Lung Volumes

Question 1

as we age ( ) goes up and ( ) goes down and ( ) doesn’t change

Answer 1

RV goes up
IRV goes down
tidal volume

Question 2

Increased PaCO2 in asthma is a sign of

Answer 2

respiratory failure, possible intubation

Question 3

Increased PaCO2 in COPD/bronchiectasis is a sign of

Answer 3

advanced disease

Question 4

alveolar disorders of pus leads to
water
blood

Answer 4

pneumonia
CHF
hemoptysis

Question 5

CHF presenting complaint

Answer 5

pink frothy sputum, bilateral coarse crackles (basal crepitations), CXR/ECHO
treat with beta blockers, ace inh, diuretics

Question 6

Pneumonia presenting complaint

Answer 6

rust colored sputum, unilateral, CXR

treat with abx

Question 7

Hemoptysis presenting comlpaint

Answer 7

fresh blood, typically unilateral, CXR, CT, bronchoscopy

Question 8

what vessel supplies the lung itself?

Answer 8

bronchiole artery, generally source of hemoptysis….do a CT scan an bronchoscopy if CT neg

Question 9

MCC of hemoptysis

Answer 9

• cancer
• bronchiectasis
• arteriovenous malformation
• TB in rest of world

Question 10

MGMT of hemoptysis

Answer 10

• maintain airway
• localize source of bleed
• control hemorrhage

Question 11

common interstitial diseases

Answer 11

• PE (CT angiogram)
• PHTN (echo, right heart cath)
• fibrosis (high res CT or biopsy)

Question 12

how to treat interstitial diseases?

Answer 12

steroids

Question 13

Pleural effusion presenting complaints

Answer 13

dull percussion, thoracentesis

hyoxemia may not improve w/supp O2

Question 14

Pneumothorax presenting complaints

Answer 14

hyperresonant, CXR

Question 15

Mesothelioma presenting complaints

Answer 15

dull percussion, CT/pleura biopsy

Question 16

Malignant Mesothelioma

Answer 16

• only one exposure is needed for damage

- first causes fibrosis in lung, then tumor, then cancer

Question 17

treatment of pts with chest wall problems

Answer 17

CPAP, then invasive if needed

Question 18

problems with the following will cause breathing to stop

Answer 18

• brain (cerebellum)
• spine trauma/infection
• corticospinal fiber, alpha motor neuron (lou gehrigs)
• neuropathy (myelin sheath degradation)
• NMJ (botulism, myasthenia gravis)
• myopathy

Question 19

hypoxemic vs

hypercapnic respiratory failure

Answer 19

PaO2<60 mm/Hg

PaCO2>45

Question 20

normal partial pressure of O2 in alveoli

CO2

Answer 20

105 mm/Hg

40 mm/Hg

Question 21

diffusion of ( ) is much faster than ( )

Answer 21

CO2, O2

Question 22

normal tidal volume

Answer 22

500 cc

Question 23

MCC of ARDS

Answer 23

sepsis (caused by pneumonia)

Question 24

how to treat ARDS

Answer 24

decrease tidal volume, sedate to decrease O@ consumption, paralyze pt

Question 25

obstructive lung disease occurs when...

Answer 25

FEV1/FVC

Question 26

TLC

Answer 26

volume of air in lungs at full inspiration

Question 27

functional residual capactiy

Answer 27

volume in lungs at resting expiration

Question 28

RV

Answer 28

volume in lungs at full expiration

Question 29

FVC

Answer 29

volume of air exhaled from full inspiration to max full expiration

Question 30

FEV1/FVC ratio

Answer 30

- indicates what % of total FVC was expelled during 1st second of exhalation - important for dx of obstructive and restrictive disease

Question 31

in restrictive lung disease, TLC is ( ), VC is ( ) , FEV1 is ( ), and the ratio is ( )

Answer 31

decreased, decreased, decreased, normal

Question 32

if FEV1/FVC ratio is normal, check.....

Answer 32

FVC, can indicate restrictive disease

Question 33

if FEV1/FVC ratio is low, think....

Answer 33

obstruction, give bronchodilator and check for 200CC or 12% FEV1 improvement

Question 34

inhalation diseases are seen in... | blood....

Answer 34

upper lobe | lower lobe

Question 35

acute cough subacute chronic

Answer 35

less than 3 weeks 3-8 weeks greater than 8 weeks

Question 36

4 causes of chronic cough

Answer 36

- GERD - hidden bronchial asthma - postnasal drip - eosinophilic bronchitis

Question 37

apnea

Answer 37

cessation of breathing >20 sec | cessation of breathing <20 sec w/cyanosis or bradycardia

Question 38

OSA

Answer 38

- narrowing or collapse of pharyngeal airway during sleep | - obesity is the biggest factor

Question 39

OSA comorbidities

Answer 39

- HTN - Afib - heart failure - stroke - decreased insulin sensitivity - depression

Question 40

mgmt of OSA

Answer 40

- weight loss - CPAP or BiPAP - surigcal

Question 41

MCC of congenital stridor

Answer 41

- laryngomalacia - bilateral vocal cord paralysis - subglottic stenosis - tracheal compression

Question 42

MCC of bacterial tracheitis

Answer 42

staph aureus

Question 43

croup

Answer 43

acute laryngotracheobronchitis | "steeple sign"

Question 44

MCC of epiglottitis

Answer 44

H influenza, loss of voice, no cough | "thumb sign"

Question 45

Rendu-osler-weber syndome

Answer 45

AVM, telangectasia

Question 46

Bilateral Vocal Cord Paralysis:

Answer 46

Inspiratory stridor associated with weak cry & respiratory distress

Question 47

Laryngomalacia:

Answer 47

Inspiratory stridor that often positional.