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Jenna's Shit List > Shit -Respiratory > Flashcards

Shit -Respiratory Flashcards

1
Q

club cell functions

A
  • Secrete component of surfactant
  • degrade toxins
  • Reserve cells
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2
Q

VIP surfactant lecithin

A

dipalmitoylphosphatidylcholine

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3
Q

Lecithin:sphingomyelin ratio

A

>2 in amniotic fluid = mature lungs

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4
Q

Aspiration: upright vs supine

A

upright = inferior of R. inf. lobe

supine = superior of R. inf. lobe

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5
Q

Collapsing pressure on alveoli equation

A

Pc = 2 (ST) / r

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6
Q

Physiological deadspace calculation

A

phys deadspace = anatomical + alveolar

VD = VT + VA

P1V1 = P2V2

VA*PA = VT*PT

(VT-VD)*PaCO2 = PECO2*VT

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7
Q

Lung area providing most of alveolr dead space

A

Apex

(because decreased BF)

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8
Q

Minute ventilation

A

=VT*RR

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9
Q

Alveolar ventilation

A

= VA*RR

= (VT - VD)*RR

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10
Q

Taut vs Relaxed Hb

A

Taut = tissues = low affinity for oxygen

Relaxed = respiratory = high affinity

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11
Q

Hb exhibits:

A

positive cooperativity and negative allosterity (23DPG decreases affinity)

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12
Q

Cheynne stokes breathing:

A

delayed response but high sensitivity to PCO2

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13
Q

MetHb: what, how, s/s, rx, use

A

Hb 3+

Nitrites, benzocaine, dapsone

s/s = cyanosis/dusky skin (baby with sulfa drug)

Rx = Vitamin C + methylene blue

Use: rx for cyanode poisoning (Hb3+ has increased affinity for cyanide)

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14
Q

cyanide poisoning s/s

A

rapidly developing tachypnea, tachycardia, flushing, HA, NV, confusion, weakness

Severe lactic acidosis with low A-V gradient

Burnt almond smell

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15
Q

Left shift seen with:

A

CO

Fetal Hb (dereased 23DPG binding)

Myoglobin (no + cooperativity)

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16
Q

Perfusoin vs. diffusion limited

A

Perfusion = normal

Diffusion = emphysema or fibrosis

During exercise still perfusion, but close

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17
Q

PVR equation

A

PVR = (Ppulm a. - Pwedge (LA) )/CO

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18
Q

Alveolar gas equation

A

PAO2 = PIO2 - (PaCO2/R)

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19
Q

HYpoxemia (low PaO2) via:

A

High altitude

Hypoventilation

V/Q mismatch

Diffusion-limited

right-to-left shunt

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20
Q

where in lung are ventilation and perfusion greatest?

A

base

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21
Q

shunt vs dead space

A

shunt = V/Q = 0

(no ventilation; blood shunted away)

deadspace = V/Q = œ

(no blodo flow, so like a dead space)

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22
Q

Exercise and VQ

A

increases Q at apex via vasodilation; lung zones more uniform

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23
Q

Haldane vs Bohr

A

Haldane = lung

Bohn = peripher

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24
Q

Bacterial superimposed infections on rhinosinutisis

A

s. pneumoniae
h. flu
m. catarrhalis

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25
Q

Samter’s triad

A

ASA-intolerance:

  • asthma
  • nasal polyps
  • bronchospasms
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26
Q

Epistaxis locations

A

MC = ant = Kisselback plexus

Most severe = post = sphenopalatine artery

27
Q

pleuritic chest pain with tachycardia and tachypnea

A

PE

28
Q

Fat embolism triad

A
  • Hypoxemia
  • Neurological
  • Petechial rash
29
Q

PE test

A

CT angiography

30
Q

Reid index

A

Chronic bronchitis

>50% from LP to MP is glands

31
Q

Curshman spirals vs. Charcot-leyden crystals

A

Curshman spirals = shed epithileum

Charcot = eosinophil breakdown releases MBP; hexagonal double-needle crystals

32
Q

pulsus paradoxus seen in:

A

cardiac tamponade, pericarditis, croup, asthma, OSA

33
Q

Chronic necrotizing infection of bronchi: disease, causes

A

Bronchiectasis

Poor ciliary motility (CF, Kartageners, smoking), bronchial obstructions (tumour, foreign body), allergic bronchopulmonary asthma

34
Q

Elastase: from where, what breaks it down?

