Respiratory

Question 1

These two structures extend to end of bronchi?

Answer 1

Cartilage and goblet cells

Question 2

Type of cells in terminal bronchiole?

Answer 2

pseudostratified ciliated columnar cells

Question 3

Smooth muscle of the airway wall stops at?

Answer 3

Terminal bronchiole

Smooth muscles helps sweep mucous out of lungs

Question 4

Respiratory zone of lung contains what type of cells?

Answer 4

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

Question 5

These cells secrete surfactant?

Answer 5

Lamellar bodies of type 2 pneumocytes

Question 6

2 ways to increase surfactant of fetus? dec?

Answer 6

Corticosteroids or thyroxine inc surfactant. Insulin decreases surfactant

Question 7

What are clara cells?

Answer 7

nonciliated columnar cells with secretory granules

Question 8

Relation of pulmonary artery to bronchus at each lung?

Answer 8

RALS– right anterior; Left superior

Question 9

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

Answer 9

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

Question 10

Inspiratory muscles during exercise?

Answer 10

External intercostals, Scalene, Sternocleidomastoid

Question 11

Expiratory muscles?

Answer 11

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

Question 12

Physiologic dead space equations? (ventilation but no perfusion)

Answer 12

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

Question 13

Cyanide poisoning treatment? and MOA?

Answer 13

Nitrites to oxidize Hb to methemoglobin

Question 14

Treatment of methemoglobin?

Answer 14

Methylene blue– treat met with methylene blue

Question 15

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

Answer 15

thisulfate– forms thiocyanate and is renally excreted

Question 16

Cherry red blood?

Answer 16

Carbon monoxide poisoning

Question 17

How does carbon monoxide effect the dissociation curve?

Answer 17

Shifts curve to left, but limits oxygen carrying capacity

Question 18

Diffusion limited disorders?

Answer 18

CO, emphysema, fibrosis

Question 19

Histology findings in pulmonary hypertension?

Answer 19

Plexiform lesions; intimal fibrosis and medial hypertrophy

Question 20

Don’t forget about hypoxic vasoconstriction and its causes

Answer 20

Don’t forget about hypoxic vasoconstriction and its causes

Question 21

Calculate A-a gradient

Answer 21

PAo2= PIo2- (paCO2/R)—

150-(PaCo2/R)

Question 22

Oxygenation of Hb promotes dissociation of?

Answer 22

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

Question 23

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

Answer 23

Fat emboli– associated with bone fractures and liposuction

Remember petechial RASH

Question 24

Amniotic fluid emboli can lead to?

Answer 24

DIC– perhaps due to anaphylactic reaction to fetal antigens

Question 25

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

Answer 25

Amniotic fluid embolus-- bleeding is due to DIC

Question 26

Histology of asthma?

Answer 26

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

Question 27

what are charcot leyden crystals?

Answer 27

Breakdown of eosinophils in asthma

Question 28

Commonly associated with bronchiectasis?

Answer 28

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

Question 29

2 causes of pulmonary edema caused by increased hydrostatic pressure?

Answer 29

Left sided heart failure; and mitral stenosis

Question 30

2 causes of pulmonary edema caused by decrease oncotic pressure?

Answer 30

Nephrotic syndrome and Cirrhosis

Question 31

Restrictive lung diseases with normal A-a gradients?

Answer 31

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

Question 32

Honeycombing of lung?

Answer 32

Interstitial fibrosis

Question 33

Drugs that cause interstitial lung disease?

Answer 33

Busulfan; methotrexate; amiodarone; bleo

Question 34

Black lung?

Answer 34

Anthracosis

Question 35

Pathophys of silicosis?

Answer 35

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

Question 36

Increases susceptibility to TB?

Answer 36

silicosis

Question 37

Egg shell calcification?

Answer 37

Silicosis

Question 38

Ivory white calcified pleural plaque?

Answer 38

asbestos-- affects lower lobes

Question 39

Most common pulmonary lesions in asbestosis?

Answer 39

pleural plaque

Question 40

Lobes of lung for silicosis and asbestosis?

Answer 40

Silicosis upper; Asbestosis lower

Question 41

Pathophys of ARDS?

Answer 41

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

Question 42

White out on chest Xray?

Answer 42

ARDS

Question 43

Blood gases in sleep apnea?

Answer 43

Respiratory acidosis

Question 44

Causes of central sleep apnea?

Answer 44

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

Question 45

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

Answer 45

Atelectasis (if not tracheal deviation than pleural effusion)

Question 46

Golden brown fusiform rods dumbbell shaped?

Answer 46

Asbestos bodies

Question 47

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

Answer 47

Retinopathy and bronchopulmonary dysplasia

Question 48

defect in BMPR2 leads to? Pathogenesis?

Answer 48

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

Question 49

Most common lung cancer in nonsmokers and overall?

Answer 49

Adenocarcinoma

Question 50

Cancer associated with clubbing

Answer 50

Adenocarcinoma (hypertropic osteoarthropathy)

Question 51

Cancer that grows along alveolar septa?

Answer 51

Bronchioalveolar subtype of adenocarcinoma-- great prognosis

Question 52

Keratin pearls with intercellular bridges lung cancer?

Answer 52

Squamous

Question 53

Cavitation lesions cancer?

Answer 53

Squamous cell

Question 54

Lung cancer that causes hypercalcemia?

Answer 54

squamous cell

Question 55

Tumor may produce ADH or ACTH?

Answer 55

Small cell

Question 56

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

Answer 56

Small cell

Question 57

Dark blue cells lung cancer?

Answer 57

Small cell

Question 58

Psammoma bodies lung cancer?

Answer 58

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

Question 59

Cold agglutinins; dry cough, arthralgias?

Answer 59

Atypical pneumonia