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SBM > Respiratory > Flashcards

Respiratory Flashcards

(107 cards)

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1
Q

Which airways have cartilage and which airways do not?

A

large airways- cartilage

small airways- non-cartilage

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2
Q

What decreases and increases surface tension in lungs?

A

decreased- saline filled lungs

increased - surfactant deficiency

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3
Q

Flow limitation

A

point where any increase in effort makes no increase in flow because airway can collapse

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4
Q

Pcritical is a marker of

A

tendency of airways to collapse

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5
Q

Three Factors that contribute to maximum flow rate

A

decreased Elastic recoil
Increase in Pcritical
Increase in R upstream

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6
Q

decreased expiratory flow rates seen in (3)

A

1- increased airway resistance
2- decreased elastic recoil
3- decrease in lung volume

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7
Q

RV is increased most in

A

obstructive airway disease (air trapping)

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8
Q

5 general categories of restrictive lung disease

A 
neuromuscular disease
chest wall problems
pleural disease 
loss of lung
interstitial lung disease
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9
Q

Efferent impulses in respiratory control from Cranial nerves

A

9,10,11,12

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10
Q

Length tension, a short muscle is a

A

weak muscle

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11
Q

energy consumption is via 2 factors in muscles

A

tension produced by muscle

velocity of shortening in muscle

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12
Q

two reasons resp muscles require more energy

A
  • asked to do more

- at a mechanical disadvantage

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13
Q

Centriacinar Emph

A

enlarged resp bronchioles and normal distal ascini

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14
Q

panacinar emph

A

resp–>distal ascini all affected

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15
Q

Paraseptal emph

A

distal ascinus only

associated with bullae and pneumothroax

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16
Q

charcot-leyden crystals

A

degranulated eosinophil membranes found in asthma

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17
Q

curschmann spirals

A

whorls of shed epithelium in asthma

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18
Q

acute vs late phase asthma

A

acute- mast cell mediated

late phase- leukocyte mediated, tissue destruction

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19
Q

3 types of medications for COPD

A

B-agonists, Anticholinergic, Methylxanthines

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20
Q

when are glucocorticoids appropriate for COPD patients?

A

<50% FEV1 and freq exaccerbations

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21
Q

airway remodeling

A

increase in ECM

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22
Q

pulmonary arterial hypertension

A

pH when fundamental abnormality arises in pulmonary vasculature

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23
Q

2 ways that pulmonary arterioles dilate

A

passive- thin-walled and contain little muscle (so due to CO2)
active- release of EDRF/NO

