Resp Flashcards by Nathan Hansen

Sinus development

Maxillary inital, prmanent

Ethmoid initial, permanent

Sphenoid initial, permanent

Frontal inital, permanent

birth, 4

birth, 12

<2, 12

6-8, 15-18

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Control of respiration

Voluntary from the ___

Automatic from __ and __ pacemaker cells

Activate__ and __ spinal motor neurons

cerbral cortex

pons/medulla

cervical/thoracic

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Automatic Control of respiration

signal location
vagal affarents from ___
__/__ receptors inhibit inspiration

Muscle/joint receptors, as movement stimulates __

Carotid/aortic chemoreceptors
CO2/H+ __ conc activates impulses to medulla
O2 ___ conc activates impulse to medulla

Medlla chemoreceptors
__/indirect __ inc conc stimulates respiration

lungs
stretch/irritant

respiration

inc
dec

H+/CO2

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Maximum exercise capacity deermined by ___

exercise requires increased ____

Proportional to ___

__ inc in hyperbolic pattern
__ inc in linear pattern

Training increases ____

oxygen uptake

minute ventilation

CO2 production

tidal volume
respiratory rate

maximm tidal volume

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TLC
RV
FVC
FEV1

obsstruction asthma
COPD
restriction Obesity
weakness
Lung

normal, inc, dec, dec

inc, inc, dec, dec

n, n, dec, de

dec, inc, dec, dec

dec, dec, dec, dec

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Elastic property of chest wall and lungs is ___
change in __ for change in intrapleural ___

Tendency of deformable body to return to baseline shape is ____

compliance
volume, pressure

recoil

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compliance is __ in obstructive dz
elastic recoil is ____

compliance is ___ in restrictive dz
elastic recoil is ____

inc
dec

dec
inc

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DLCO should be normal in __ and __ and ___

altered in __ and ___

asthma, obesity, weakness

COPD, IPF

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O2 binding in lung
inc w dec ___/__, high __
___ 2/3BPG

O2 release in tissue
inc __ and ___
low ___
___ 23BPG

temp, CO2
pH
dec

temp, CO2
pH
inc

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Resonant percussion, vibratory TF, auscultation is vesicular

lung is ___

normal

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percussion is dull, TF is inc, auscultation is dec/bronchial

dx is ___

lobar consolidation

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percussion is dull, TF is dec, auscultation is dec

dx is

pleural effusion

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percussion is inc, TF is dec, auscultation is dec

dx is ___

pneumothorax

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<2 yrs old, particularly 2-6m
copius rhinorrhea
wheezing, retractions, tachypnea

dx is ___
caused by ____

bronchiolitis

RSV

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unimunized
high fever, drooling.distress

dx is ____
caused by ___

epiglotitis

Hib

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<3 YO, acute progressive cough
inspiratory stridor

dx is _____
caused by ___

laryngotracheitis

parainfluenza virus

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<6m or teenager
mild cough, becomes paroxysmal
gradually resolves

dx is ____
caused by -___

pertussis

bordetella pertussis

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newborn
chronic, croup like cough
inspiratory stridor, no RDS

dx is __

caused by inc ___

tracheomalacia

proportion of mucous membreans

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acute otitis media
usually ____ of middle ear

orgs
S pneumo- resistance via __
Hib ressitance via __
possible M/S/S

acute onset __/__/___
middle ear effusion w __/impaired ___
inflammation shows __/__

bacterial infection
penicillin binding proteins
beta lactamses

moraxella, staph, strep

fever/pain/irritability
opacity, mobility
bulging/redness

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if ear pain, low grade fever, irritable, rhinorrhea

tympanic membrane is clear

dx is ____
tx w ____

OM w effusion

ibuprofen

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asx
tachypnea, poor feeding, FTT
crecendo/decrescendo murmur at RUSB

dx is ___
can be due to __/__/__ valve

aortic stenosis

bicuspid/unicsupid/dysplastic

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upper airway noisy breathing
cyanosis w feeding
imrpoves w crying

dx is ____
presents w ____

choanal atresia

midface growth abnorm

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Premature, sudden RDS
hypoxia

Dx is ___
inc ___

PTX

transpulm pressure

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Worse w agitation, tachypnea, cyanosis
harsh systolic murmur RVOT obstruction

dx is ____
4 components

tetralogy of fallot

VSD/overriding aorta/RVH/PS

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RDS w feeding aspiration dx is ____ failed __ of ____

