Resp Random Flashcards
(174 cards)
1
Q
formation lung in embryonic
A
tertiary bronchi
2
Q
errors embryonic
A
TE fistula
3
Q
formation in pseudoglandular
A
terminal bronchioles
4
Q
respiration capable
A
25 weeks
5
Q
terminal ducts
A
sacccular phase 26 weeks
6
Q
alveolar phase
A
secondary septation in terminal sacs
7
Q
end alveolar phase
A
8 years
8
Q
associations pulmonary hypoplasia
A
congenital diaphragmatic hernia and bilateral renal agenesis
9
Q
bronchogenic cysts
A
abnormal budding of foregut and dilation of terminal or large bronchi
10
Q
club cells
A
nonciliated, low cuboidal
secrete component of surfactant and degrade toxins
11
Q
secretion of surfactant
A
from lamellar bodies in type II pneumocytes
12
Q
composition surfactant
A
lecithins, mostly DPPC
13
Q
time surfactant synthesis
A
26 weeks
14
Q
risk factors neonatal respiratory distress syndrome
A
prematurity, maternal diabetes (due to fetal insulin), C section (decrease glucocorticoids)
15
Q
result supplemental O2
A
retinopathy of prematurity, intraventricular hemorrhage, bronchopulmonary dysplasia
16
Q
least airway resistance
A
terminal bronchioles
17
Q
anatomic dead space
A
does not participate in gas exchange
18
Q
extend to beginning of terminal bronchioles
A
ciliated
mucociliary escalator
19
Q
smooth muscle cells
A
extend to end of terminal bronchioles
20
Q
histology respiratory bronchioles
A
cuboidal cells
then simple squamous cells up to alveoli
21
Q
termination cilia
A
respiratory bronchioles
22
Q
pulmonary artery relative to bronchus
A
right anterior
left superior
23
Q
carina
A
posterior to ascending aorta
anteromedial to descending aorta
24
Q
upright aspiration
A
basal RLL
25
supine aspiration
posterior RUL
26
at T8
IVC, phrenic
27
at T10
esophagus, vagus
28
at T12
aorta, thoracic duct, azygos vein
29
bifurcation carotic
C4
30
bifurcation trachea
T4
31
abdominal bifurcation
L4
32
normal tidal volume
500 mL
33
residual volume
cannot be measured by spirometry
34
inspiratory capacity
IRV+TV
35
FRC
RV+ERV
36
vital capacity
TV+IRV+ERV
37
TLC
IRV+TV+ERV+RV
38
largest contributor of dead space
apex
39
pathologic dead space
unable to perform gas exchange
40
physiologic dead space
anatomic and alveolar dead space
41
inward pull of lung balanced by outward pull of chest wall
FRC
and system pressure is atmospheric
intrapleural pressure is negative
42
high compliance
easy to fill
| emphysema and normal aging
43
low compliance
pulmonary fibrosis, pneumonia, NRDS, pulmonary edema
44
hysteresis
lung inflation different than deflation due to need to overcome surface tension in inflation
45
positive cooperativity and negative allostery
Hb
46
taut form for unloading
Cl, H, CO2, 23BPG and T
47
O2 affinity in fetal Hb
from decrease affinity for 23 BPG
48
methemoglobin
oxidized
| increase affinity for cyanide
49
induced methemoglobin
nitrite followed by thiosulfate
| used for cyanide poisoning
50
decrease O2 binding capacity with left shift in dissociation, decrease unloading
carboxyhemoglobin
51
treatment methemoglobinemia
methylene blue and vitamin C
52
cause Fe2 to Fe3
nitrites and benzocaine
53
does not show positive cooperativity
myoglobin
54
left shift
renal hypoxia leads to increase EPO
| compensatory erythrocytosis
55
perfusion limited
O2, CO2, N2O
equilibrates early
only increase diffusion with increase in flow
56
diffusion limited
O2 in emphysema and fibrosis, CO
| does not equilibrate
57
causes increase A-a gradient
shunting, V/Q mismatch, fibrosis
58
hypoxemia with normal A-a
high altitude
| hypoventilation
59
loss of blood flow
decrease venous drainage
| impeded arterial flow
60
wasted ventilation
apex
61
wasted perfusion
base
62
shunt
airway obstruction
| does not improve with 100% O2
63
dead space
blood flow obstruction
| improves with 100% O2
64
carboxyhemoglobin
CO2 bound to N terminus of globin
65
highest % CO2 transport
HCO3
66
altitude sickness
increase ventialtion leading to respiratory alkalosis
