Feddock Pulmonary Flashcards Preview

Integrative Week One > Feddock Pulmonary > Flashcards

Flashcards in Feddock Pulmonary Deck (125):
1

Maxillary Sinuses

at birth
complete at 4 years

2

Frontal Sinuses

at 6-8
permanent at 15-18

3

Ethmoid Sinuses

at birth
permanent at 12

4

Sphenoid

develop during first two years of life

5

Peripheral Chemoreceptors

carotid and aortic bodies
sense decreased O2
increased H/CO2

6

Central Chemoreceptors

medulla
sense increased H/CO2

7

Control of Respiration

cerebral cortex, pons, medulla

8

Initial Physiological Effect of Exercise

increase RR
increase TV
decrease exp reserve volume

9

Effect of Training

increase TLC and VC
(increases maximum TV)

10

TV

increases in hyperbolic pattern

11

RR

increases in linear fashion

12

compliance

ability to breathe air in
elastic property of CW and lungs
increases with surfanctant, COPD, decreases with restrictive

13

elastic recoil

ability to breathe air out
due to CW, elasticity of lung tissue, alveolar surface tissue
increases with restrictive, decreases with COPD, surfactant

14

TLC

increase with COPD
decrease with restrivive dz (weakness, lung)

15

FRC

increase with COPD
decrease with obesity, restrictive lung

16

RV

increase with asthma, weakness, COPD
decrease with restrictive lung dz

17

FVC

decrease with all

18

FEV1

decrease with all

19

Asthma values

decrease FEV1/FVC
decreased FEV1
decreased FVC
normal DLCO

20

COPD values

decreased FEV1/FVC
decreased FEV1
decreased FVC
decreased DLCO

21

Obesity/Restrictive Values

Normal FEV1/FVC
Normal/decreased FEV1
decreased FVC
Normal DLCO

22

Weakness/Restrictive Values

Normal FEV1/FVC
Decreased FEV1
decreased FVC
Normal DLCO

23

Restrictive Lung dz values

increased FEV1/FVC
Normal/decreased FEV1
decreased FVC
decreased DLCO

24

Increased O2 binding to hemoglobin

increased PH
decreased Co2
low temp
lung tissue

25

Decreased O2 binding to hemoglobin

decreased pH
increased Co2
high temp
peripheral tissue

26

Breathe faster

losing Co2
increasing pH
Increasing O2 binding to hemoglobin

27

2,3BPG

increased synthesis when living at high altitudes

28

Normal Lung Sounds

Resonant Percurssion
Vibratory Tactile Fremitus
Vesicular Ausculation

29

Lobar Consolidation Lung Sounds

Dull Percussion
Increased TF
Decreased/Bronchial ausculation

30

Pleural Effusion Lung Sounds

dull percussion
decreased TF and ausculation

31

Pneumothorax lung sounds

hyperresonant
decreased TF and ausculation

32

Egophony

pneumonia
atelectasis

33

Laryngeotracheitis

croup
parainfluenza
inspiratory wheeze, stridor
treat with dexamethasone, humidified air

34

Bronchiolitis

RSV
exp sounds/wheeze
<2 yo

35

Epiglottis

drol, dysphagia

36

Tracheomalacia

collapse of trachea during exp>inspir
cough, stridor
no distress

37

Causes of OM

S. pneumonia
H. influenza
Moraxella

38

resistance to s. pneumonia

penicillin binding proteins

39

resistance to H influenza

beta lactamase

40

Types of Congenital Diphargmatic Hernia

most left sided > right sided > retrosternal

41

Chonal Atresria

upper airway obstruction, noisy breathing
cyanosis with feeds, better with crying

42

Diaphragmatic Hernia - clinical

worsening resp distress within hours after birth
barrel chest
no breath sounds on left and scaphoid abdomen

43

pneumothorax clinical in babies

premature infant and RDS

44

tetraology of fallot

RVOT obstruction with feeding

45

tracheoesophageal fistula

resp distress with aspiration and feeding

46

Neonatal RDS

surfactant def leads to high surface tesnion
decreased compliance leads to atelectasis and hypoxia
lung inflamm and epithelial cell injury - pulm edema