TEF | lateral septation of forgeut

Neonatal RDS __ def leads to high surface tension dec __ leads to atalectasis and hypoxia Lung __ and epithelial cell __ leads to ___ CM: tachypnea, N/R, cyanosis PTX and air leaks

surfactant compliance inflammation, injury, PE nasal flaring, retractions

Dx neonatal RDS __ infant Xray shows diffuse __ appearance and ___ prevent w ___ at 23-34 w GA tx w ____

premature reticulogranular, air bronchograms CS surfactant

pt around 6m of age w recurrent infections esp P jirovecci dx is ___

SCID

freq infections over lifespan PNA/sinusitis/malabsorption bacteria such as staph aureus, Pseudo, B cepacia dx is ___ __ defect causing thickened ___

CF | ion channel, airway secretiions

PNA/sinusitis in male infections w encapsulated orgs dx is ___

XLA

chronic allergic rhinitis recurrent sinusitis/otitis autoimmune cx like transfusion rxn dx is ___ deficient in ____

IgA def | IgA prodxn

alcohol assc cancers (3) arsenic (5) b/k/l/l/s asbestos assc cancer 2 Beryllium assc cncer cadmium assc cancer chromium assc cancer

H./N/lng bladder/kidney, liver/lung/skin lung/mesothelioma lung lung lung

Tobacco cancers B/C/C/H/N/L/P pesticides assc cancer H/N/L/P/S/S radon assc cancer PVC assc cancer __ and __

bladder/cervix/colon/H/N/kidney/lung/pnancres H/N, lung, prostate, skin, stomach lung lung, angiosarcoma

dyspnea, reduced FEV1, cough, coryza, SpO2 is normal intercostal retractions dx is ___ treat w ___ test w ___

asthma albuterol spirometry

well controled asthma has nighttime sx less than __ per m albuterol used ___ poorly controlled has nighttime sx greater than __ per w albuterol used ____

1 less than 2d/w 1 multiple times daily

<7, wheezing, nighttime cough, episodic SOB dx is ___ dynamic ___ from __ infalmm of airways

asthma airflow limitation eosinophilic

recurrent bacterial infections IC/CF pt chronic productive cough/SOB dx is ___ __ and ___ of major bronchilole walls after ____

bronchiectasis | dilated/destroyed, recurrent infections

adult > 50 gradual SOB/cough smoker dx is ____ distortion of ___ from progrssive ___

PF Pulmonary architectre fibrosi

adult >40 >20 py smoking dyspnea, cough, productive dx is ____ progressive __ from enhanced ___

COPD airflow limitation inflammatory response

acute PE < 2 ya progressive SOB exercise intolerance dx is ___

Pulm HTN from recurrent thromboemboism

daytime sleepiness fatigue, snoring dx is ___ test w __ looking for __/__ on AHI> 5/hr tx w ___ and ___ Wl cannot __ but __ can

OSA polysomnography apnea/hypopnea CPAP, weight loss resolve apnea, CPAP

otitis media, sinusitis, pediatric PNA gram positive batceria tx w ___

amoxicillin

uncomp PNA and COPD exacerbation tick born dz nongonoccal uretrhtisis good for gram positive atypical chlamydia tx w ___

doxycycline

dual therapy for PNA and meningitits good for gram +/- tx w ___

cefotaxime

nosocomial PNA, skin/soft tissue infections good for MRSA/VRE tx w ____

linezolid

MCC of pneumo 5-40 YO diffuse interstitial pattern could be __ or ___

mycoplasma | chlamydophila

spread by inhalation of aerosols PNA is ___

legionella

HC assc PNA multiple comorbids usually ___ such as K/E/P

gram neg rods klebsiella, escheria, pseudo

gradual fever, coguh, SOB, hypoxia IC pt PNA w ____

pneumocystis

primary sx of TB xray shows __ and ___ reactivation sx xray shows ___ and ___ some __/___

fever hilar AN, pleural effusion cough, WL, fatigue, F/NS upper lobe infiltrate/cavity hilar AN/PE

HIV + person recent contact w TB CXR consistent w TB immunosupression PPD should be ___

recent immigration IVDU HIV neg high risk setting ``` high risk for acitve dz siicosis L/L WL gastrectomy child younger than 4 ``` PPD should be ___

