Pulmonary Flashcards

(156 cards)

1
Q

Alveolar Gas equation

PAO2=

A

PIO2 - (PaCO2/R)

Can be approximated PAO2= 150 - PaCO2/0.8***

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

A-a gradient

A

PAO2-PaO2 = 10-15 mmHG

increased indicates underlying lung pathology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Air in the stomach on CXR in an infant be concerned w/

Early warning in the mother?

A

Trachealoesophageal fistula and esphageal atresa

Polyhydrominos

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Most common type of tracheal esophageal fistula

A

C type w/ esophageal atresia and distal fistula

Type E (or H type) is the just a fistula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Diaphragm is made by the joining of what 4 structures?

Failure leads to?

A
septum transversum (from the cranial aspect)
fuses w/ pueroperitonela folds, abdominal walls, and esophageal mesentery

Failure congenitally leads to herniation and lung hypoplasia (usually the L) polyhydraminos associated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Presentation of congenital diaphragm heniation

A

polyhydraminos in utero
hypoplastic lung -> cyanosis and inability to breath

flattened stomach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

5 structures perforating the diaphragm and at what level?

A

T8 - IVC
T10 - esophagus
T12 - aorta, azygos vein, thoracic duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

innervation of the diaphragm

A

Phrenic C3-5

leads to referred pain to the shoulder (spleen and cholecysitis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Aspiration pneumonia is more likely going to be found in what lobe?

A

R lobe due to wider and more vertical

Peanut inspiration the same but if lying down will be in the superior portion od the right inferior lobe while standing up it will be inferior portion of R inferior lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Importance of bronchopulmonary segments? Contains?

A

separated by connective tissue - has a bronchus, and 2 arteries per segment, veins are in the periphery

Spepaerates out the right 3 lobes and the L 2 lobes further

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Smokers will see what transformation in their trachea

A

columnar ciliated cells -> stratified squamous through metaplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Chronic sinusitis, infertility and situs inversis?

Cause?

A

Kartagener syndrome

Due to dyenin not functioning leading to cilia defects all over

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Important measure of fetal lung maturity

A

lecithen:Springomyelin ratio being greater than 2.0

See if enough dipalmitolphasphatidylcholine is being made

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Product of type II pneumocytes?

A

dipalmitolphasphatidylcholine

other type II and I pneumocytes during injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Role of type I pneumocytes?

A

gas diffusion - very thin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

muscles of inspiration

  • quiet
  • exercise(3)
A

diaphragm

Sternocleidomastoid, scalenes, external intercostals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

muscles of expiration

  • quiet
  • exercise
A

quiet is passive

exercise - internal intercostals, transverse abdominus, rectus abdominus, internal and external obliques

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

TLC is the combination of?

A

Functional Residual capacity and Inspiratory capacity or

Inspiratory reserve volume and Tidal volume and experatory reserve volume and residual volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Inspiratory capacity is a combination of?

A

Tidal volume and inspiratory reserve volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Vital capacity is a comination of

A

expiratory reserve capacity, tidal volume and inspiratory reserve capacity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Functional reserve capacity

A

residual volume and expiratory reserve volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Determining the physiologic dead space formula

A

Dead space
= Tidal volume x [(PaCO2 - PeCO2)]/PaCO2

a= arterial
e expired air

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Functional residual capacity (FRC) what is the relationship between chest wall and lungs

how does it change in emphysema?

How does it change in fibrosis?

A

they are balanced in their pull - airway and alveolar pressure are 0 and the intrapleural pressure is negative

in emphasymia there is increased compliance so the FRC is increased. More volume at given pressure

in fibrosis there is decreased compliance so less volume at a given pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Diffusion limited gases are?(2)

what does that mean?

