Respiratory Review Flashcards
What type of cell is involved in gas exchange?
Type 1 epithelial cells
What type of cell is involved in making surfactant?
Type 2 epithelial cells
What lung product increases compliance?
surfactant
What happens to FEV1/FVC, TLC, RV, and FRC in Obstructive Lung Disease?
Decrease - FEV1/FVC
Increase - TLC, RV, FRC
What happens to FEV1/FVC, TLC, RV, and FRC in Restrictive Lung Disease?
Increase - FEV1/FVC
Decrease - TLC, RV, FRC
B2 agonist that is primarily used as a bronchodilator
Albuterol
Mast cell stabilizer (prevents the release of histamine & other pro-inflammatory substances)
Cromolyn Sodium
Leukotriene Receptor Blocker Antagonist
- inhibits proinflammatory leukotrienes
Montelukast
- 5-lipoxygenase inhibitor
- inhibits synthesis of leukotrienes
Zileuton
- inhibits PDE –> increases cAMP
- increases release of epinephrine
Theophylline (Milrinone)
Name the Pneumoconiosis:
- egg shell calcification
- sandblasting
- stone masons/carvers
Silicosis
Name the Pneumoconiosis
- modular opacities in the upper lung
- due to man mad carbon accumulation
Coal Miner’s
(Black Lung Disease)
Name the Pneumoconiosis
- seen in industrial works from oil refineries, natural gas industries, and electronics
Beryllium
Name the Pneumoconiosis
- pleural plaques (pleural biopsy)
- can have calcified nodules inside chest wall
- seen in construction and shipyard workers
Asbestosis
What are the 3 cytokines involved in granuloma formation?
IL-2
TNF-alpha
IF-gamma
What does a Carotid Sinus Massage due to HR and CO?
- increases afferent baroreceptor firing
- decreases HR and CO
Name the abnormality
- absent/decreased breath sounds
- no fremitus or resonance
- trachea deviates toward mass
Bronchial obstruction
Name the abnormality
- decreased breath sounds
- dullness to percussion
- decreased fremitis
Pleural effusion
Name the abnormality
- decrease breath sounds
- hyperresonant to percussion
- absent tactile fremitis
- trachea deviates AWAY from lesion
Pneumothorax
Name the abnormality
- bronchial breath sounds over lesion
- dullness to percussion
- INCREASED tactile fremitis
Pneumonia (lobar)
Formula for Compliance
change in volume/change in pressure
The goal of ____ is to reduce surface tension and increase lung compliance
Surfactant
At the apex of the lung, there is wasted _______.
ventilation
At the base of the lung, there is wasted _______.
perfusion
What drug cleaves the disulfide bonds and loosens mucus plug?
N-acetylcysteine
Used to treat COPD and CF
MOA of Chlorpheniramine
1st gen H1 blocker
MOA of Cetirizine
2nd gen H1 blocker
MOA of Fexofenadine
2nd gen H1 blocker
What do we use loratadine for?
allergies
MOA of doxylamine
H1 blocker
What do we use Roflumilast for?
(Severe) COPD and plaque psoriasis
MOA of Roflumilast
PDE-4 inhibitor
MOA of Dextromethorphan
NMDA receptor antagonist
Tx for Acetaminophen overdose
N-acetylcysteine
What drug causes Rhinitis Medicamentosa?
Topical nasal decongestants (eg ephedrine, pseudoephedrine)
MOA of phenylephrine
A1-adrenergic agonist
Can teat nasal congestion, edema, etc.
Why is pseudoephedrine controlled?
CNS stimulation/anxiety
MOA of bosentan
- endothelin 1 receptor antagonist
SE: hepatotoxic LFT
What are the three classes of drugs used to tx pulmonary Hypertension?
- Endothelin-receptor antagonists
- PDE-5 inhibitors
- Prostacyclin (PGI2) analogs
Which drug causes pulmonary and systemic vasodilation and inhibits platelet aggregation?
prostacyclin analogs
(epoprostenol, iloprost)
What drug causes cyanopia?
Sildenafil (viagra)
What is the electrolyte imbalance caused by albuterol especially if its given in escalating doses in the ER?
HYPOkalemia
MOA of iloprost
Prostacylin analog
What is the SE of inhaled budesonide?
Oral Thrush
- Tx: mouth rinse, nystatin, spacer
DOC for whooping cough (pertussis)
Macrolides
DOC for a pt with Mycoplasma Pneumoniae
Macrolides (no cell wall)
What is the MOA of nedocromil?
Mast cell stabilizer
Tx for Epiglottitis in an unvaccinated child
Ceftriaxone
Tx for aspiration pneumonia
- Ampicillin-sulbactam
- antipseudomonal penicillins
Antimuscarinic for COPD
Ipratropium and tiotropium
What is the time frame for lungs to be fully developed?
8 years old
At what week do the lungs start to form?
Week 4
What cell type degrades toxins and secretes surfactant components?
Club Cells
What Syndrome is know to show ‘ground glass’ in the lung field?
ARDS
(acute respiratory distress syndrome)
Patient presents flushed, with a cherry red appearance and their breath smells like almonds…
Cyanide Poisoning
What is Virchow’s Triad?
SHE
- Stasis
- Hyper-coagulability
- Endothelial Damage
Where are DVTs commonly found?
in the proximal deep veins of the lower extremity
What are the 4 causes of an anterior mediastinal mass?
4 T’s
- thyroid
- thymus
- teratoma
- “terrible” lymphoma
What are the two main causes of a Middle Mediastinal Mass?
- bronchogenic cysts
- hilar hernia
What are the 4 types of Obstructive Lung Diseases?
BECA
- Bronchiectasis
- Emphysema
- Chronic Bronchitis
- Asthma
Pt has dilation of bronchioles and bad breath
Bronchiectasis
- dilated bronchioles due to mucus/bacteria trapping
- necrosis of airways causes halitosis
What type of obstructive lung disease has an increased Reid index?
Chronic Bronchitis
If you see Charcot-Leyden Crystals and Curschmann’s Spirals - what do you have?
Asthma
Aspirin Induced Asthma is due to …
- leukotriene overproduction
(due to inhibition of COX)
Hyperresonance to Percussion
Pneumothorax
Increased Tactile Fremitis
- lung consolidation (pneumonia or edema)
