Chapter 9: High Yield Respiratory Flashcards

1
Q

Most common cause of Rhinitis

A

Adenovirus

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2
Q

Biopsy - pleomorphic keratin-positive epithelial cells in a background of lymphocytes. Associated with EBV.

A

Nasopharyngeal carcinoma

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3
Q

Hoarse, “barking” cough and inspiratory stridor. Inflammation of the upper airway. Most common cause = parainfluenza virus

A

Laryngotracheobronchitis (Croup)

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4
Q

Consolidation of an entire lobe of the lung. Usually bacterial (S. pneumoniae 95%; Klebsiella pneumoniae) Red hepatization –> Gray hepatization

A

Lobar pneumonia

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5
Q

Scattered patchy consolidation centered around bronchioles. Multifocal and bilateral.

A

Bronchopneumonia

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6
Q

Diffuse interstitial infiltrates. Mild upper respiratory symptoms.

A

Interstitial (atypical) pneumonia

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7
Q

Most common cause of Community-acquired poneumonia

A

S pneumoniae. - lobar pneumonia

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8
Q

Pneumonia in cystic fibrosis patients

A

P. aeruginosa (Bronchopneumo)

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9
Q

Most common cause of atypical pneumonia. Military recruits

A

Mycoplasma pneumoniae

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10
Q

Most common cause of atypical penumia in infants

A

RSV

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11
Q

Farmers and vets - cattle.

A

Coxiella burnetii

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12
Q

Pneumonia in malnourished, alcoholics, diabetics. currant jelly sputum

A

Klebsiella pneumonia (lobar)

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13
Q

Gohn complex

A

Primary TB ( mycobacterium tuberculosis)

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14
Q

Caseating granulomas; AFB bacilli. Apex of lung

A

Secondary TB

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15
Q

Caseating granulomas; AFB bacilli. Apex of lung

A

Secondary TB

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16
Q

Decreased FVC; Greatly decreased FEV1; Increased TLC

A

COPD

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17
Q

Most common cause of centriacinar emphysema

A

smoking

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18
Q

You see a barrel chested ‘pink puffer’ in ___

A

Emphysema

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19
Q

Productive cough with spiral-shaped mucus plugs (curschmann spirals) and eosinophil-derived crystals (Charcot-Leyden cyrstals)

A

Asthma

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20
Q

The 4 COPDs are:

A
  1. Chronic bronchitis 2. Emphysema 3. Asthma 4. Bronchiectasis
21
Q

Permanent dilation of bronchioles and bronchi due to necrotizing inflammation [Cystic fibrosis; Kartagener syndrome]. Couch, dyspnea and foul-smelling sputum. Can get secondary (AA) amyloidosis!

A

Bronchiectasis

22
Q

Decreased TLC and greatly decreased FVC; FEV1: FVC ratio is increased (FVC reduced more than FEV1)

A

Restrictive diseases:

Idiopathic pulmonary fibrosis; Pneumoconioses; Sarcoidosis; Hypersensitivity pneumonitis)

23
Q

Fibrosis of lung interstitium due to TGF-Beta. Subpleural patches initially, leading to diffuse fibrosis and end-stage “HONEYCOMB” Lung

A

Idiopathic pulmonary fibrosis

24
Q

Fibrosis of lung interstitium due to TGF-Beta. Subpleural patches initially, leading to diffuse fibrosis and end-stage “HONEYCOMB” Lung

A

Idiopathic pulmonary fibrosis

25
Q

Stellate inclusions (asteroid bodies) seen within giant cells of non-caseating granulomas. systemic disease. Granulomas of hilar lymph nodes and lungs leading to restrictive lung disease. CD4+ helper T-cell response. Elevated serum ACE and hypercalcemia.

A

Sarcoidosis

26
Q

Plexiform lesions

A

Seen in severe, long standing pulmonary HTN ( MAP > 25 mmHg)

27
Q

Plexiform lesions

A

Seen in severe, long standing pulmonary HTN ( MAP > 25 mmHg)

28
Q

BMPR2

A

Inactivation mutation leads to proliferation of vascular smooth muscle –> primary pulmonary HTN

29
Q

Tx of ARDS

A

ventilation with positive end-expiratory pressure (PEEP)

30
Q

Tx of ARDS

A

ventilation with positive end-expiratory pressure (PEEP)

31
Q

Surfactant production begins ____ and reaches adequate levels _____

A

Begins at 28 weeks;

Adequate levels at 34 weeks

32
Q

What condition in the mother decreases surfactant production

A

Diabetes. Insulin decreases surfactant production

33
Q

What condition in the mother decreases surfactant production

A

Diabetes. Insulin decreases surfactant production

34
Q

Key risk factors for lung cancer [3]

A

Cigarette smoke [polycyclic aromatic hydrocarbons and arsenic]; radon; and asbestos

35
Q

Lung Cancer usually metastasis to ___

A

adrenal gland

36
Q

Male smoker. Central tumore from neuroendocrine cells. May produce ADH or ACTH or cause Eaton-Lambert syndrome [pre-synaptic Ca channel antibody - paraneoplastic syndrome]

A

Small cell carcinoma

37
Q

Keratin pears or intercellular bridges. Most common tumore in male smokers. Central; may produce PTHrP (can get hypercalciemia)

A

Squamous cell carcinoma

38
Q

Metastasis TO lung

A

Breast and colon carcinoma. Presents like multiple ‘cannon-ball’ nodules

39
Q

Metastasis TO lung

A

Breast and colon carcinoma. Presents like multiple ‘cannon-ball’ nodules

40
Q

Penetrating chest wall injury. Trachea is pushed OPPOSITE to the side of injury

A

Tension pneumothorax - Chest tube = medical emergency..

41
Q

Equation for physiologic dead space Vd

A
Vd= Vt * [ (PaCO2 - PECO2) / PaCO2 ]                            
Vt = tidal volume. PECO2 = expired air PC02 Pa = arterial
42
Q

Equation for physiologic dead space Vd

A
Vd= Vt * [ (PaCO2 - PECO2) / PaCO2 ]                            
Vt = tidal volume. PECO2 = expired air PC02 Pa = arterial
43
Q

Normal Hb amount in blood

A

15 g/dL

cyanosis results when deoxygenated Hb > 5g/dL

44
Q

O2 binding capacity =

A

20.1 mL02/dL

45
Q

Bohr effect

A

In peripheral tissue, inc H+ from tissue metabolism shifts curve to right, unloading O2.

46
Q

Haldane effect

A

In lungs, oxygenation of Hb promotes dissociation of H+ from hb. This shifts equilibrium toward CO2 formation; therefore CO2 is released from RBC

47
Q

Dorsiflexion of foot causes calf pain

A

+ Homan’s sign. indicate DVT

48
Q

DVT tx

A

heparin for prevention and acute management;

Warfarin for long-term prevention of DVT recurrence

49
Q

Classic triad: hypoxemia, neurologic abnormalities and petechial rash

A

Fat emboli