>10

screen pt for lung cancer criteria annual ___ CM: H/I/D/C

55+ w 30+ py smoking hx low dose CT hemoptysis, infection, SOB, cough

``` lung cancer fx hyponatremia via __ fatigable limb weakness via ____ ab directed against ___ plethora/facial edema, SOB, distendedd neck veins via ___ ``` dx is ____

SIADH LEMS voltage gated Ca channels SVC syndrome SCLC

lung cancer fx Hypercalcemia via ___ Horner syndrome/shoulder pain via ___ tumor located in ___ dx is ___

pancoast syndrome superior sulcus NSCLC

high probabilyt of PE tx options begin ___ image via ____ and __ if -

heparin | CT angiography, Doppler US

PF:serum protein < ___ PF: serum LDH < ___ Pleral fluid LDH < ___ must have ___ effusion is __ common cx inc hydrostatic pressure H/C dec oncotic pressure H/N/C/M

.5 .6 200 all transudate HF, constrictive pericarditis hypoalbuminemia, nephrotic sx, cirrhosis, mal

PF: serum protein > .5 PF: serum LDH >.6 Plerual fluid LDH >200 if have ____ PE is ___ seen w I/N/C/P/H

any exudative infection/neoplasm/CVD/pulm infarct/hemothorax

movement of interstitial fluid into pleural space PE is ___

exudative

Empyema is ___ __ into pleural space fluid is __, with high __ or positive ___ tx ___

exudative bacteria acidic, LDH, culture chest tube

Chylothroax is ____ __/__ of thoracic duct can result from ___ such as thoracic surgery or severe chest trauma or ___ such as L/L/met ccancer pleural fluid TG > ____

exuative obstruction/disrupton trauma malignancy 110

idiopathyic multisystem granulomatous dz dx is ____ CM: F/W/N Dry ___, bilateral __ skin shows ____ hyper___ as granuloma produces ____ ``` Lofgren syndrome F B E Arhritis, usually in ___ ```

sarcoidosis fever, wl, night sweats cough, hilar LN EN Ca, calcitriol fever bilateral hilar LN EN ankle

PaO2 <60 SOB, cyanosis, confusion, delirium, tachycardia, tachypnea RF is _____

hypoxemic

hypoxemic V/Q mismatch P/C w blood flow but poor ventilation good ventiltion, poor perfusion ____ intrapulmonary shint like __/___

PNA/COPD PE PNA/AVM

Hypoxemic rf diffusion defect thickened alveolar membrane like ____ fluid filled aveoli like P/E/A

ILD | PNA, edema, atalectaiss

PaCO2 >50 SOB, HA, hyperemia, hypopnea, apnea, asterixis __ RF ``` hypoventilation pulm dz liek __/___ CNS dz like H__/H__/E__ NM dz like __ or ___ Sedation__ chest wall dysfxn ___ O ```

hypercarbic ``` COPD/asthma head trauma/herniation/enceph GB/ALS opioids scoliosis obesity hypovent syndrome ```

Resp acidosis retains ___ acute has HCO3 inc __ for each __ inc pCO2 metaolic compensation begins ____ CNS depressin like S/I/T/I/B chronic: HCO3 inc __ for each __ inc PCO2 inc renal excretion of ___ in 24hrs NM causes G/M/M/A resp casues C/I/P

CO2 1, 10 immediately sedation, ischemia, trauma, infect, tumor 4, 10 NH4 GB/MS/MG/ALS COPD/ILD/PE

Resp alkalosis loses ___ via hyperventilation CM: P, a ``` acutely A/P S S/P/C S ``` ``` chronic H H P C ```

CO2 paresthesias, anxiety anxiety/pain stroke salicylates, prg, catecholamines sepsis hyperT hypoxia preg cirrhosis

ARDS most common etiology also A/P/severe ___ PaO2/FiO2 __ infiltration causing __ infiltrate inc ___ resulting in PE __ daage w pneumcyte destxn/fibrosis loss of __ creates surfactant def

sepsis aspiration/pna/traua 200 pulm infiltrates HF PMN, alveolar infalm lung perm epithelial t2P

CO poison ___ indoors malfxn ___ CM occurs in ___ HA/lighthead/confusion/CP/SOB __ appearnace to skin evaluate pulse ox/ABG is ____ measure ___ manage w ___

burning heat source heating system multiple members cherry red normal carboxyhemogolobin supplemental o2

Barotrauma- complication of ___ ___: compression air in lungs comps P/H __ oxerexpansion of air in lungs comps A/P

scuba descent PE/hemorrhage ascent alveolar rupture/PTX

Decompression sickness descent loads tissues w __ ascent liberates __ leading to vessel ___ CM: J/P/P

nitrogen gas bubbles obstruction joint pain, paresthesias, PG embolis

High altitude sickness hypoxic stress inc ___ __/__ edema Tx __ and hyperbaric __ precent w __/___

blood flow cerebral/pulm descnet, O2 acclimitazation, acetazolamide

20 yr after asbesots progressive SOB multinodular/reticular findings + pleural plaques dx os___ direct toxic effects of __ and ___ activation

asbestosis | fibers, inflamm

hr/day after exposre F, chills, cough, malaise, SOB diffuse reticular opacity dx is ____ caused by ___ such as animals/farming/dust

hypersensitivity Pneumonitis inhalaltional antignes

nonprod cough, cp, SOB constitutional sx patchy alveolar opacities on CXR dx ____ can be __/__ or result of ___

COP post infect, drug induced, CTD

prog cough, SOB x 3m bibasilar crackles diffuse reticular opacitieis dx is ___ ___ and __ influences

IPF genetic, environmental