A

CO and O2 (in diseased state: emphysema/fibrosis)

means that the partial pressure of the arterial will not be saturated upon leaving the lung - amount of gas carried limited by the diffusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Perfusion limited gases(3) | what does that mean?
CO2, O2, N20 it means that the amount of gas that leaves the lung, the amount of gas carried is limited by the perfusion of the lung, equilibrates very quickly
26
How does COPD lead to Cor pulmonale
Cor pulmonale is heart failure due to lung disease. In COPD there is less oxygen perfusing the pulmonary vasculature leading to vasoconstriction and increased pressure. This increased pressure feeds back on the R heart leading to failure -normally vessels expand w/ decreased O2, lungs shunt away
27
Pulmonary hypertension is defined as?
>25mmHg in rest >35 mmHg exercising Normally 10-15 mmHg
28
Pressure is equal to? How does radius affect the system?
∆P = Q x R R = (8 x length x viscosity)/(pi x r^4)
29
IN pulmonary resistance, what can change? What can't generally?
radius of the tube viscosity of the fluid can't really change the length R = (8 x length x viscosity)/(pi x r^4)
30
Adding He to Oxygen does what
decreases the viscosity of the air and thus leads to less pressure ``` R = (8 x length x viscosity)/(pi x r^4) ∆P = Q x R ```
31
Primary pulmonary hypertension is due to
BMPR2 mutation -> increased smooth muscle proliferation Loss of function mutation where normally BMPR2 regulates growth and lose radius
32
Causes of secondary pulmonary hypertension (6)
``` COPD/fibrosis (vasoconstriction w/ low alveolar oxygen) Mitral stenosis(feeds back) ``` Autoimmune (infammation -> intimal fibrosis) sleep apnea/ high altitude thromboembolic events Left to right shunt (increased circulation)
33
Rx for pulmonary hypertension (4)
bosentan/ambriasentan prostaglandin analogs Sildenafil - phosphodiesterase inhibitors Dihydropyradine CCB - nifedipine
34
Adult Hemoglobin is normally made out of? How does it compare to fetal hemoglobin?
4 globin molecules (2 alpha 2 beta) w/ 4 heme molecules Fetal hemaglobin(2 alpha 2 gamma) has a higher preference for oxygen by being less affinity high 2,3 BPG, allows acquiring of oxygen from
35
2 types of states hemoglobin can be in and what favors each state
Taut - favors tissue and unloading - in the presence of high: H, temp, 2,3 BPG, CO2 relaxed form favors O2 binding -in the presence of low CO2, how H concentration and temp and 2,3 BPG
36
Hard working muscles leads to what type of hemoglobin state?
taught form and unloading of oxygen lactic acidosis, low CO2, increased temp and metabolites of oxidation (2,3 BPG)
37
Methoglobin is what?
Ferric form (Fe 3+), oxidized iron in the hemoglobin instead of ferrous (Fe+2) form Toxic for it favors cyanide more readily and does not favor O2 as much Nitrates indue this and is Useful Rx cyanide poisoning w/ thiosulfate to excrete the thiocyante
38
Rx for methomoglobinemia (2)
methylene blue and Vitamin C Also can give cimetidine over longer time
39
Agents known to cause methoglobin(6)
Methelglobin is the oxidized form of hemoglobin (Fe +3) ``` Nitrates/nitrities Antimalarials - chloroquine/primaquine Dapsone sulfonamide local anesthetics - lidocaine metoclopramide ```
40
Carboxyhemaglobin is? Complications associated w?
hemoglobin bound to CO, see cherry red lips - have decreased oxygen unloading in the tissues as a result Causes a L shift in the graph due to readily binding of CO to the hemoglobin and thus not able to carry as much oxygen (thus why pulse ox still shows high % sat because cannot differentiate what the hemoglobin is saturated w)
41
CO causes what kind of shift in the oxygen hemoglobin curve
Left shift Causes a L shift in the graph due to readily binding of CO to the hemoglobin and thus not able to carry as much oxygen (thus why pulse ox still shows high % sat because cannot differentiate what the hemoglobin is saturated w)
42
that causes a right shift in the hemoglobin oxygen curve and what does that mean from a oxygen unloading stanpoint
