29
Q

Centriacinar emphysema

A

SMOKING

Upper lobes

30
Q

Panacinar emphysema

A

A1AT deficiency

  • -> misfolded protein accumulates in hepatocytes –> PAS+
  • PiZ = most common
  • PiZZ = panacinar + cirrhosis
31
Q

Curschmann spirals and charcot-leyden crystals

A

Asthma

Eosinophil membrane proteins

32
Q

Causes of bronchiectasis

A

Necrotizing infection –> PERMANENTLY dilated airways

Allergic aspergilloma
CF*
Kartageners
Tumor or foreign body

33
Q

Middle aged male w/ B/L rales, end-expiratory crackles, no wheezing

A

Idiopathic pulmonary fibrosis (restrictive)

  • TGF-B
  • amiodarone, bleomycin
  • “honeycomb” lung
34
Q

Diffuse lung fibrosis and RA

A

Caplan syndrome in coal miner

- upper lobes

35
Q

Athracosis

A

carbon-laden MO

36
Q

Fibrotic nodules in upper lobes, “egg shell” calcification of LNs, birefringent spicules, inc risk for TB

37
Q

Person works at NASA, noncaseating granuloma in organs and hilar LNs

A

Berylliosis

- INC RISK FOR LUNG CANCER

38
Q

Noncaseating granuloma in multiple organs, cough, elevated serum ACE, hyperCa, African-American

A

Sarcoidosis

39
Q

Asteroid bodies

A

Sarcoidosis

40
Q

White, calcified pleural plaques, Golden-brown fibers (ferrugenous bodies), shipyard worker, plumber, LOWER lobes

A

Asbestosis

  • fibrosis of lung and pleura
  • inc risk of lung cancer
41
Q

Fever, cough, dyspnea in pigeon breeder that gets better when he goes home, granulomatous inflammation

A

Hypersensitivity pneumonitis

- resolves w/ removal

42
Q

Exertional dyspnea, peripheral edema, Plexiform lesions

A

Pulmonary HTN (>25) –> RVH –> cor pulmonale

  • Primary = BMPR2 in young females
  • Secondary = COPD
43
Q

White out on CXR

A

ARDS

  • hyaline membrane
  • Tx = PEEP
44
Q

Neonatal RDS causes

A

B4 34wks
C-section
Maternal DM –> insulin dec surfactant production

45
Q

Cyanosis after birth, “ground glass” CXR

A

Neonatal RDS

  • PDA
  • Necrotizing enterocolitis
  • 100% O2 –> BLINDNESS & bronchopulmonary dysplasia
46
Q

The S’s of lung cancer

A

Small cell
Smokers
Central
Syndromes

47
Q

Male smoker, inc ADH, ACTH, LE syndrome

A

Small cell

- Central

48
Q

Most common lung tumor in MALE smokers

A

SCC

- squamous, sentral, smoking

49
Q

Male smoker with hyperCa, keratin pearls and intracellular bridges

A

SCC

  • PTHrP
  • Central
50
Q

Most common lung tumor on non-smoker and FEMALE smokers

A

Adenocarcinoma

  • Peripheral
  • Pleural effusion
  • Glands or mucin
51
Q

Columnar cells along bronchioles and alveoli, pneumonia - like consolidation

A

Bronchoialveolar carcinoma

  • Peripheral
  • Excellent prognosis
  • NOT smoking related*
  • Clara cells
52
Q

Chromogranin +, collar button lesion, polyp-like mass in bronchus

53
Q

Peripheral lung cancers

A

Adenocarcinoma

Bronchioalveolar

54
Q

Mets of lung cancer

A

ADRENAL gland

55
Q

Trachea shift TO side of collapse

A

Spontaneous (bleb)

  • paraseptal emphysema
  • apical bullae rupture in young healthy person
56
Q

Trachea shift OPPOSITE collapse

57
Q

TOC for PE

A

helical CT

58
Q

Hyperlucency in CXR

A

Emphysema

- pink puffers

59
Q

No breath sounds, resonance, tactile fremitus

A

Obstruction

60
Q

Dullness for percussion, dec tactile fremitus

A

Pleural effusion

61
Q

Dullness to percussion, inc tactile fremitus

62
Q

Hyperresonant, dec fremitus

A

Pneumothorax

63
Q

Sheets of tumor cells w/ nuclear molding, “salt and pepper”

A

Small cell lung carcinoma

“Kulchitsky cells”

64
Q

Winter’s forumla for compensation

A

Expected PCO2 = 1.5 x HCO3- +8 +/-2

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