Respiratory Review

Question 1

What type of cell is involved in gas exchange?

Answer 1

Type 1 epithelial cells

Question 2

What type of cell is involved in making surfactant?

Answer 2

Type 2 epithelial cells

Question 3

What lung product increases compliance?

Answer 3

surfactant

Question 4

What happens to FEV1/FVC, TLC, RV, and FRC in Obstructive Lung Disease?

Answer 4

Decrease - FEV1/FVC

Increase - TLC, RV, FRC

Question 5

What happens to FEV1/FVC, TLC, RV, and FRC in Restrictive Lung Disease?

Answer 5

Increase - FEV1/FVC

Decrease - TLC, RV, FRC

Question 6

B2 agonist that is primarily used as a bronchodilator

Answer 6

Albuterol

Question 7

Mast cell stabilizer (prevents the release of histamine & other pro-inflammatory substances)

Answer 7

Cromolyn Sodium

Question 8

Leukotriene Receptor Blocker Antagonist
- inhibits proinflammatory leukotrienes

Answer 8

Montelukast

Question 9

• 5-lipoxygenase inhibitor
• inhibits synthesis of leukotrienes

Answer 9

Zileuton

Question 10

• inhibits PDE –> increases cAMP
• increases release of epinephrine

Answer 10

Theophylline (Milrinone)

Question 11

Name the Pneumoconiosis:
- egg shell calcification
- sandblasting
- stone masons/carvers

Answer 11

Silicosis

Question 12

Name the Pneumoconiosis
- modular opacities in the upper lung
- due to man mad carbon accumulation

Answer 12

Coal Miner’s
(Black Lung Disease)

Question 13

Name the Pneumoconiosis
- seen in industrial works from oil refineries, natural gas industries, and electronics

Answer 13

Beryllium

Question 14

Name the Pneumoconiosis
- pleural plaques (pleural biopsy)
- can have calcified nodules inside chest wall
- seen in construction and shipyard workers

Answer 14

Asbestosis

Question 15

What are the 3 cytokines involved in granuloma formation?

Answer 15

IL-2
TNF-alpha
IF-gamma

Question 16

What does a Carotid Sinus Massage due to HR and CO?

Answer 16

• increases afferent baroreceptor firing
• decreases HR and CO

Question 17

Name the abnormality
- absent/decreased breath sounds
- no fremitus or resonance
- trachea deviates toward mass

Answer 17

Bronchial obstruction

Question 18

Name the abnormality
- decreased breath sounds
- dullness to percussion
- decreased fremitis

Answer 18

Pleural effusion

Question 19

Name the abnormality
- decrease breath sounds
- hyperresonant to percussion
- absent tactile fremitis
- trachea deviates AWAY from lesion

Answer 19

Pneumothorax

Question 20

Name the abnormality
- bronchial breath sounds over lesion
- dullness to percussion
- INCREASED tactile fremitis

Answer 20

Pneumonia (lobar)

Question 21

Formula for Compliance

Answer 21

change in volume/change in pressure

Question 22

The goal of ____ is to reduce surface tension and increase lung compliance

Answer 22

Surfactant

Question 23

At the apex of the lung, there is wasted _______.

Answer 23

ventilation

Question 24

At the base of the lung, there is wasted _______.

Answer 24

perfusion

Question 25

What drug cleaves the disulfide bonds and loosens mucus plug?

Answer 25

N-acetylcysteine Used to treat COPD and CF

Question 26

MOA of Chlorpheniramine

Answer 26

1st gen H1 blocker

Question 27

MOA of Cetirizine

Answer 27

2nd gen H1 blocker

Question 28

MOA of Fexofenadine

Answer 28

2nd gen H1 blocker

Question 29

What do we use loratadine for?

Answer 29

allergies

Question 30

MOA of doxylamine

Answer 30

H1 blocker

Question 31

What do we use Roflumilast for?