increased: CO2, [H] (low pH), temp and 2,3 BPG causes a right shift. Meaning there is left hemoglobin saturation at a given partial pressure of oxygen favoring unloading into the tissue(taut form) The opposite is true for low CO2, [H], temp and 2,3 BPG and CO-> fairs Hg saturation at lower arterial pressure
43
Anemia leads to what changes in the the following lab results: PaO2 Total oxygen content O2 saturation
PaO2 normal total oxygen content decreased O2 saturation normal
44
COPD leads to what changes in the the following lab results: PaO2 Total oxygen content O2 saturation
PaO2 decreased Total oxygen content down O2 Saturation decreased Physiologic shunt moves oxygen away from healthy tissue
45
Exercise leads to what changes in the the following labs PaO2 venous O2
PaO2 normal venous O2 is lower -due to increased metabolites -> right shift on the hemoglobin oxygenation curve
46
Normal A-a gradient? - what does it mean what may raise A-a gradient
15-10 mmHg means the difference in the O2 content in the alveoli - the O2 content in the arterial elevated gradient may mean hypoxemia - V-Q mismatch - older age - elevated FiO2 (giving O2) - fibrosis
47
If PaCO2 increases and all else is the the same, what happens to PAO2?
It decreases PAO2 =150 - (PaCO2/0.8)
48
What may change the PI02 in the alveolar gas equation
normally PAO2 = PIO2 (PaO2/R) -> PAO2= 150 - (PaCO2/0.8) PI O2 varries w/ atmospheric pressure and FiO2( the % oxygen content) high altitude lowers PAO2
49
A-a ratio
PaO2/FiO2 normally equals 300mmHg <200 = severe hypoxemia
50
What may cause normal A-a gradient hypoxeima?(2) Elevated ?(4)
normal ( low O2 in alveoli -> low O2 in blood) - elevated altitude - hypoventilation Elevated (not transfering) - fibrosis - VQ mismatch - R to L Shunt
51
What is ischemia and what are some causes?(2)
lack of blood FLOW Obstruction - MI/stroke Venous blockage - traffick jam
52
What is hypoxia and some causes? (4)
hypoxia is lack of O2 in the tissue heart failure, low CO output anemia hypoxemia CO poisoning
53
V/Q ratio at the base of the lungs?
is < 1 due to gravity there is excess perfusion to the amount of ventillation
54
V/Q ratio at the apex of the lungs
>1 due to blood falling down, there is excess ventilation ( why TB loves it here) With exercise the ratio approaches 1 w/ capillary recruitment of the apex
55
V/Q in pulmonary edmea
approaches 0 and is known as a shunt | airway obstruction limits the ventilation no mater how much blood flows through
56
Which of the following circumstances benefits from O2 High V/Q or low V/Q
Higher ventilation to perfusion would benefit more because of capillary recruitment low V/Q or ~ 0 would be a shunt and no mater how much O2 you give it will not make it
57
V/Q ratio in a PE
Blood obstruction leads to V/Q ratio approaching infinity The small flow can be increased w/ other capillaries being recruited with the ventilation -assuming less than 100% deadspace
58
CO2 is carried in the blood how (3)
- dissolve in blood - Bicarb - carried on the N terminal of the glob in (NOT heme group) as carbaminohemoglobin - -binding encourages taut form (O2 release)
59
Exercise has what effect on the following? ``` V/Q ratio pulmonary blood flow pH PaO2 PaCo2 Venous O2 Venous Co2 ```
``` V/Q-> 1 pulmonary blood flow increases w/ CO pH drops w/ lactic acidosis Pa O2 - No∆ Pa Co2 - no ∆ Venous O2 - decreases Venous CO2 - increases ```
60
How does hematocrit and Hemoglobin change in high altitude
Increases 40%-> 60% hematocrit 15 g/dL -> 20 g/dL
61
Responses of the bode to high altitude(5)
Increase in ventilation Increase in EPO -> (increased Hct and Hbg) Increased bicarb excretion (renal comp for Resp alkalosis) Increase in 2,3 BPG -> right curve shift Increase in mitcochondria
62
How does acetazolamide help with acute mountain sickness
acetazolimide augments the loss of bicarb already being losses to help with respiratory alkalosis due less alveolar oxygen pressure -> hypoxemia
63
How many Gs needed to pass out why do you pass out
4-6 Gs Due to blood pooling in the legs and abdomen -> lack of return to the heart and lack of brain perfusion
64
Clinical derangements seen in acute MTN sickness(4)
HA Fatigue Acute cerebral edema (hypoxia induced vasodialtion) Acute pulmonary edema (hypoxia induced vasoconstriction -> local HTN and permeability)
65