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24
Q

ihibitors vs constrictors in PVR

A

inhibitors- prostacyclin, NO

vasoconstriction- thrmboxane A2, endothelin-1, 5HT

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25
Pressure left atrium best estimated by
pulmonary wedge pressure
26
pulmonary artery pressure equation
Ppa= (CO x PVR) + PLa
27
two types of granulomatous ILD
sarcoidosis | hypersensitivity pneumonia
28
smoking related ILD
respiratory bronchiolitis ILD | desquamative interstitial pneumonia
29
first thing that happens in ILD
type 2 pneumocyte hyperplasia
30
3 ways lung can get fibrotic
fibroblast can get activated -->interstitum thicker epithelial gets injured-->fibrin leaks out and fibroblasts pass through granulomas
31
caplan syndrome
rheumatoid arthritis + pneumoconiosis
32
2 forms silicosis
crystalline- most fibrogenic, 100x smaller than sand | amorphous (talc)-more clearance, less firbogenic
33
two fiber types in asbestosis
serpentine-curly and flexibile- more widely used in industry amphibole- straight and rigid- more pathogenic
34
smoking + asbestos
55 fold increase in lung cancer-->synergistic!
35
three examples of hypersensitivity pneumonitis
1) farmers lungs 2) pigeon breeders lungs 3) humidifier lung
36
patient profile of sarcoidosis
cytokines- IL2 CD4+ lymphs activated macrophages class II HLA expression
37
why does ILD have decreased compliance and diffusion impairment?
deposition of collagen | thickening of interstitum
38
ILD breath patterns
rapid and shallow
39
treatments in IPF
Pirenidone-inhibits TGFB1- slows progression IPF Nitendanib- inhibits multiple tyrosine kinases and a variety of growth factor receptors-->slows decline in lung function
40
inertial impaction increases with
large particle size high inspiratory flow rates tortuous pathways interceptors
41
sedimentation increases with
lower airflow smaller airway lumen optimal particle size
42
three variations of disease in mucociliary disease
cystic fibrosis: sol phase chronic bronchitis: gel phase kartagener syndrome: cilia
43
varenicline
smoking pharmaceutic--partial agonist of A4B2 nicotinic acetylcholine receptor which may play a role in addiction
44
pleurodesis
process or intervention where inject something or do something to pleural surface to make it inflamed and when body has inflammation, responds by forming adhesions
45
opiate antidote
naloxone
46
central alveolar hypoventlation
due to altered function of brainstem resp neurons, resulting in hypoventilation
47
Obestiy-Hypoventilation/Pickwickian Syndrome
R heart failure due to plum vasoconstriction from hypoxemia
48
no hypercapnia in
asthma
49
where is periodic breathing seen
bilateral cerebral dysfunction congestive heart failure hypoxia
50
paraneoplastic syndrome
signs and symptoms caused by factors produced by cancer cells that act a distance from both primary cancer site and its metastases
51
ectopic ACTH secretion
small cell lung carcinoma with poor prognosis
52
inappropriate secretion of ADH
small cell lung carcinoma that does not effect prognosis
53
pancoast tumor
tumor at lung apex where pleural reflex is horner's syndrome pancoast syndrome recurrent laryngeal nerve-->hoarseness
54
squamous cell carcinoma
central lesion, may cavitate
55
adenocarcinoma
peripheral lesion
56
Erlotinib
EGFR-TK1 tyrosine kinase inhibitor
57
Class 1 mutation
defective protein product
58
class 2 mutation
defective protein processing
59
class III
defective protein regulation- diminished ATP binding and hydrolysis
60
class IV
defective protein conductance- defective chloride conductance or channel gating
61
class V
promoter or splicing abnormality-reduced number of CFTR transcripts due to promoter or splicing abnormality
62
class VI
accelerated turnover-accelerated turnover from cell surface
63
fetal vasoconstriction
physical lung fluid dec O2 and pH leukotrienes thrmboxane A2
64
fetal vasodilation
NO increase O2 and pH PGI2 prostacyclin
65
major constrictor ductus arteriosus
ET1
66
major dilator ductus arteriosus
PGE2
67
4 things that cause DA constriction
increase PaO2 decrease PVR from O2-->decrease in BP in DA decrease PGE2 (loss of placenta and increased PG removal from lung) decrease in PGE2 receptors in DA wall
68
indomethacin
prostaglandin synthetase inhibitors complications-renal failure, GI perforations, necrotizing enter colitis
69
what age are alveoli close enough to caps to transmit o2?
24 weeks
70
bronchial tree developed by
16th week of intrauterine life
71
alveoli continue to grow
through life
72
preacinar blood vessels follow
airways
73
intra-acinar vessels
follow alveoli
74
aberrant subclavian artery only compresses
esophagus
75
anomalous innominate artery only compresses
trachea
76
extrathoracic obstruction produces
inspiratory stridor
77
intrathoracic obstruction
exp wheeze
78
single point of obstruction
one wheeze
79
mutiple pts of obstruction
lots of little wheezes
80
in situ means
hasn't invaded through the basement membrane yet
81
cytokeratin
intermediate filament in the cytoplasm of epithelial cells
82
vimentin
intermediate filament in the cytoplasm of tissue derived from mesoderm
83
TTF1
nuclear transcription factor expressed in lung epithelium and thyroid epithelium
84
synaptophysin
neuroendocrine marker
85
Met vs Primary
Met has sharp demarcation of metastasis
86
carcinoid tumor
ribbons of cells
87
positive synaptophysin stain
small cell carcinoma
88
virchow's triad
endothelial injury abnormal blood flow hypercoag
89
saddle embolus
thromboembolus that lodges at bifurcation of right and left plum arteries associated with sudden death
90
pulmonary infarcts early
deep red color ischemic necrosis diffuse RBC exudate
91
infarcts greater than 48 hrs
RBC lysis hemosiderin laden macrophages lung appears paler
92
days
fibrosis (from margins inward) | gray-white color
93
compliance
deltaV/deltaP
94
Pmax=
Pelastic-Pcrit/R upstream
95
Pcrit=
>0 tendency to collapse <0 tendency to stay rigid Pcrit=Pcollapse-Ppleural
96
PIO2
(Pb-47)(.21)
97
sol phase
water and solute that lines resp tract
98
gel phase
glyoprotiens
99
pleurodesis
chemical irritant put to increase inflammation and remove what is bothering
100
zone 1 conditions
Palv>Ppa>Ppv | no cap perfusion; in normal conditions no zone 1
101
zone 2 conditions
Ppa>Palv>Ppv driving pressure is difference between Ppa and Palv as you move down the lung, driving pressure and blood flow increases
102
zone 3
Ppa>Ppv>Palv | traditional flow relationship
103
pvr=
ppa-pla/co usually < 2
104
hemoglobin does not affect
po2 or O2sat
105
oxygen content but not saturation shift based on
polycythemia vs anemia
106
extrathoracic obstruction causes
collapse on inspiration (decrease flow on inspiration)
107
intrathoracic obstruction causes
a collapse on expiration (decrease flow on expiration)

SBM (18 decks)

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