47

Neonatal RDS clinical

tachypnea, nasal flaring, cyanosis, pneumothorax, air leaks

48

NRDS diagnosis

premautre
diffuse reticulogranular with air bronchogram on x ray

49

Prevention of NRDS

antenatal corticosteroids at 23-24 weeks

50

Kartagner syndrome

immotile cilias syndrome
recurrent infections, bronchiectasis
situs invertis

51

Severe Combined Immunodef

defect in t+/- B
first few months of life
recurrent diarrhea, infections, FTT

52

Common Variable Immunodef

no B cell maturation and T cell fxn
1-5 yr or 18-25 yrs
sinopulmonary and GI infections

53

CF diagnosis

neonatal: immunoreactions to trypsin
child: sweat >60mmol

54

Exacerbations of CF

s aureus
pseudomonas
burkholderia - worsed lung fxn and survival

55

Intermittent Asthma

<2/week
Normal Fev1/fvc
prn albuterol

56

Mild Persistant Asthma

>2/week
Normal FEV1/FVC
ICS

57

Moderate Persistent Asthma

daily
decreased 5% FEV1/FVC
ICS + LABA

58

Severe Persistent Asthma

throughout day
decreased, greater than 5% FEV1/FVC
ICS + LABA

59

COPD treatment

LABA
anticholinergics

60

Obstructive Sleep Apnea

daytime sleepiness
fatigue
snoring

61

Polysomnography

AHI >5 per hour

62

Obstructive Sleep APnea management

weight loss
cpap
mandibular advancement device

63

apena

cessation of airflow x 10 seconds

64

hypopnea

reduction of airflow x 10 seconds +
Sa drop >/= 4%

65

S pneumonia

most common cause of lobar

66

Chylamdia and mycoplasma pneumonia

5-40, most common
diffuse interstitial pattern

67

Legionalla Pneumonia

inhalation of aerosols

68

GNR Pneumonia

klebsiella, pseudomonas
HAP
medical cormorbidities

69

S aureua pneumonia

post-influenza
necrotizing

70

Anaerobe pneumonia

aspiration - alcohol, dysphagia

71

Histo pneumonia

bird/bat droppins

72

PCP pneumonia

HIV
gradual onset of fever, cuogh, dyspnea, hypoxia

73

Primary TB

FUO

74

PPD 5mm Induration

HIV
immunosuppression
contacts
fibrotic CXR changes

75

lung cancer screening

low dose CT
30+ pack year smoking

76

SCLC complications

hyponatremia-SIADH
Lambert Eaton
SVC syndrome

77

Lambert Eaton

fatigable limb weakness
ab against vg ca channel

78

SVC syndrome

plethora, facial edema, dyspnea
disteneded neck veins

79

NSCLC complications

hypercalciemia (PTH)
pancoast

80

pancoast tumor

shoulder pain, horner's syndrome

81

High probability PE - symptoms

sudden onset dyspnea, pleuritic cp
tachypnea, tachycardia

82

High probability PE - risk factors

immoblization
recent surgery
activate malignancy
DVT

83

if high probability of PE you would

begin heparin
CT angiography
maybe ultrasound doppler

84

Transduate

all of
PF/S prot < 0.6
PF LDH <200

85

Transudate causes

increased hyrostatic pressure - HF, constrictive pericarditis
decreased oncotic pressure - hypoalbuniemia, cirrohosis, neprhotic syndrome, malnutriton

86

Exudate Causes

any of PF:S prot >0.6
PF/S LDH > 0.6
PF LDH >200

87

causes of exudative

neoplasma
infection
collagen vascular disease
pulmonary infarctions
hemothorax

88

Parapneumonic effusion

exudative, mvmt of fluid into pleural space

89

Empyema

exudative, bacterial infasion into pleural space
fluid ph 1000 or culture
chest tube placement

