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first aid diseases > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Lg airways have (2)?

Lg and sm airways to term bronchioles have?

A
  • Cartilage and goblet cells

- pseudostratified ciliated columnar cells; SmM in airway walls

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2
Q

Cells of conducting zone?
Cells of resp zone?
Clara cells are?

A
  • Pseudostratified ciliated columnar cells
  • Cuboidal cells in resp bronchioles (type II pneumocytes) and simple sq cells (type I pneumocytes) in alv
  • nonciliated columnar cells w/ secretory granules
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3
Q

Collapsing P of alv?

- Incr’d T? incr’d r?

A

P = 2T/r

  • incr’d T -> incr’d collapsing P
  • incr’d r -> decr’d collapsing P (as w/ insp)
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4
Q

Surfactant prod begins when? Mature levels when?

A

Begins at 26wks

Mature levels at 35wks

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5
Q

Where is the PA in relation to the bronchus at ea lung hilus?

A

RALS:
R ant, L sup
R PA is ant to the R bronchus; L PA is sup to the L bronchus

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6
Q

R lung fissures?

L lung fissures?

A

R: Horiz fissue in front sep’ing Upper from Middle loves; Oblique fissure on side/bottom sep’ing Middle from Lower lobes
L: Oblique fissure sep’ing Upper and Inf lobes

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7
Q

What struc’s go thr diaphragm? At what levels?

A

T8 - IVC
T10 - eso (and 2 trunks of vagus)
T12 - Ao (and thoracic duct, azygous v.) (red, white and blue)

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8
Q

Diaphragm:

  • innervated by?
  • pain from it is referred to where?
A

C3,4,5 keep the diaphragm alive!

Shoulder (C5) and Trapezius ridge (C3,4)

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9
Q

Dead space of lung =

A

vol of inspired air that doesn’t participate in gas exchange
Vd = TV x [(PaCO2 - PeCO2)/PaCO2]
aka total vol breathed in x frxn of air NOT expired

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10
Q

At FRC: P’s of airway, alv and intrapleura are?

A

Airway and alv are 0, intrapleural space is (-) to prevent pneumothorax

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11
Q

Methemoglobin =

  • trtmt of methemoglobinemia?
  • nitrates -> poisoning, how?
A

Ox’d Hb (Fe3+) that doesn’t bind O2 -> binds CN

  • methylene blue + VitC (reducing agent to make Fe2+ again)
  • ox’ing Fe2+ to 3+
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12
Q

Cyanide poisoning -> trtmt?

A
  • Nitrates: oxidize Hgb to Fe3+ to bind CN (so doesn’t hurt cytochrome oxidase func)
  • Thiosulfate: bind CN on methemoglobin -> thiocyanate -> renal excretion
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13
Q

Diff btwn myoglobin and Hgb?

A

Myoglobin in monomeric -> no sigmoid binding curve (looks like sidewards upsidedown L)

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14
Q

1* pulm HTN due to?

A

Mutation in BMPR2 gene -> incr’d vasc SmM prolif, usu in yg F

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15
Q

Plexiform lesion =

- see in?

A

tuft of cap’s together

- severe LT pulm HTN

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16
Q

PVR =

A

[P(PA) - P(LA)] / CO

- where P(LA) = PCWP

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17
Q

Alv gas equ, PAO2 =

A

PAO2 = PIO2 - PaCO2/R

= 150 - PaCO2/0.8

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18
Q

Haldane effect w/ CO2 in lungs?

- what happens in the tissues to make CO2 bind RBCs?

A

Oxygenation of Hb promotes dissociation of H+ from Hb -> CO2 is made, and thus released from RBCs
- incr’d H+ from tissue metab -> shifts curve to right (Bohr effect) -> unloading O2 so H+ can bind Hb (CO2 is carried as bicarb in the bl)

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19
Q

Virchow’s triad =

A

stasis
hypercoag
endo damage

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20
Q

Sign of DVT on PE?

A

Homans’ sign = dorsiflexion of foot -> calf pain

21
Q

Fat emboli are assoc’d w/?

3 presenting sx?

A
  • fx of long bones, lipo

- hypoxemia, neuro abnl’ities, petechial rash

22
Q

How to tell if thrombus was made before or after death?

A

Lines of Zahn = alt’ing layers of plts mixed w/ fibrin (lighter) and RBCs (darker); made from thrombus being at site of rapid bl flow
-> thus was pre-mortum (thrombus also will be attached to wall)

23
Q

COPD = chronic bronchitis or emphysema

What is the difference in mech btwn these two?

