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Flashcards in Pulm 1 Deck (29):
1

Rubber like qualities of elastin due to...?

Extensive cross linking between elastin monomers

Facilitated by lysyl oxidase

2

Legionnaire's disease clinical findings

Affects smokers

- Very high fever
- Diarrhea
- HA, confusion (CNS findings)
- Lab studies = hyponatremia

G(-) rod -- not detected on gram stain

3

Most common form of CF

- Mutation in CFTR gene
- Causes defective post-translational folding and glycosylation
- Result => degradation of membrane protein before it reaches cell surface

∆F508 mutation

4

Kartagener syndrome triad

- Situs inversus
- Chronic sinusitis
- Bronchiectasis

5

Pathophysiology of Kartagener syndrome

Primary ciliary dyskinesia

Mutations => failure to form dynein arms in cilia => immotility

Recurrent resp infections, infertility (sperm in men, fallopian tubes in women)

6

PE is associated with what on an ABG?

Respiratory alkalosis

7

Centriacinar emphysema inflammatory infiltrate...?

PMNs

Alveolar macros

Release proteinases!

8

Why does pus/sputum turn green because of a bacterial infections?

Presence of myeloperoxidase

- blue/green heme-based enzyme
- released from PMN azurophilic granules
- Forms hypochlorous acid

9

Most common non-small cell lung cancer

- Adenocarcinoma
- Found in women and non-smokers

10

Which lungs cancers are associated with smoking?

Squamous cell carcinoma

Small cell carcinoma

11

Adenocarcinoma

- Women/non-smokes
- Located peripherally
- Consists of tumor cells that form glandular or papillary structures

12

Mycobacterium avium complex

MAC

- Common opportunistic infection
- Causes disseminated disease in HIV+ pts
- CD4+

13

Cromolyn & nedocromil MOA

- Inhibit mast cell degraulation (prevents release of histamine)

Prevent acute attacks

Less effective than inhaled steroids

Considered 2nd-line for tx of allergic rhinitis and bronchial asthma

14

Pleuritic chest pain

- Sharp, localized, often severe
- Can be due to PNA
- Exacerbated by coughing, breathing, or changing position
- Worse on inspiration
- Results from any inflammation of the pleura

15

Referred pain from pleuritic chest pain

C3-C5 distribution (based of neck and over the shoulder)

Phrenic nerve irritation

Diaphragmatic and mediastinal pleura pain fibers

16

Cancer associated with asbestos exposure?

MOST COMMON:
Bronchogenic carcinoma

Less common:
malignant mesothelioma

17

Epiglottitis presentation (sx)

- Acute fever
- Inspiratory stridor
- Drooling
- Odynophagia
- (+) "thumb sign" on lateral cervical x-ray (b/c of edema)

18

H Flu vx develops Abs to what?

- Polyribosyl-ribitol-phosphate (PRP
- Response to capsular material

Facilitates complement-dependent phagocytosis and killing through opsonization

19

Methacholine

- Cholinergic muscarinic agonist
- Commonly used as an inhaled test substance for pts thought to have asthma

20

What is diffusing capacity?

- How much oxygen travels from alveoli to blood stream
- Decreased diffusing capacity = destruction of alveoli and adjoining cap beds

21

How do you measure fetal lung maturity via amniotic fluid?

Lecithin (phosphatidylcholine) : Sphingomyelin (L/S ratio)

22

Via amniotic fluid, how do you know when fetal lungs are mature?

L/S ratio is 2:1 or higher

Lecithin sharply increases after 30 weeks gestation

23

Two types of CD4+ T-helper cells

Th1

Th2

24

What does Th1 secrete?

- gamma-interferon
- IL-2
- others

25

What does Th1 activate?

- Macros
- CD8+ cytotoxic T-cells

Think type 4 delayed hypersensitivity

26

What does Th2 secrete?

- IL-4
- IL-13
- IL-5

27

What does Th2 activate?

- B-cell Abs

28

IL-4 and IL-13 do what?

Class switching to IgE

29

IL-5 does what?

Activates eosinophils

IgA synthesis