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High Yield Flashcards

1
Q

What are the characteristics of IPF?

A

Usual interstitial pneumonia Heterogeneous Fibroblastic foci

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2
Q

What are the characteristics of COOP?

A

Masson bodies All uniform - space throughout the lungs Loose connective tissue

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3
Q

Characteristics of silicosis?

A

Sand blasting Increased risk of TB Macrophage dysfunction

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4
Q

What are the characteristics of hypersensitivity pneumonitis?

A

Type III hypersensitivity Loose granulomas Resolves after removing stimuli

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5
Q

What are the characteristics of pulmonary alveolar proteinosis?

A

A-cellular surfactant in the intraalveolar spaces Antibodies to GM-CSF

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6
Q

What are characteristics of Squamous Cell Carcinoma?

A

Intercellular bridges Keratin pearls Many syndromes - cushing, hypercalcemia, etc

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7
Q

What cardiac abnormality is associated with pectus excavatum?

A

Mitral valve prolapse

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8
Q

What is the role of the subcostal muscles?

A

Function to depress ribs during heavy exercise, assisting with forced expiration

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9
Q

What are the top and bottom muscles?

A

Serratus posterior superior - Top

Serratus posterior inferior - bottom

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10
Q

What is the target of Ipratropium?

A

Cholinergic receptors

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11
Q

What can cause a diaphragmatic herina?

A

Incorrect folding of the pleuroperitoneal fold

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12
Q

What is the lowest you would hear breathe sounds on in the back mid scapula?

A

10th rib

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13
Q

COPD causes dilation of what?

A

Alveolar ducts and respiratory bronchiole

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14
Q

Adrenergic receptors are a part of what system?

A

Sympathetic

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15
Q

What are the important muscles used for forced inspiration?

A

Serratus posterior superior

Sternocleidomastoid

Scalene

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16
Q

Can you have incomplete compensation?

A

YES!!!

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17
Q

What is pancoast syndrome?

A

Apical bronchogenic tumor can push on adjacent structures

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18
Q

This graph demonstrates a person with?

A

Decreased lung compliance needing more pressure to generate flow

The value of PTP or a given lung volume is greater than in the normal lung.

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19
Q

This graph demonstrates a person with?

A

Increased airway resistance

compliance is normal, PALV-PPL , i.e. the volume component is also normal for any volume.

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20
Q

What is the equation for alveolar ventilation?

A

(TV-VD)xRR

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21
Q

What determines the stretch of the lungs?

A

PALV-PPL and compliance

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22
Q

What determines the creation of airflow?

A

PB-PALV and Resistance

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23
Q

What is venous return on blood?

A

PO2 = 40

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24
Q

How does changing diffusion affect the concentrations of PaO2 and CO2?

