Respiratory smart book Flashcards by Trevor Johnson

Round basophilic bodies found in the nuclei

whats this things function?

nucleolus

Site of ribosomal subunit maturation

rRNA synthesized by RNA polymerase I

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what are the nueroendocrine elements that small cell carcinoma of the lung can present with?

Small dark blue cells

chromogranin,

neuron-specific enolase,

NCAM (adhesion molecule)

Nuerofilaments

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what is the Amnionic fluid lecithin/sphingomyelin ratio used for

Lecithin is a type of phospholipid

the ratio is used to measure fetal lung maturity

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what is methacholine used for?

its a muscurinc agonist used to test for asthma

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whats x-linked agammaglobinemia

a deficiency of B-cells/ decr. all Ig classes

recurent bacterial and enteroviral infections after 6 months (maternal igG goes away)

no CD19/20

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on spirometry test, when is pulmonary vascular resistance the lowest?

its at the end of regular expiration

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what type of lung pathology does obesity cauase (obstructive or restrictive)

Restrictive

Reduction of ERV(expir. reserve volume)

but sometimes everthing else can be decreased as well

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what is the major cause of lung abscesses

which organisms cause this?

Aspiration due to loss of consciousness

-alchoholics/drug OD/epileptics/brainprollems-

Bacteroides, peptostrepto, fusobacterium

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what type of vaccines do you use for bacteria that have capsules (like strep pneumo)

You use a conjugated polysaccharide vaccine

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which viral infection puts transplant patients at risk?

CMV

owl eys on histo

Enveloped/ double stranded / DNA virus

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what does cord factor do in TB

its a virulence factor which inhibits nuetrophils/ destroys mitochondria/ and releases tnf-a

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tell me about CF

its a deletion of f508 gene/ CFTR protein

fucked up Cl channels so they cant reabsorb Cl, Na, or H20 from sweat glands

high salt wasting due to lack of reabsorption

Hyponatremia

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What causes Superior Vena Cava syndrome?

A malignacy (Lung/mediastinal) that pinches the SVC

Facial plethora, blanching, JVD

dilated collateral veins

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PaCO2 is major stimulate for respiration in healthy peeps

incr. in PaCO2 will cause hyperventilation

(central chemorecptors)

______________

but in COPD patients, Co2 effects get blunted so they rely on paO2 which is controlled by

peripheral Chemoreceptors

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does the visceral pluera carry pain fibers?

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Parietal pluera

what innervates the diaphragm/mediastinal pleura?

Phrenic nerve

C3-5

pain gets refered to the shoulder

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Sarcoidosis facts

40 yo AA femal

noncaseating granuloma, hilar lymphadenopathy, increased ACE levels and Hypercalcemia

(the granulomas produce ACE and 1,25 D3)

you get a very high CD4 count (t cells)

Difference between Absolute and Relative erythrocytosis

Absolute- increase in totalt RBC mass

Relative - no increase

shows that the lung extends just above the clavicle

guy gets chicken bone stuck in his throat

wheres the most common location of this

which nerve is at risk for injury? reflex is injured?

Piriform recess

internal laryngeal nerve

Cough reflex 9 & 10

Super-normal expiratory flow

RESTRICTIVE DZ

what causes Kussumaul breathing?

Metabolic Acidosis

what type of breathing is this and what causes it?

Cheynne Stokes breathing

CHF

This is apnea (periods of no breathing) thats followed by increasing and decreasing tidal volumes

what kind of breathing is this?

Obstructive sleep apnea

what enzyme deficiency causes Chronic granulomatous dz? what are the diagnostic test to be familiar with?

**NADPH oxidase deficiency** Nitroblue Tretrazolium (NBT) / Dihydrohomanine (DHR) no immunoflourescene

Whats the triad of Kartageners

Situs inversus, bronchiectasis, chornic sinusitis

what makes up **MHC class I** molecules? \_\_\_\_\_ **MHC Class II**

MHC class I **Heavy chain** & **B2** **microglobulin** **\_\_\_\_\_\_\_\_\_** MHC class II **alpha** & **beta polypeptides**

If you see **meconium illeus** of an infant at birth what should you think? Inspissisated?

**Cystic Fibrosis**

What are the main causes of death in a CF patient

Pnuemonia, Bronchiectasis, Cor pulmonae

symptoms of pancoast tumor (superior sulcus)

Horners, SVC syndrome, Hoarseness ## Footnote **Sensory-motor defects** **Shoulder pain**

pneumocisis with **eggshell calcifications** in the **hilar nodes** **bifringent/ fibrosis** what has this been associated with?

Silicosis associated w/ risk of TB it fucks up the macrophages

a smoker comes in with pneumonia, confusion, diarrhea, and high fever sputum doesnt tell you anything.

Legionella legionairres dz

Cystic fibrosis

mutation at **CFTR F508** impairs **post-translational transcription** so CFTR gets shunted to proteasome for degredation

Left sided heart failure --\> increased pulmonary vein pressure --\> increased hydrostatic pressure --\> pulmonary edema --\> **decreased lung compliance**

Pressure = (2 x tension)/ radius

takes **2-4 weeks** for you to get an immune response from mycobacterium tuberculosis \_\_\_ before then, the bacteria is steadily replicating in the macrophage

High altitude ---\>hypoxemia--\> **hyperventilation** ---\>respiratory alkylosis ---\> after 2 days your kidneys shoot out bicarb

role of Vit A

Visual pigments stimulates differentation of **epithelial cells** (pancreatic cells and mucus secreting) prevents **squamous metaplasia** give to CF patients with bad pancreas

chest tube placement thru the Serratus anterior

whats a lung hamartoma (pulmonary chondroma)

a round **coin lesion** composed of **cartilage, fat,** and **fibrous tissue**

what part of the lung gets affected in ***_chronic_*** **transplant rejection?**

The **Small airways** via inflammation and fibrosis ## Footnote **bronchiolitis obliterans**

live attenuated vs killed vaccines

**Live attenuated** (cellular defense) enter the cell to stimulate MHC class I/CD8 T cells that kill viurs infected cells upon reinfection \_\_\_\_\_\_\_\_\_\_ **killed vaccines** (humoral/ab) dont enter the cell, which means it cant stimulate T cell memory. it creates antibodies against virulence factors of the virus