Answer 31

(Severe) COPD and plaque psoriasis

Question 32

MOA of Roflumilast

Answer 32

PDE-4 inhibitor

Question 33

MOA of Dextromethorphan

Answer 33

NMDA receptor antagonist

Question 34

Tx for Acetaminophen overdose

Answer 34

N-acetylcysteine

Question 35

What drug causes Rhinitis Medicamentosa?

Answer 35

Topical nasal decongestants (eg ephedrine, pseudoephedrine)

Question 36

MOA of phenylephrine

Answer 36

A1-adrenergic agonist Can teat nasal congestion, edema, etc.

Question 37

Why is pseudoephedrine controlled?

Answer 37

CNS stimulation/anxiety

Question 38

MOA of bosentan

Answer 38

- endothelin 1 receptor antagonist SE: hepatotoxic LFT

Question 39

What are the three classes of drugs used to tx pulmonary Hypertension?

Answer 39

- Endothelin-receptor antagonists - PDE-5 inhibitors - Prostacyclin (PGI2) analogs

Question 40

Which drug causes pulmonary and systemic vasodilation and inhibits platelet aggregation?

Answer 40

prostacyclin analogs (epoprostenol, iloprost)

Question 41

What drug causes cyanopia?

Answer 41

Sildenafil (viagra)

Question 42

What is the electrolyte imbalance caused by albuterol especially if its given in escalating doses in the ER?

Answer 42

HYPOkalemia

Question 43

MOA of iloprost

Answer 43

Prostacylin analog

Question 44

What is the SE of inhaled budesonide?

Answer 44

Oral Thrush - Tx: mouth rinse, nystatin, spacer

Question 45

DOC for whooping cough (pertussis)

Answer 45

Macrolides

Question 46

DOC for a pt with Mycoplasma Pneumoniae

Answer 46

Macrolides (no cell wall)

Question 47

What is the MOA of nedocromil?

Answer 47

Mast cell stabilizer

Question 48

Tx for Epiglottitis in an unvaccinated child

Answer 48

Ceftriaxone

Question 49

Tx for aspiration pneumonia

Answer 49

- Ampicillin-sulbactam - antipseudomonal penicillins

Question 50

Antimuscarinic for COPD

Answer 50

Ipratropium and tiotropium

Question 51

What is the time frame for lungs to be fully developed?

Answer 51

8 years old

Question 52

At what week do the lungs start to form?

Answer 52

Week 4

Question 53

What cell type degrades toxins and secretes surfactant components?

Answer 53

Club Cells

Question 54

What Syndrome is know to show 'ground glass' in the lung field?

Answer 54

ARDS (acute respiratory distress syndrome)

Question 55

Patient presents flushed, with a cherry red appearance and their breath smells like almonds...

Answer 55

Cyanide Poisoning

Question 56

What is Virchow's Triad?

Answer 56

SHE - Stasis - Hyper-coagulability - Endothelial Damage

Question 57

Where are DVTs commonly found?

Answer 57

in the proximal deep veins of the lower extremity

Question 58

What are the 4 causes of an anterior mediastinal mass?

Answer 58

4 T's - thyroid - thymus - teratoma - "terrible" lymphoma

Question 59

What are the two main causes of a Middle Mediastinal Mass?

Answer 59

- bronchogenic cysts - hilar hernia

Question 60

What are the 4 types of Obstructive Lung Diseases?

Answer 60

BECA - Bronchiectasis - Emphysema - Chronic Bronchitis - Asthma

Question 61

Pt has dilation of bronchioles and bad breath

Answer 61

Bronchiectasis - dilated bronchioles due to mucus/bacteria trapping - necrosis of airways causes halitosis

Question 62

What type of obstructive lung disease has an increased Reid index?

Answer 62

Chronic Bronchitis

Question 63

If you see Charcot-Leyden Crystals and Curschmann's Spirals - what do you have?

Answer 63

Asthma

Question 64

Aspirin Induced Asthma is due to ...

Answer 64

- leukotriene overproduction (due to inhibition of COX)

Question 65

Hyperresonance to Percussion

Answer 65

Pneumothorax

Question 66

Increased Tactile Fremitis

Answer 66

- lung consolidation (pneumonia or edema)