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Flashcards in Respiratory Deck (59):
1

These two structures extend to end of bronchi?

Cartilage and goblet cells

2

Type of cells in terminal bronchiole?

pseudostratified ciliated columnar cells

3

Smooth muscle of the airway wall stops at?

Terminal bronchiole
Smooth muscles helps sweep mucous out of lungs

4

Respiratory zone of lung contains what type of cells?

cuboidal cells in respiratory bronchioles and then squamous cells up to alveoli-- NO CILIA

5

These cells secrete surfactant?

Lamellar bodies of type 2 pneumocytes

6

2 ways to increase surfactant of fetus? dec?

Corticosteroids or thyroxine inc surfactant. Insulin decreases surfactant

7

What are clara cells?

nonciliated columnar cells with secretory granules

8

Relation of pulmonary artery to bronchus at each lung?

RALS-- right anterior; Left superior

9

Structure that perforates diaphragm at T8, T10, and T10?

I ate ten eggs at twelve (IVC8; Esophagus10; Aorta12-- also thoracic duct and azygos vein)

10

Inspiratory muscles during exercise?

External intercostals, Scalene, Sternocleidomastoid

11

Expiratory muscles?

Rectur abdonimin, internal and external obliques; transversus abdominis, internal intercostals

12

Physiologic dead space equations? (ventilation but no perfusion)

Vd= Vt X ((PaCO2- PECO2)/PaCO2) Taco, Paco, Peco Paco

13

Cyanide poisoning treatment? and MOA?

Nitrites to oxidize Hb to methemoglobin

14

Treatment of methemoglobin?

Methylene blue-- treat met with methylene blue

15

What should be used to get rid of cyanide methemoglobin complex?

thisulfate-- forms thiocyanate and is renally excreted

16

Cherry red blood?

Carbon monoxide poisoning

17

How does carbon monoxide effect the dissociation curve?

Shifts curve to left, but limits oxygen carrying capacity

18

Diffusion limited disorders?

CO, emphysema, fibrosis

19

Histology findings in pulmonary hypertension?

Plexiform lesions; intimal fibrosis and medial hypertrophy

20

Don't forget about hypoxic vasoconstriction and its causes

Don't forget about hypoxic vasoconstriction and its causes

21

Calculate A-a gradient

PAo2= PIo2- (paCO2/R)---
150-(PaCo2/R)

22

Oxygenation of Hb promotes dissociation of?

H+ from Hb; shifting equilibrium towards CO2 formation and CO2 release from RBCs

23

Patient presents with hypoxemia, delirium, and petechial rash. He broke his femus 2 days ago---?

Fat emboli-- associated with bone fractures and liposuction

Remember petechial RASH

24

Amniotic fluid emboli can lead to?

DIC-- perhaps due to anaphylactic reaction to fetal antigens

25

Patient presents with actue onset of dyspnea, cyanosis, respiratory acidosishypotension and bleeding after giving birth--?

Amniotic fluid embolus-- bleeding is due to DIC

26

Histology of asthma?

Basement membrane thickening; smooth muscle hypertrophy; airway inflammation; mucous plugging; charcot leyden crystals (breakdown of eosinophils); curschmanns spirals (shed epithelium forms mucus plugs)

27

what are charcot leyden crystals?

Breakdown of eosinophils in asthma

28

Commonly associated with bronchiectasis?

Smoking, CF, Kartageners, allergic bronchipulmonary aspergillosis (45 degree angle)

29

2 causes of pulmonary edema caused by increased hydrostatic pressure?

Left sided heart failure; and mitral stenosis

30

2 causes of pulmonary edema caused by decrease oncotic pressure?

Nephrotic syndrome and Cirrhosis

31

Restrictive lung diseases with normal A-a gradients?

Polio, myasthenia= Muscular dysfunction
Scoliosis, morbid obesity= Structural

32

Honeycombing of lung?

Interstitial fibrosis

33

Drugs that cause interstitial lung disease?

Busulfan; methotrexate; amiodarone; bleo

34

Black lung?

Anthracosis

35

Pathophys of silicosis?

Macrophages respond to silica by release fibrogenic factors leading to fibrosis. Silica may disrupt phagolysososmes and impair macrophage-->increase susceptibility to TB

36

Increases susceptibility to TB?

silicosis

37

Egg shell calcification?

Silicosis

38

Ivory white calcified pleural plaque?

asbestos-- affects lower lobes

39

Most common pulmonary lesions in asbestosis?

pleural plaque

40

Lobes of lung for silicosis and asbestosis?

Silicosis upper; Asbestosis lower

41

Pathophys of ARDS?

Acute damage-->macrophages release cytokines-->attract neutrophils-->neutrophils damage type I and type II pneumocytes-->decrease in surfactant-->atelectasis

42

White out on chest Xray?

ARDS

43

Blood gases in sleep apnea?

Respiratory acidosis

44

Causes of central sleep apnea?

Narcotics; renal failure; high altitude; heart failure (remember hypoxic vasoconstriction)

45

Decreased breath sounds; dullnees to percussion; decreased fremitus; tracheal deviation towards side of lesion?

Atelectasis (if not tracheal deviation than pleural effusion)

46

Golden brown fusiform rods dumbbell shaped?

Asbestos bodies

47

Therapeutic supplemental O2 can result in xxxxx and xxxx in neonatal respiratory distress syndrome?

Retinopathy and bronchopulmonary dysplasia

48

defect in BMPR2 leads to? Pathogenesis?

Primary pulmonary hypertension
BMPR2 normall functions to inhibit vascular smooth muscle proliferation

49

Most common lung cancer in nonsmokers and overall?

Adenocarcinoma

50

Cancer associated with clubbing

Adenocarcinoma (hypertropic osteoarthropathy)

51

Cancer that grows along alveolar septa?

Bronchioalveolar subtype of adenocarcinoma-- great prognosis

52

Keratin pearls with intercellular bridges lung cancer?

Squamous

53

Cavitation lesions cancer?

Squamous cell

54

Lung cancer that causes hypercalcemia?

squamous cell

55

Tumor may produce ADH or ACTH?

Small cell

56

Difficulty climbing stairs and rising from seated position-- cancer?

Small cell

57

Dark blue cells lung cancer?

Small cell

58

Psammoma bodies lung cancer?

Mesothelioma-- malignancy of pleura results in hemorrhagic pleural effusions and pleural thickening

59

Cold agglutinins; dry cough, arthralgias?

Atypical pneumonia