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FOM Final Knowledge Exam > Quiz 3 Material pt 2 > Flashcards

Quiz 3 Material pt 2 Flashcards

(85 cards)

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1
Q

How can measured FEV and FVC obtained from spirometry differentiate obstruction from restriction?

A

Obstruction results in a lower FEV/FVC ratio, while restriction results in a proportional decrease in both FEV and FVC, with a normal ratio

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2
Q

Understand the following lung capacities pictured

A
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3
Q

What two primary variables determine air resistance in a tube (used in airway resistance)?

A

length and radius of tube

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4
Q

Which of the two primary variables in calculating air resistance has a greater importance? Why?

A

radius, because mathematically it is raised to the 4th power

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5
Q

Where is blood flow/perfusion (Q) highest in the lung?

A

the base of the lung

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6
Q

What is a normal V/Q ratio?

A

0.8

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7
Q

What is dead space?

A

Area of the lung/airways that does not participate in gas exchange; V/Q = infinity

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8
Q

What is the difference between anatomic and physiologic dead space?

A

Anatomic is present in all humans and is about 150ml, physiologic is present in individuals with damaged alveoli

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9
Q

What is a shunt?

A

Gas exchange is not possible due to lack of ventilation of area; V/Q = 0

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10
Q

What is the paO2 and paCO2 of mixed venous blood?

A

paO2 = 40mmHg
paCO2 = 46mmHg

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11
Q

What is the paO2 and paCO2 of systemic arterial blood?

A

paO2 = 100mmHg
paCO2 = 40mmHg

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12
Q

What is the Bohr effect associated with?

A

Increased CO2, decreased pH, increased temperature, and increased 2,3-DPG

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13
Q

What is the Haldane effect?

A

When less O2 is bound to Hg, its affinity for CO2 will increase

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14
Q

What innervates the costal parietal pleura?

A

intercostal nerves

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15
Q

What innervates the diaphragmatic parietal pleura?

A

the phrenic nerve

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16
Q

What innervates the mediastinal parietal pleura?

A

the phrenic nerve

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17
Q

What innervates the viscera parietal pleura?

A

visceral sensory nerves via the vagus nerve

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18
Q

What is the pathology of pneumothorax?

A

Pressure in the lungs equalizes with the pleural space, causing lung collapse

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19
Q

What is the meaning of the acronym RALS?

A

RIGHT PA is ANTERIOR to bronchus, LEFT PA is SUPERIOR to bronchus

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20
Q

What spinal cord levels provide sympathetic innervation of the lungs?

A

T1-T5

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21
Q

What is the postsynpatic nerve that innervates the lungs?

A

the cardiopulmonary splanchnic nerve

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22
Q

As AMP levels rise and activate AMPK, what is the effect on metabolism?

A

Catabolic metabolism is activated

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23
Q

What are two main cellular effects of mitochondrial uncoupling?

A

Increased NADPH oxidation and O2 consumption

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24
Q

What is the mechanism of mitochondrial uncoupling?

A

Since ATP generation is uncoupled from the ETC, cells will upregulate glycolysis, TCA, and ETC