Chronic MTN sickness see? (6)
``` increase in RBC mass and hematocrit increased blood viscosity -> decreased flow elevated pulmonary artery pressure -> right sided heart enlargement -> peripheral artery pressure falls -> CHF ```
66
How is the following affected by zero gravity? ``` blood volume RBC mass muscle strength Cardiac Output bone mass ```
all is decreased Bone mass lost due to loss of Ca and phosphate
67
What is nitrogen necrosis and pathophys
nitrogen necrosis is when N in the air is dissolved into the neural membrane causing reduced neuronal excitability in high pressure environments Diver -> jovial and carless (drunk) - loss of strength and coordination
68
Hyperbaric treatment is useful for what 4 conditions
CO poisoning Decompression sickness Gas gangrene - clostridium Osteomyolitis
69
Symptoms of decompression sickness(3)
``` Pain ->in the joints, and muscles of arms/legs Neurologic symptoms -> dizziness, paralysis, syncope Chokes -> SOB, pulmonary edema and death ```
70
Virchows triad -> risk of DVT
hypercoagability -post partum, sickle cell, polycythemia, CHF, estrogen Stasis -post op, long trips, pregnancy Endothelial damage - fracture, infection, post op
71
Symptoms of DVT
swollen foot or ankle +/-: - pain - homan's sign - pain with calf dorsiflexion - palable cord
72
Diagnosis of DVT?(2)
- D dimer if low probability | - compression US if high
73
Rx for DVT
heparin or enoxaparin until the Warfarin is therapeutic
74
PE symptoms(5) can mimic?
``` Pleuritic chest pain* SOB* cough hemptysis - rare fever ``` tachypenia* tachycardia* acute mental status ∆* MI
75
Studies that can help diagnosis a PE (6)
``` elevated D dimer large A-a gradient EKG CT VQ scan pulmonary angiogram ```
76
What is seen in 20% of PE EKGs
S1Q3T3 -acute pressure an R ventricle overload wide S on lead 1 Lead 3: large Q and inverted T wave
77
Causes of emboli and respective sources(6)
Fat emboli - long bone fractures and liposuction Bacteria - endocarditis amniotic fluid - post partum Thrombi - vichows triad tumor air- IV(rarely); the bends
78
A negative D dimer tells you what?
rules out clotting and PE for lack of fibrin degeneration products, plasmin is not dissolving things Positive does not tell you much
79
Primary pneumothorax is due to?
tall younger thin males that have blebs that rupture no lung disease prior
80
obstructive lung disease: FEV1 FVC FEV1/FVC TLC
FEV1 decreased a lot FVC decreased Ratio is decreased - less than 80% TLC is increased
81
Restrictive lung disease FEV1 FVC FEV1/FVC TLC
FEV1 decreases the same amount as FVC. FVC may a little more -> Normal to slightly increased ratio TLC is decreased
82
blue bloater
chronic bronchitis | hypoxemia, hypercapneia
83
pink puffer
emphysemia | hyperventilation, dypsnea
84
Most common cause of pulmonary hypertension?
COPD
85
chronic bronchitus is defined clinically as
Productive cough > 3months over 2 years
86
Reid2 ty index
Measure of chronic bronchitis where goblet cells hypertrophied to greater than 50% the distance of the bronchial wall
87
chronic bronchitis pathophysiology
a form a COPD (blue bloater), the patin has constant exposure to som irritant leading to mucal hyperplasia and narrowing of bronchial wall -> hypoxemia, wheezes, crackles, cyanosis, and late onset dypsnea
88
Emphysema pathophysiology
destruction of lung parenchyma either through increased elastase activity w/ lack of alpha1 antitrypsin deficiency or due to smoking leads to increased lung compliance and enlargement of air spaces NOT cyanotic
89
2 types of emphysema and etiologies
Panacinar in the lower lung fields is associated w/ alpha 1 antitrypsin deficiency Centriacinar is in the upper lung fields and associated w/ smoking
90
Have a patient w/ history of emphysema that presents with acute exacerbated SOB be worried of?
pneumothorax
91
Key feature of asthma as an obstructive lung disease
it is reversible
92
Curschmanns spirals
sloughed off epithelium that forms mural plugs in asthma
93
Charcot leyden crystals
breakdown of eosinophils from inflammation associated w/ asthma
94
Findings in asthma
cough, wheeze, tachypnea, dypsnea, hypoxemia, low I/E ratio, pulsus paradoxis
95
Pulsus paradoxis is? Associated w?
