PULM1

Question 1

RESTtrictive or obstructive in ARDS

Answer 1

restrictive\ca

cause pul edema

Question 2

atelectasis restrictive or obsturcitve

Answer 2

restrictive

Question 3

why does asthma have an increase DLCo

Answer 3

due to increased pulmonary capillary blood volume

Question 4

Rheumatoid arhtitis obstructive or restrictive

Answer 4

restritctive

Question 5

which T cell increased in COPD

Answer 5

cd8 T cells

Question 6

bronchiolitis obliterans affects the

Answer 6

small aireways

Question 7

hypoxic vasconstriciton improves VQ mismath by

Answer 7

decreaseing phys shunting in poorly ventialted alveoli leading to overall more efficient gas exchagne

Question 8

PUL HTN complication of

Answer 8

CREST syndrome

Question 9

no normal PFT in hypoxic vasoconstriction

Answer 9

TRUE

seen in chronic lung disease or hypoventilation syndromes

Question 10

destruction of vascular beds

Answer 10

emphysema: raisess vasculare resistance; contributing to PAH

Question 11

cavitary lung lesions caused by

Answer 11

aggregations of activated leuklocytes

( release of proteases, NO, ROS) cause cavitary ; damage

Question 12

stimulation of hypoglossal nerve does what

Answer 12

cause tongue to move forward slighlty; increasing AP dimater of airway

Question 13

reid index is the ratio of

Answer 13

thickness of submucosal bronchial glands to thickness of bronchial wall bw epithelial basement membrane and bronchial cartialges

mucous glands/submucos + lp

Question 14

larger diamter, shroter, and more vertically oreinted

Answer 14

right main bronchus

Question 15

where should thoracentesist be performed

Answer 15

above 8th rib in midclavicular line, the 10th rib along midaxillary line, and 12th rib along posterior scapualr or paravertebral line

lower than these poitns: increase risk of penetrating abdominal structures

Question 16

lung is located about 8th in mid axillary

Answer 16

true

Question 17

staph aureus
burkholderia cepacia
serratia marcescens
nocardia
aspergillus

Answer 17

CGD

Question 18

2 major mechanisms of hypoxemia in advanced COPD

Answer 18

1. emphsyemaptous destructio nof alveolar capillary membrane results in impaired diffusion of O2
2. airway obstruction (due to bronchial inflammation and mucus secretion) and air-trapping (due to both bronchial inflammation and emphseymeatous airway collapse ) cause vq mismatching

Question 19

air trapping leads to an increase in

Answer 19

FRC in pt’s w copd

Question 20

perpetual collapsin force on lugns caused by

Answer 20

alvoelar transmural pressure always being positive

Question 21

ARDS assoc intersitial edema and hyaline membrane formation along w fluid filled alveoli collapse and atelectasis result in decreased lung compliance and increased work of breathing. the fluid filled, collapsed alveoli are unable to deliver oxygen despite continuing to receive adequate blood flow, resulting in Vq mismatch and hypxoia

Answer 21

true

Question 22

ARDS incraese or decrease lung complaicen

Answer 22

decrease

Question 23

inspissated mass green

Answer 23

meconium ileus

dehdyrated meceoniem

Question 24

most common cause of ddeeath in hirschprung

Answer 24

enterocolitis

Question 25

impaired fodling and glycoyslation of CFTR

Answer 25

Cystic fibrosis

Question 26

eosinohils recruited by

Answer 26

IL5

Question 27

decrease ERV is most focmmon dinicator of

Answer 27

obestiy related disease

Question 28

classic triad in fat embolism syndrome

Answer 28

neurologic abnormality hypoxemia petechiae

Question 29

astham has no effect on

Answer 29

lung compliacnce

Question 30

VTE prohylaixixs

Answer 30

lmwh

Question 31

high vq regions have large capacity to

Answer 31

exhale additional co2

Question 32

why does hyperventialtion not significantly improve arterial oxygenation

Answer 32

hemoglobin is nearly fully satured w o2 in areas of normal vq ratio, there is little capacity for high vq regions to increase blood o2 content much furtehr