67
responses altitude sickness
EPO
increase 2,3BPG
incrase HCO3 excretion
pulmonary vasoconstriction
68
response to exercise
increase O2 consumption
increase ventilation rate to meet O2 demand
V/Q more uniform
decrease pH
no change in PaO2 or PaCO2 but increase in venous CO2 content and decrease in venous O2 content
69
drain maxillary sinuses
middle meatus
70
superimposed rhinosinusistis
s pneumo, h flu, m catarrhalis
71
Kisselbach plexus
anterior segment of nostril
72
sphenopalatine artery
life threatening posterior segment hemorrhage
| branch of maxillary
73
risk factors head and neck cancer
tobacco, alcohol, HPV 16, EBV
74
field cancerization
damages wide mucosal area leading to multiple tumors that develop independently
75
Virchow triad
stasis
hypercoag
endothelial damage (exposed collagen)
76
imaging DVT
compression ultrasound with Doppler
77
acid base in PE
respiratory alkalosis
78
Lines of Zahn
found only in thrombi before death
| pink-platelets, fibrin
79
imaging for PE
CT pulmonary angiography
80
fat emboli
hypoxemia, neuro, petechial rash
81
amniotic fluid emboli
leads to DIC
82
obstructive lung volumes
increased
| but decreased ratio
83
restrictive lung volumes
decreased
| but increased ratio
84
chronic hypoxic vasoconstriction in obstructive
leads to cor pulmonale
85
chronic bronchitis histology
hypertrophy and hyperplasia of mucus glands in bronchi
86
diagnostic bronchitis
>3 months for >2 consecutive years
87
histology emphysema
enlarged air spaces
88
pursed lips
increase airway pressure and prevent airway collapse
89
decreased inspiratory/expiratory ratio, pulsus paradoxus
asthma
90
histology asthma
smooth muscle hypertrophy and hyperplasia
91
Curschmann spirals
shed epithelium forms wholed mucous plugs
92
Charcot-Leyden crystals
eosinophilic, hexagonal, double pointed, needle-like crystals from breakdown of eosinophils in sputum
93
aspirin induced asthma
leukotriene overproduction
| associated with nasal polyps
94
purulent sputum, recurrent infections, hemoptysis, digital clubbing
bronchiectasis
95
associations bronchiectasis
obstruction, poor motility
| smoking, Kartagener, CF, ABPA
96
poor breathing mechanics in restrictive
muscular-polio, MG, GBS
| structural-scoliosis, morbid obesity
97
hypersensitivity pneumonitis
mixed III/IV HSR
seen in farmers and birds
reversible if stimulus avoided
98
bronchoscopy of inhalation injury
edema, congestion, soot deposition
| resolution at 11 days
99
risks from pneumoconioses
cor pulmonale, cancer, Caplan (RA and pneumoconioses)
100
calcified supradiaphragmatic and pleural plaques
asbestos
101
golden brown fusiform rods resembling dumbbells found in alveolar sputum sample, visualized with Prussian blue
asbestos bodies
102
risk from asbestos
pleural effusions
103
noncaseating granulomas in aerospace
berrylliosis
| affects upper lobes
104
anthracosis
asymptomatic condition from sooty air
105
macrophages and silica
release fibrogenic factors leading to fibrosis
| increase susceptibility to TB
106
eggshell calcifications
silicosis
107
hemorrhagic pleural effusion from cancer
mesothelioma
108
stain mesothelioma
cytokeratin and calretinin+
109
hypoxemia in ARDS
due to intrapulmonary shunting and diffusion abnormalities
110
associations ARDS
sepsis, pancreatitis, pneumonia, aspiration, trauma, shock
111
steps of ARDS
endothelial damage leading to increase capillary permeability
protein rich leakage and alveolar damage
112
histology ARDS
hyaline membranes
113
source of damage ARDS
neutrophilic substances injure alveolar wall and pulmonary capillary endothelial cells, free radicals, oxygen-derived free radicals
114
management ARDS
ventilation with low tidal volumes
115
nocturnal hypoxia in sleep apnea
systemic and pulmonary HTN
| arrhythmias and sudden death
116
obstructive sleep apnea
from excess parapharyngeal tissue and adenotonsillar hypertrophy
117
treatment obstructive sleep apnea
weight loss, CPAP, surgery
118