A

PMN; A1-AT

Macrophages; TIMPS

35
Q

sarcoidosis causes increased:

A

Ca and ACE

36
Q

Restrictive disease with eosinophilic granulomas

A

langerhans cell histiocytosis or hypersensitivity pneumonitis

37
Q

drugs causing restrictive lung disease

A

Bleomycin, busulfan, MTX, amiodarone

38
Q

Decreased FVC and FEV1 seen in:

A

BOTH obstructive and restrictive

obstructive has much lower FEV1

39
Q

Hypersensitiyivty pneumonitis: who, s/s, histo

A

farmer/bird people

s/s = dyspnea, cough, tight chest, headache

histo = type III and IV (non-caseating granulomas in alveoli)

40
Q

pneumoconiosis complications

A

cor pulmonale

Caplan syndrome: RA + intrapulmonary nodules

41
Q

lobe and pneumoconiosis

A

Lower = asbestos

Uppers = beryliosis, coal workers, silliosis

42
Q

pneumoconiosis with pleural and superdiaphragmatic nodules

A

Asbestosis

43
Q

ferruginous bodies

A

asbestosis; golden-brown dumbbells in alveolar septae

44
Q

Job and pneumoconiosis:

  • roofer, plummer, shipbuilder
  • aerospace + manufacturing
  • coal
  • foundries, sandblasting, mines
A
  • roofer, plummer, shipbuilder: asbestosis
  • aerospace + manufacturing: berylliosis
  • coal: CWP
  • foundries, sandblasting, mines: sillicosis
45
Q

lecithin:spingomyelin

A

NRDS

46
Q

complications of NRDS:

A

metabolic acidosis

PDA

necrotizing enterocolitis

47
Q

complications of NRDS Rx (supplemental O2)

A

Retinopathy of prematurity

Intraventricular hemorhage

Bronchopulmonary dysplasia

48
Q

Causes of ARDS

A

trauma, sepsis, shock, gastric aspiration, uremia, backterial pneumonia, acute pancreatitis, amniotic fluid embolism

49
Q

complications of nocturnal hypoxia in sleep apnea

A

systemic/pulmonary HTN

arrythmyas (a fib//flutter)

sudden death

50
Q

plexiform lesions

A

tufts of capillaries after long term PulmHTN

51
Q

Pulmonary arterial hypertension (PAH)

A

1’ = BMPR2 activating mutation (2 hits), AD, variable penetrance, no prevention of sm proliferation

2’ = long-term cocaine/amphetamines (appetitie suppressants), CT disease, HIV, portal HTN, congenital heart disease, schistosomiasis.

Pther 2’ PHTN: hypoxic VC, lung destructoin, recurrent microthrombi

52
Q

Trachea movements and lung lesiosn

A

AWAY = large pleural effusion or tension pneumothorax

TOWARDS = atelectasis or simple pneumothorax

53
Q

increased fremitus

A

consolidation ONLY i.e. lobar pneumonia, pulmonary edema

54
Q

signs of consolidation (lobar pneumonia, pulmonary edema)

A
  • tactile fremitus
  • dull resonance
  • bronchial breath sounds
  • late inspiratory crackles
55
Q

chylothorax via:

A

Thoracic duct injury (left) from trauma or malignancy

56
Q

Lung abscess: via disease + bugs; classic sign, Rx

A

Disease = aspiratoin of OROPHARYNGEAL contents or bronochial obstruction

Bugs = fusobacterium, peptostreptococcus, bacteroides, s. aureus

Classic sign = air-fluid level

Rx = clindamycin (anaerobes above diaphragm)

57
Q

Mesothelioma can cause:

A

hemorrhagic pleural effusion (exudate), pleural thickening, psammomma bodies

58
Q

mesothelioma RFs

A

asbestos (MC cause lung cancer)

NOT smoking

59
Q

Pancoast tumour can casue: (4)

A

SVC syndrome [also via catheter thrombosis]

Horners

hoarseness

sensorimotor deficits

60
Q

lung cancers mets to:

lung cancer mets from:

A

TO: adrenals, brain, bone, liver

FROM: breast, colon, brostate, bladder

61
Q

Paraneoplastics in lung cancer:

A

small cell = ACTH, SIADH, Lamber-Eaton

Squamous cell = PTHrp

62
Q

Gene mutatoins in lung cancers:

A

small cell = amplification of L-myc

adenoCA = activating mutations in KRAS, EGFR, ALK

Squamous cell = erb-B1

63
Q

Markers in lung cancer

A

small = neuroendocrine (chromogrannin A, synaptophysin, enolase, neurophysin); kulchinsky cells

Adeno = mucin

Squamous = keratin and intercellular bridges

large = b-HCG

brochial carcinoid = neuroendocrine

64
Q

chemo vs surgery for lung cancer:

A

small cell = chemo

large cell = surgery

Jenna's Shit List (23 decks)

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