smaller pals pressure associated with decrease L ventricular filling due to overfilling of the R ventricle upon inspiration asthma
96
Bronchiectasis is associated w/ what pathology(4)
kartageners syndrome CF Smoking allergic bronchopulmonary aspergillosis
97
Bronchiectasis pathophysiology
chronic necrotizing infection of bronchi -> permanently dilated airways w/ purulent sputum discharge abcesses
98
Concern w/ beta 2 agonists?
there is some spillover to beta 1, levabuterol has less see tachycardia and arrhythmia at higher doses
99
adenosine may not work in emergency cardio situations due to the presence of what other drug>
Theophylline
100
If a patient is having to use their albuterol inhaler more than 2x/week consider adding on a
inhaled steroid - fluticasone - beclomethasone - budesonide
101
antihistamine used in N/V
promethazine
102
antihistamine used in vertago
meclizine
103
antihistamine used in appetite stimulation
cyproheptadine
104
Expectorants (2)
Guaifenesin | N acytelcysteine
105
Types of restrictive lung disease | (3 general categories)
Poor breathing mechanics -poor muscular effort(Guillian barrie, myasthenia gravis, polio) -poor structural apparatus (scoliosis, kyphosis, obesity) Interstitial lung disease - ARDS - Neonatal RDS - Pneumoconioses - Sarcoidosis - idiopathic pulmonary fibrosis - Goodpastures syndrome - Granulamatosis w/ polangiitis - wegeners - Langerhans histiocytosis/eosinophilic granuloma - Hypersensitivity pneumonitis - drug toxicity
106
Interstitial Lung disease causes (10)
- ARDS - Neonatal RDS - Pneumoconioses - Sarcoidosis - idiopathic pulmonary fibrosis - Goodpastures syndrome - Granulamatosis w/ polangiitis - wegeners - Langerhans histiocytosis/eosinophilic granuloma - Hypersensitivity pneumonitis - drug toxicity
107
Sarcoidosis associations/presentation
A GREULING Disease ``` ACE increase Granulomas - noncaseating RA - sometimes Erythema nodosum Uveitis LAD (hilar, bilateral) Idiopathic Not TB Gamma globulinema D- Vit D increase -> hypercalcemia ```
108
honeycombing of the lungs
idiopathic pulmonary fibrosis
109
tennis racket shape cytoplasmic organelles
Beirbeck granules in langerhans histiocytosis, eosinophilic granuloma
110
Hypersensitivity pneumonitis examples?
Restrictive lung cause | - organic dust leading to farmers lung or pidgins lung
111
Pneumoconioses (4) and brief cause
Anthracosis - Coal miners lung Silacosis - sand balding and the mines Asbestosis - pumbers/shipyards/roofers Berylliosis - aerospace manufacturing
112
Anthracosis is and associations?
Coal miners lung - > restrictive lung disease in the upper lobes - damage due to macrophage response No risk of CA
113
Silacosis hisology? associations?(2)
Eggshell calcification of hilar lymph nodes -> macrophages respond to silica and release fibrogenic factors -> restrictive lung disease in the upper lung Associated w/ increase risk of TB and bronchogenic carcinoma
114
Asbestosis histology (3) Associations?
see ivory white calcified pleural plaques in the lower lobes Asbestos bodies - golden brown fusiform rods (dumbbells) w/in ferruginous bodies - hemosiderin (Fe) laden bode asbestos fibers Higher risk of -bronchogenic carcinoma* mesothelioma
115
golden brown fusiform rods resembling dumbbells found on histology
asbestos bodies
116
Beryllliosis | 2 associations
aerospace manufacturing - > noncaseasting granulomas - > increased lung cancer risk
117
Therapeutic oxygen in neonatal respiratory distress carries what risk?(2)
retinopathy of prematurity( white reflex due to vascular prolix in the inner retina) and bronchopulmonary dysplasia
118
Maternal steroids should be given how soon before a premature mother gives birth
24-48 hrs
119
Causes of ARDS
``` truama sepsis shock gastric aspitation pancreatitis toxic gas inhalation high O2 uremia infection heroin overdose ```
120
the pathophysiology of ARDS
Injury due to (shock, sepsis, High O2, Heroin OD.... ) -> inflammatory cells and mediators and oxygen free radicals - >alveolar damage to the Type I pneumocytes or endothelial cells - > increase alveolar capillary permeability - > Diffuse Alveolar Damage and Hylaine Membrane Disease Which feeds back and causes more damage w/ recruited cell mediators Immune system causes more damage after the initial insult