A
  • Chronic bronchitis is dz of sm vessels, high mucus production (Reid index >50)
  • Emphysema is enlargement of air spaces from destruc of alv walls -> incr’d compliance and decr’d elastic recoil so sm airways collapse on exhale
24
Q

Panacinar emphysema is usu where in lungs? Where is centriacinar?

A

Pan - LLs (a1AT defic)

Centri - ULs (smoke rises)

25
Q

Curschmann’s spirals =

- seen in?

A

shed epi which forms mucus plus

- asthma

26
Q

Charcot-Leyden crystals =

- seen in?

A

formed from brkdwn of MBP from Eo’s in sputum

- asthma, in coughed up mucus

27
Q

What is bronchiectasis?

- 2* comp of this is?

A

Obstruc lung dz w/ infec of bronchi -> dilated airways w/ no tone -> air trapping
- 2* amyloidosis from chronic inflamm -> acute phase rct (SAA) -> AA -> deposited as amyloid

28
Q

CF, Kartagener’s, and bronchopulm aspergillosis are all assoc’d w/ what obstruc lung dz?

A

Bronchiectasis

29
Q

Eo’ic granuloma in lung w/ restrictive lung dz?

A

Langerhans cell histiocytosis

30
Q

What 4 drugs can cause restrictive lung dz?

A

Bleomycin, busulfan, amiodarone, MTX

31
Q

Why does silicosis incr your risk for Tb?

- also incr’s risk for?

A

Impairs formation of phagolysosomes in Mphage -> risk for Tb

- lung ca

32
Q

Eggshell calcification in hilar LNs?

A

Silicosis

33
Q

Lower lobes, ivory white calcified pleural plaques?

A

Asbestosis

34
Q

Noncaseating granulomas in lung, hilar LNs and organs?

A

Sarcoid OR Be exposure (from aerospace workers, miners)

35
Q

3 RFs for neonatal RDS?

- CXR shows?

A

Premature
Mat DM (incr’d fetal insulin -> inhib’s surfactant prod)
Csxn deliv (decr’d release of fetal gcc’s)
- diffuse granularity of lung (hazy)

36
Q

What is the only lung condition w/ bronchial breath sounds and incr’d fremitus?

A

Consolidation (lobal pneumo - late insp crackles; or pulm edema)

37
Q

Who gets nasopharyngeal ca?

- what is it assoc’d w/?

A

Af kids and Chinese adults

- EBV

38
Q

Lung ca’s that start w/ S are all…

A

central, assoc’d w/ smoking, and cause paraneoplastic syndromes
aka SCC and sm cell ca

39
Q

Where does lung ca met to?

A

Ad’s, brain, bone, liver

40
Q

Adenoca in lung:

  • common mutation?
  • common in who?
  • assoc’d w/ what on PE?
A
  • k-ras act’ing mutation
  • nonsmokers and F’s
  • clubbing (hypertrophic osteoarthropathy)
41
Q

CXR shows hazy infiltrate like pneumo, what ca?

A

Bronchioloalveolar = ca along alv septa -> thickening of alv walls; derived from Clara cells

42
Q

SCC in lung

  • on histo see what 2 things?
  • can produce?
A
  • keratin pearls and intercellular bridges (desmosomes spreading out bc cells are pulling apart)
  • PTHrP -> hyperCa
43
Q

Sm cell lung ca

  • can produce what 3 things?
  • common amp of what oncogene?
  • stain for what?
  • histo shows?
  • trtmt?
A
  • ACTA, ADH or Abs (LES)
  • myc
  • chromogranin bc is from neuroendocrine cells
  • Kulchitsky cells: sm dk blue cells
  • chemo, only lung ca you don’t first take to surgery
44
Q

What lung ca’s are located in the periph?

A

Adenoca

Lg cell ca (highly anaplastic w/ pleomorphic giant cells, bad)

45
Q

Chromogranin(+) cells that grow as polyp-like mass in bronchioes?

A

Bronchial carcinoid tumor, good prognosis

46
Q

Causes of lobar pneumo?

A

95% STREP PNEUMO

5% Klebsiella

47
Q

Causes of bronchopneumo?

  • if it were a CF pt?
  • if it were a COPD pt?
A

S. aureus, S. pneumo, H. flue, Klebsiella

  • Pseudomonas
  • Moraxella, H. flue
48
Q

Atyp pneumo:

- yg adult? baby? immsupp’d? old person? farmer?

A
  • Mycoplasma in yg adults (cold hemolytic anemia)
  • RSV in infant
  • CMV in immsupp’d
  • Influenze -> 2* bac pneumo in old person
  • Coxiella (Q Fever, high F) in farmers and vets

first aid diseases (16 decks)

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