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25
What vitamin is necessary for NAD cofactor formation?
Niacin (vitamin B3)
26
What vitamin is necessary for FAD cofactor formation?
Riboflavin (vitamin B2)
27
What vitamin is necessary to make Coenzyme A?
Pantothenic acid (vitamin B5)
28
What vitamin is necessary for a-ketoglurate dehydrogenase function?
Thiamine (vitamin B1)
29
What two prominant conditions can result from vitamin B1 deficiency?
Wernicke encephalopathy and Korsakoff syndrome
30
How is Wernicke encephalopathy characterized?
confusion and loss of mental activity that can progress to coma and death
31
How is Korsakoff syndrome characterized?
Long term memory loss due to vitamin B1 deficiency
32
Referred pain from the phrenic nerve might appear in which dermatomes?
C3-C5
33
Which pulmonary cell is most easily dysregulated and overactive in cases of chronic smoking?
alveolar macrophages (dust cells)
34
What is the pathology of RSV (respiratory syncytial virus)?
the virus binds to the epithelial cells and causes necrosis and ciliary dysfunction; inflammation leads to edema, and resistance to flow causes wheezing
35
What characterizes emphysema?
large alveoli and increased compliance (large, deflated, and low elastic recoil)
36
What are the two main functions of club cells in the lungs?
They act as respiratory exocrine cells, and can serve as stem cells to mitigate damage (they represent 80% of respiratory epithelium in bronchioles)
37
Where does the sympathetic innervation of kidney arise from the spinal cord?
T10-T12
38
What nerve supplies sympathetic innervation to the kidney?
The lesser or least splanchnic nerves
39
What nerve supplies parasympathetic innervation to the kidney?
There is no PS innervation of kidney
40
What two capillaries beds form the nephron portal system?
the glomerulus and the peritubular capillaries
41
What is the name of the second capillary bed in juxtamedullary nephrons?
the vasa recta
42
How much of the renal filtrate is absorbed back into the blood?
99%
43
What are the two functioning parts of the countercurrent multiplier system?
TAL- allows for Na+ effluex into interstitium DTL- allows for H2O to enter interstitial fluid
44
What is the purpose of the vasa recta in the countercurrent exchange system?
To move Na+ from the TAL to the DTL interstitium, and H2O from the DTL interstitium to the TAL
45
What is the ultimate effect of the RAAS system?
An increase in BP
46
During what weeks does the Embryonic stage of pulmonary development take place?
Weeks 4-7
47
What main events occur during the Embryonic stage of lung development?
Respiratory diverticulum -> tracheal growth -> esophagus and trachea separate -> lung buds form
48
What main pathologies originate from the Embryonic stage of lung development?
TEF and EA
49
During what weeks does the Pseudoglandular stage of pulmonary development take place?
Weeks 6-17
50
What main events occur during the Pseudoglandular stage of lung develoment?
terminal bronchioles and capillary network forms -> inactive alveoli begin to form
51
What main pathologies occur during the Pseudoglandular stage of lung development?
Potter's sequence as well as diaphragmatic hernia
52
During what weeks does the Canicular stage of pulmonary development take place?
Weeks 17-26
53
What main events occur during the Canicular stage of lung development?
Respiratory bronchioles and alveolar ducts form, T1 and T2 pneumocytes appear
54
During what weeks does the Saccular stage of pulmonary development take place?
Weeks 24-36
55
What main events occur during the Saccular stage of lung development?
Surfactant production begins, and the blood/air barrier forms completely
56
What main pathologies occur during the Saccular stage of lung development?
Respiratory Distress Syndrome
57
During what weeks does the Alveolar stage of pulmonary development take place?
32 weeks to 8 years
58
How does retinoic acid (Vitamin A) affect lung development?
Key for lung bud initiation Insufficient retinoic acid can lead to lung defects or pulmonary aplasia
59
Branching morphogenesis of the lungs is dependent on what growth factor?
FGF
60
Around what period does the pronephros first appear?
4 weeks
61
What vitamin is pronephros formation dependent on?
Vitamin A
62
For what period is the mesonephros present?
Weeks 5-16
63
What induces the mesonephros to develop?
the mesonephric duct
64
What critical structure appears during the mesonephros period?
the ureteric bud
65
The Metanephros begins development at what week? Around what week does it finish?
Week 5; Week 10
66
What are the two functional parts of the Metanephros?
the metanephric blastema and the ureteric bud
67
What part of the nephron is formed by the metanephric blastema?
Bowman's capsule through the DCT
68
What part of the nephron is formed by fetal capillaries?
the glomerulus
69
What part of the nephron is formed by the ureteric bud?
CT through the ureter (minor/major calyces and renal pelvis)
70
What structure induces the ureteric bud to elongate and begin branching morphogenesis?
the metanephric blastema
71
What is the function of Wilms Tumor 1 gene in nephrogenesis?
WT1 is required for maintenance of the blastema
72
What is the function of retinoic acid in nephrogenesis?
ureteric bud formation
73
What is the function of FGF in nephrogenesis?
stimulation of bud growth and branching
74
Around what period do the kidneys relocate from a sacral to lumbar position?
6-9 weeks
75
What is the main pathology of congenital hydronephrosis?
blockage of the ureter
76
In a patient with an ectopic ureter where might dribbling of urine be found?
the vagina, rectum, etc.
77
What is the net transaction of the phosphate buffer system in the nephron?
1 H+ secreted into tubular lumen for 1 HCO3 added into bloodstream
78
What does an elevated ion gap mean?
That there are additional organic acids in the bloodstream acting to lower the pH
79
The acronym MUDPILES is used to represent potential causes of elevated ion gap metabolic acidosis. What does it stand for?
Methanol, Uremia, Diabetic ketoacidosis, Paraldehyde or Paracetamol or Propylene glycol, Iron tablets, Lactic acidosis, Ethylene glycol, Salicylates or Starvation ketoacidosis
80
What are the potential causes of a normal anion gap metabolic acidosis (HARDASS)?
Hyperalimentation (tube feeds), Addison's disease, Renal tubular acidosis, Diarrhea, Acetazolamide, Spironolactone, Saline infusion
81
What are causes of acute/chonic respiratory acidosis?
Acute- airway obstruction, CNS depression to due drug overdose, pneumonia, pulmonary edema Chronic- COPD, emphysema, CNS depression, NM impairment (ALS)
82
What are causes of metabolic alkalosis?
Vomiting, diuretics, exogenous HCO3, excessive aldosterone
83
What can cause respiratory alkalosis?
Acute- hyperventilation, salicylate intoxication or sepsis Chronic- pregnancy, cirrhosis
84
How could you calculate anion gap from lab results?
Na+ + HCO3 - Cl-
85
When is an anion gap elevated?
When it is greater than 14

FOM Final Knowledge Exam (6 decks)

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