A

If decreased by too much it will lose the PO2 will go down

If only slightly decreased, then it can be normal

25
Unilateral chest expansion is significant for?
Pneumonia or Post intubation
26
Clubbing is a sign of?
Respiratory disorder CF
27
If sternocleidomastoid and scalene muscles are being used for breathing, what can this be a sign of?
COPD
28
Increased tactile fremitus that is unilateral is indicative of?
Pleural effusion If it is symmetric it decreases the likelihood of it
29
What does hyperresonance symbolize?
Pneumothorax
30
Unilateral sounds after intubation predict what?
Right mainstem intubation
31
Rales (Crackles) have what characteristics?
Inspiratory and are early Indicative of CHF, pneumonia or pulmonary fibrosis
32
What are the characteristics of rhonchi?
Snoring quality, low pitched Think airway secretions
33
What are the characteristics of stridor?
Loud upper airway obstruction Epiglottitis
34
What are the characteristics of wheezing?
High pitched, continuous musical sound COPD or asthma
35
Rales are the same as?
Crackles!
36
Egophony is a sign for?
Pneumonia EEEEE to AAA change
37
Whispered pectoriloquy is a sign of what?
Consolidated lung
38
What are the common gram negative pulmonary infections?
E. coli , Klebsiella, Proteus, Pseudomonas Legionella
39
When should a person worry about gram negative infection?
Aspiration leading to gram negative At risk populations
40
Bronchiectasis is a dilation of what?
Bronchiole
41
What is the formula for carrying capacity of blood
(Hb x 1.34 x % sat) + (SaO2 x 0.003)
42
What do V and A stand for?
Venous saturation and Arterial saturation
43
Explain this graph
Changes in O2 affinity of Hb have important physiological relevance. Consider a person exercising vigorously: the Hb in the capillary blood flowing through the exercising muscles is exposed to a low pH, high PCO2, and high temperature. All these factors tend to lower Hb-O2 affinity; i.e. for a given PO2 value, Hb is less saturated. In other words, as the affinity of Hb for O2 decreases, Hb “lets go” of O2. This facilitates unloading of O2 in the exercising muscle without reducing the PO2 very much; accordingly, the PO2 gradient for O2 diffusion from the capillary to the muscle cell is maintained and allows O2 flow to continue. When the blood returns to the lungs, the Hb is exposed to a higher pH, lower PCO2 and lower temperature, all of which tend to increase Hb-O2 affinity. Now Hb likes the O2 a little more, so it picks up more O2.This facilitates loading of O2 in the lungs.
44
Explain this graph
45
Explain this graph
CO2 concentration is higher in venous blood
46
Explain this graph?
The arterial and venous blood O2 and CO2 content, in ml/dl, are plotted as a function of the respective partial pressures. The units for CO2 concentration here are different from those of the curve in the previous slide. The objectve of this slide is to compare the differences in the shapes of the O2 and CO2 curves. In the next chapter we will see the implications of these differences on pulmonary gas exchange. Several differences are apparent: 1. **In the physiologic range, blood CO2 content is about twice the blood O2 content** 2. In the physiologic range, the curve for CO2 is fairly linear, which means that changes in **PCO2 are accompanied by roughly proportionate changes in blood CO2 content** over a fairly wide range of PCO2. On the other hand, the non-linearity of the **ODC means that the changes in O2 content produced by a given change in PO2 will depend on the initial PO2 level**. As we will see in the next section, this has important implications for gas exchange. 3. The CO2 curve is much steeper: the v-a PCO2 difference is ~ 6 mmHg and the v-a CO2 content difference is 4-5 ml/dl; on the other hand, the a-v O2 content difference is 5-6 ml/dl but the a-v PO2 difference is ~ 60 mmHg. This also has implications for gas exchange, as we will see later.
47
What are the indications to used transesophageal echocardiography?
48
Increased dead space also means?
Decreased efficiency of gas exchange
49
What are the characteristics of increased dead space?
**Increased total ventilation** Increased VD/VT ratio **Typically seen as low PaO2 with little CO2 retention**
50
What are the characteristics of an airway blockage (increased shunts)?
Large PaO2 drop due to mixing PaO2 refractory to increases in PAO2 Small increase in PaCO2
51
How can metabolic alkalosis shift the O2 curve?
An increase in blood pH shifts the oxygen-hemoglobin dissociation curve to the left. This creates a tighter bond between hemoglobin and oxygen, causing decreased oxygen delivery to tissues. Hypoxemia is worsened by a compensatory hypoventilation to elevate PCO2. Hypoventilation may be severe enough to cause apnea and respiratory arrest.
52
How can you increase VO2?
Increasing cardiac output or increasing extraction
53
How can you decrease diffusion?
Decreasing volume or increasing the extraction of O2 from the alveoli
54
What is the equation for VA?
VCO2/PaCO2
55
What is the difference between COPD and alpha-1 anti-trypsin in regards to where they effect?
alpha-1 antitrypsin - alveolar ducts and alveoli Emphysema - respiratory bronchioles
56
How can neutrophils affect the lungs?
Infiltration leads to destruction of bronchiolar and septal elastic
57
In a BAL what would you see in a patient with HF?
Hemosiderin laden macrophages
58
How would a patient with CF have Cl- on their skin but not in their airways?
The cells of the sweat fail to reabsorb NaCl while in the airway there is decreased Cl- secretion and increase H2O and Na+ reabsorption
59
What is one role of Mast cells?
BALT and edema

Pulmonary (42 decks)

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