Question 33

pulm edema affecss where in lung

Answer 33

lung bases

Question 34

untreated OSA causes

Answer 34

pulmonary Hypertension

Question 35

cancers located in apex of lung

Answer 35

superior sulcus

Question 36

anterior mediastinum mass

Answer 36

thymoma, teratoma, thyroid cancer, terrible lymphoma

Question 37

VTE vs tricuspid valve endocarditis

Answer 37

tricuspid valve: high grade fever, recent IV drug use; multiple infarcts

Question 38

primary site of lactate clearance

Answer 38

liver

Question 39

lactic acidosis in septic schok results from tissue hypoxia which

Answer 39

impairs ox phosphorylation and causes shunting of pyruvate to lactate following glycosis. tehre is a buildup of nadh

Question 40

initial treatment of choice for sacrocidois

Answer 40

oral glucocorticoids 9prednisone)

Question 41

syphillis

Answer 41

caseating granulomas | rash on maculopapulor involved palms and soles

Question 42

OSA | resp effort

Answer 42

resp effort adquate THROUGHOUT

Question 43

cheyne-stokes breathing seen in

Answer 43

advanced CHF

Question 44

cyclic breathing patternr in which apnea is followed by gradually increasing then decreasing tidalvolumes until next apneic period

Answer 44

cheyne stokes breathing

Question 45

chesst tube for drainigae of pleural effusion into 4th or 5th ics in anterior axillary or midaxillary lin traverses

Answer 45

serratus anterior muscle intercostal muscles parietal plerua

Question 46

heart failure cells seen in

Answer 46

CHRONIC left heart failure if acute; more likely transudate cardiogenic pulm edema

Question 47

neutrophils in alveolar fluid

Answer 47

exduate

Question 48

restoring CFTR proteins to emmbrane

Answer 48

lumacaftor

Question 49

enhance protein function

Answer 49

ivacaftor (chloride transport)

Question 50

whorled collagen fibers and dust laden macs

Answer 50

silicosis

Question 51

sound vibrations travel faster and more efficeintly thorugh liquids than gases thus

Answer 51

increased breath sound, increased tactile fremiuts lobar consolidiaton pulm edema

Question 52

peripheral chemoreceptors located in the

Answer 52

carotid and aortic bodies

Question 53

in copd: what decreses

Answer 53

peripheral chemoreceptors. remember not senstiive to paco2; so peripheral becomes major drive (hypoxemia) peripiheral chemoreceptors are primarily responsbile for sensingpao2; and can be suppressed with oxygen administraiton

Question 54

lung apices extend above

Answer 54

clavicle and first rib

Question 55

ansa cervacilis

Answer 55

arise from c1, c2, c3 nerve roots and innervates sternohyoid, sternothyroid, omohyoid penetrating trauma to neck above cricoid cartialage can injure this nerve

Question 56

leakage of protein-rich fluid in alveolar airspaces

Answer 56

lobar pneumonia; happens in congestion neutrophils respond to bacterial components by releasing cytokines that increase permeability of pulmonary capillary endothelium

Question 57

excesssive fibroblast proliferation and ecm matrix depsotion

Answer 57

idopathic pulmonary fibrosis

Question 58

absolute vs relative | erythrocytosis

Answer 58

absolute has a true increase in RBC mass Relative Has a normal rBC mass

Question 59

relative erytrhocytosis due to dehydration or

Answer 59

excessive diruessis normal RBC mass

Question 60

causes lung abscess formation driven by

Answer 60

neutrophil recuritment and activation leading to release of cytotoxic granules that kill bacteria but also cause liquefying necorsis of surrounding tissue

Question 61

decrease chest wall compliance

Answer 61

increases work of breathing

Question 62

UTI: sepsis leads to what pulm

Answer 62

ARDS

Question 63

wedge shaped areas of hemorraghic necrosis caused

Answer 63

by pulmonary embolism

Question 64

SVC sydnroem caused by

Answer 64

anterior mediastinal mass