121
Complication Risks of ARDS?
DIC and coagulation cascade activation
122
Sleep apnea is defined as
repeatesd cessation of Breathing >10s during sleep -> disrupted sleep -> disrupted daytime
123
Pulmonary HTN w/ Sleep Apnea?
due to hypoxemia and responding vasoconstriction of the lungs can lead to systemic?
124
4 common METS of lung cancer
BLAB Bone Liver Adrenal Brain
125
Presentation of lung Ca? (variety)
``` Cough and hoarseness - Recurrent laryngeal Horners syndrome Weight loss coin lesion wheezing Dysphagia paraneoplastic syndromes -Hypercalcemia w/ squamous cell -SIADH, Lambert Eaton, and Cushings in Small cell ```
126
4 traditional tumors and their respective locations
Non small cell - Adrenocarcinoma - periphery - Large cell carcinoma - periphery - Squamous cell - central Small cell - central
127
Lung Cancers associated w/ Smoking(4)
Large cell Bronchioalveolar subtype of adrenocarcinoma squamous cell small cell/ Oat cell
128
Lung cancers not associated w/ Smoking(3)
Adrenocarcinoma mesothelioma Bronchial Carcinoid tumor
129
Most common cancer in nonsmokers and associated mutation
Adrenocarcinoma - k RAS CEA + Subtype bronchioalveolar is associated w/ smoking and presents as hazy infiltrates ~ pneumonia
130
Cancer that may first appear as pneumonia or hazy infiltrate
bronchioloalveolar subtype of adenocarcinoma
131
Highly anapestic, undifferentiated tumor made of pleomorphic giant cells in the periphery of the lung?
Large cell carcinoma poor prognosis
132
Squamous cell carcinoma of the lung presents as (4)
hilar mass in the bronchus Keratin pearls Cavitations on CXR or CT Hypercalcemia w/ paraneoplastic PTHrP
133
Small cell carcinoma presents as (5)
Paraneoplastic - SIADH - Cushings w/ ACTH produced - Lambert Eaton (weakness due to Ab against presynaptic Ca channels) Central and undifferentiated Kylchitsky cells - small dark blue cells myc associated
134
Kulchitsky cells
small dark blue cells in small cell carcinoma myc oncogene associated
135
Lung tumor associated with right sided heart lesions and murmurs. What also may be seen (3)
Bronchial carcinoid tumor -neuroendocrine cells secreting serotonin BFDR Bronchospasm Flushing Diarrhea R Sided Heart symptoms and murmurs
136
Pancoast tumor may present as(2)
Horner syndrome - ptosis - myosis - anhydrosis hoarsness (recurrent laryngeal nerve compression)
137
Radon exposure leads to an increase risk of?
Lung cancer - seen in mines and basements
138
Mesothelioma is found where and presents as? (3)
associated w/ apsestosis and found in the pleural lining hemorrhagic pleural effusions pleural thickening psammoma bodies
139
Most common cause of pneumonia in immunecompromised
pneumocystis jirovecii
140
most common cause of atypical pneumonia
mycoplasma pneumonia
141
common pneumonia in alcoholics
Klebsiella
142
common cause of pneumonia in bird handlers
chlamydophilia psittaci
143
often causes pneumonia in a patient w/ a history of exposure to bat or bird droppings
histoplasma
144
Often cause pneumonia w/ a history of traveling to S Cali, New mexico, W Texas
Coccidiodes
145
current jelly sputum pneumonia
klebsiellia
146
q fever pneumonia
Coxiella burnetti
147
Most common cause of pneumonia in children 1 yr old or younger
RSV
148
Most common cause of pneumonia in neonate (birth -28days)
Group B | E coli
149
Most common cause on pneumonia in children and young people
mycoplasma pneumonia
150
Most common cause of viral pneumonia
RSV
151
Wool sorter's disease pneumonia due to
Bacillus anthacis
152
Common cause of pneumonia in ventilator patients and those w/ CF
Pseudomonas
153
lung abcesses are often due to
aspiration of oropharyngeal contents - anaerobes (bacteriodes, fusobacterium, peptostreptococcus) - S aureus - Klebsiella
154
Chylothorax
lymphatic tissue from the thoracic duct that has been damaged leaking into the pleural space causing an effusion milky white appearance
155
Transudate causes of pleural effusion
Volume overload - CHF, cirrosis | Lack of protein - nephrotic syndrome
156
Exudate causes of pleural effusion
malignancy, pneumonia, callogen vascular disease, trauma all due to increase vascular permeability w/ inflammation