central sleep apnea
CNS injury, HF, opioids
119
respiration patterns central sleep apnea
Cheyne-Stokes respiration
120
treatment central sleep apnea
positive airway pressure
121
obesity hypoventilation syndrome
hypoventilation increase PaCO2 during waking hours and during sleep
Pickwickian syndrome
122
results pulmonary HTN
arteriosclerossis, medial hypertrophy, intimal fibrosis, plexiform lesions
123
genetics heritable PAH
inactivating BMPR2 gene
| normally inhibits vascular smooth muscle proliferation
124
causes pulmonary arterial hypertension
amphetamines, cocaine, connective tissue disease, HIV, portal hypertension, congenital HTN, schistosomiasis
125
causes left heart disease
systolic/diastolic dysfunction
| valvular disease
126
tracheal deviation tension pneumo
away from lesion
127
consolidation
increase fremitus
| dull to percussion
128
bronchial breath sounds
late inspiratory crackles, egophony, bronchophony, whispered pectoriloquy
129
atelectasis
dull to percussion
deviates toward lesion
decreased fremitus
130
hyperresonant
simple or tension pneumothorax
131
cause transudate
increase hydrostatic pressure (HF) or decrease oncotic pressure (nephrotic syndrome, cirrhosis)
132
cause exudate
malignancy, pneumonia, collagen vascular disease, trauma
| due to increase vascular permeabiltiy
133
content lymphatic effusions
TG
| from trauma or malignancy
134
primary spontaneous pneumothorax
tall, thin, young males
135
secondary spontaneous pneumothorax
diseased lung, mechanical ventilation with high pressures
136
causes bronchopneumonia
strep pneumo, staph, h flu, klebsiella
137
cryptogenic pneumonia
inflammation of bronchioles
| no response to ABX
138
congestion pneumo
1-2 days
red-purple, partial consolidation of parenchyma
exudate with bacteria
139
red hepatization
3-4 days
red-brown
exudate with fibrin, bacteria, RBC, WBC
140
gray hepatization
5-7 days
uniformly gray
WBCs and fibrin
141
resolution
+ days
| enzymes digest components of exudate
142
air fluid levels on CXR
lung abscess
143
hoarseness from Pancoast
recurrent laryngeal nerve
144
Horner syndrome
stellate ganglion
145
sensorimotor deficits
brachial plexus
146
other damage superior sulcus tumor
brachicephalic vein
| SVC
147
causes SVC
pancoast
| thrombosis from indwelling catheters
148
sites of mets lung
adrenal, brain, bone, liver
149
lung cancer from mets
breast, colon, prostate, bladder cancer
150
risk factors lung cancer
smoke, radon, asbestos, family history
151
genetics small cell
amplification of myc oncogenes
152
histology small cell
neuroendocrine, small blue
| chromogranin A+, neuron-specific enolase +
153
mutations adenocarcinoma
KRAS, EGFR, ALK
154
hypertrophic osteoarthropathy clubbing
adenocarcinoma
155
histology adenocarcinoma
glandular pattern
| mucin+
156
bronchoalveolar adenocarcinoma
along septa
| apparent thickening of alveolar walls
157
keratin pearls and intercellular bridges
squamous cell carcinoma
158
carcinoid tumor histology
neuroendocrine cells
| chromogranin A+
159
thins secretions
guaifenesin
| does not suppress cough reflex
160
MOA n-acetyl
disrupt disulfide bonds
161
antagonist to NMDA glutamate receptors
dextromethorphan
| can cause serotonin syndrome
162
drug to open eustachian tubes
pseudophedrine or phenylephrine
163
competitively antagonizes endothelin-1 receptors
bosentan
164
adverse bosentan
hepatotoxic
165
adverse epoprostenol, iloprost
flushing, jaw pain
166
MOA epoprostenol, iloprost
PGI2 with vasodilatory effects
167
bronchoconstriction in asthma
inflammatory
| parasympathetic tone
168
adverse salmeterol
tremor and arrhythmia
169
cause oral thrush
inhaled corticosteroids
170
long acting muscarinic antagonist
tio
171
MOA zileuton
5 lipoxygenase inhibitor
172
MOA montelukast
blocks CysLT1 receptor
| good for aspirin-induced asthma
173
binds mostly unbound serum IgE and blocks binding to FCERI
omalizumab
174
increase cAMP from inhibition of phosphodiesterase
theophylline