90

chylothorax

exudative
obstruction or disruption of thoracic duct
trauma, malignancy
pleural fluid TG >110

91

Lofgren syndrome

sarcoidosis
fever, bilateral hilar LAD
erythema nodsum
arthritis - esp ankle

92

sarcoidosis systemic

fever, wt loss, night sweats

93

sarcoidosis pulm

dry cough, dyspnea, bilateral hilar LAD

94

sarcoidosis metabolic

hypercalemia due to granulmoa production of calcitrol

95

Hypoxema

PaO2<60
V/Q mismatch
diffusion defect
intrapulmonary shunt

96

v/q mismatch

poor ventilation - penumonia, COPD
poor perfusion - PE

97

diffusion defect

thickened alevolar membrane - interstitial lung dz
fluid filled alveoli - pulm edema, atelectasis

98

intrapulmonary shunts

pneumona
av
malformations

99

Hypercarbic

PAco2 > 50
CNS, Neuromuscular, Chest wall dysfunction, obesity-hypoventilation sydrome, sedation/opiods

100

CNS hypercarbia

head trauma
herniation
encephalopathy

101

neuromuscular hypercarbia

ALS
Guillan barre

102

Resp Acidosis

retention of CO2

103

acute resp acidosis

metabolic compensation immediately
CNS depression: sedatives, ischemia, trauma, infection, brain tumor

104

chronic resp acidosis

increased renal excretion of NH4 within 24 hours
neuromusuclar and resp causes

105

chronic resp acidosis - neuromuscular

GB
myasthenia gravis, MS, ALS

106

chronic resp acidosis - resp

COPD, interstitial lung dz, pulm edema

107

Resp Alkalosis

loss of co2, hyperventilation

108

Acute REsp Alkalsosi

anxiety, pain, sepsis,
CNS: stroke
drugs: salicylates, progesterone, catecholamines

109

chronic resp alkalosis

hyperthryroidism
hypoxia
pregnancy
cirrohis

110

ARDS

sepsis most common
aspiration, pneumonia, trauma
bilateral pulmonary infiltrates

111

ARDS Pathophys

neutrophil infiltration
increased lung perm - pulm edema
epithelial damage w/ type II pneumocyte destruction and fibrosis (surfactant def)

112

cherry red appearance to skin

CO poisoning

113

Barotrauma

from scuba diving
descent - compression of air in lungs --> pulmonary edema, hemorrhage
ascent - oxerexpansion o flungs - alveolar rupture/pneumothorax

114

Decompression sickness

descent loads tissues with nitrogen
ascent liberates gas bubbles,obstructs vessels
joint pain, paraestheas, weakness, pulmonary gas embolism

115

high Altitude sickness

hypoxic stress increasing blood flow
cerebral edema, pulmonary edema

116

high altitude sickness prevention

acclimatization, acetazolamide

117

Idiopathic Pulmonary Fibrosis

most common
progressiv ecough and dyspnea >3 mo
bibasilar crackls
CT: diffuse reticular opacities, traction bronchiectasis, subpleural cysts

118

Pleural plaques

abestos, most common, incidental

119

Mesothelioma

>15 years from exposure
fever, cough, wt loss, dyspnea, chest pain
unilateral irregular pleural thickening and effusion

120

Asbestosis

>20 from exposure
inspiratory crackles, clubbing, restrictive lung dz
bilateral interstitial fibrosis

121

lung cancer

asbestos exposure increases risk esp if smoking as well
more common than mesotheloma

122

IPF indistinguiable from

collagen vascular disease - RA, sclerosis
pneumoconisosi
drug induced disease

123

Cryptogenic Organizing Pneumonia causes

post infectious - viral or bact pneumonia
drugs - amiodarone, MTX, sulfasalazine, bleomycin
CT: RA, SLE, polymyositis, dermomyositis

124

COP treatment

prednisone

125

COP clinical manifestations

nonproductive cough
patchy alveolar opacities on chest radiograph