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Respiratory Flashcards

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1
Q

Dx of asthma

A

Methacholine –> M3 stimulation

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2
Q

Aspirin induced asthma Tx

A

LT receptor blockers - Zafirlukast, Montelukast

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3
Q

Restrictive lung disease

A
  1. Fibrosis
  2. ARDS
  3. Sarcoid
  4. Pneumoconioses
  5. Goodpasture’s
  6. Wegener’s
  7. Drugs - bleomycin, amiodarone, busulfan
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4
Q

Obstructive lung diseases

A

Asthma, COPD

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5
Q

FVC dec
RV, TLC, FRC dec
FEV1/FVC normal or inc

A

Restrictive lung disease

  • think of it as a small lung volume problem
  • DCLO DEC
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6
Q

FVC normal
RV, TLC, FRC in
FEV1/FVC dec

A

Obstructive lung disease

  • can’t get the air out = learn to function at higher lung capacity
  • DLCO INC
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7
Q

Spherules

A

Coccidoides immitis

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8
Q

Cells that produce surfactant

A

Type II pneumocytes

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9
Q

Calculate dead space

A

tidal volume x PACO - PECO / PACO

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10
Q

Calculate pulmonary vascular resistance

A

P-pul artery - P-l atrium / CO

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11
Q

Hypoxemia w/ normal A-a gradient

A

High altitude
Hypoventilation
= there is no impaired delivery of O2 to the blood

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12
Q

Hypoxemia w/ INC A-a gradient

A

V/Q mismatch
Diffusion limited - fibrosis
R–>L shunt

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13
Q

Hypoxia (dec O2 delivery to tissue) w/ normal A-a gradient

A

Dec CO
Hypoxemia
Anemia

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14
Q

Hypoxia w/ INC A-a gradient

A

CN

CO

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15
Q

V/Q of apex

A

3 = wasted ventilation

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16
Q

V/Q of base

A

0.6 = wasted perfusion

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17
Q

V/Q = 0

A

SHUNT blood

Airway obstruction

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18
Q

V/Q = infinity

A

DEAD space
BF obstruction
100% O2 improves PO2

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19
Q

1 rhinitis

A

adenovirus

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20
Q

Nasal polyps

A

Aspirin-intolerant asthma*

CF

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21
Q

Chinese adult w/ pleomorphic keratin+ cells in a background of lymphocytes, cervical LA

A

Nasopharyngeal CA

- EBV*

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22
Q

Single in adults or multiple in kids growth on vocal cord

A

Laryngeal papilloma

- HPV 6,11

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23
Q

Pneumonia in nursing home & diabetics

A

Kleb

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24
Q

Pneumonia in alcoholics

A

Kleb

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25
Pneumonia exacerbation of COPD
``` H. influenzae #1 = Moraxella ```
26
Cold agglutinin +, Eaton agar
Mycoplasma pneumoniae | Tx = erythromycin
27
Post-transplant pneumonia
CMV
28
Hypertrophy of bronchial mucous glands, Reid index >50%, productive cough for 3+ months for >2yrs
Chronic bronchitis "blue bloaters" | - infection & cor pulmonale
29
Centriacinar emphysema
SMOKING | Upper lobes
30
Panacinar emphysema
A1AT deficiency - -> misfolded protein accumulates in hepatocytes --> PAS+ - PiZ = most common - PiZZ = panacinar + cirrhosis
31
Curschmann spirals and charcot-leyden crystals
Asthma | Eosinophil membrane proteins
32
Causes of bronchiectasis
Necrotizing infection --> PERMANENTLY dilated airways Allergic aspergilloma CF* Kartageners Tumor or foreign body
33
Middle aged male w/ B/L rales, end-expiratory crackles, no wheezing
Idiopathic pulmonary fibrosis (restrictive) - TGF-B - amiodarone, bleomycin - "honeycomb" lung
34
Diffuse lung fibrosis and RA
Caplan syndrome in coal miner | - upper lobes
35
Athracosis
carbon-laden MO
36
Fibrotic nodules in upper lobes, "egg shell" calcification of LNs, birefringent spicules, inc risk for TB
Silicosis
37
Person works at NASA, noncaseating granuloma in organs and hilar LNs
Berylliosis | - INC RISK FOR LUNG CANCER
38
Noncaseating granuloma in multiple organs, cough, elevated serum ACE, hyperCa, African-American
Sarcoidosis
39
Asteroid bodies
Sarcoidosis
40
White, calcified pleural plaques, Golden-brown fibers (ferrugenous bodies), shipyard worker, plumber, LOWER lobes
Asbestosis - fibrosis of lung and pleura - inc risk of lung cancer
41
Fever, cough, dyspnea in pigeon breeder that gets better when he goes home, granulomatous inflammation
Hypersensitivity pneumonitis | - resolves w/ removal
42
Exertional dyspnea, peripheral edema, Plexiform lesions
Pulmonary HTN (>25) --> RVH --> cor pulmonale - Primary = BMPR2 in young females - Secondary = COPD
43
White out on CXR
ARDS - hyaline membrane - Tx = PEEP
44
Neonatal RDS causes
B4 34wks C-section Maternal DM --> insulin dec surfactant production
45
Cyanosis after birth, "ground glass" CXR
Neonatal RDS - PDA - Necrotizing enterocolitis - 100% O2 --> ***BLINDNESS*** & bronchopulmonary dysplasia
46
The S's of lung cancer
Small cell Smokers Central Syndromes
47
Male smoker, inc ADH, ACTH, LE syndrome
Small cell | - Central
48
Most common lung tumor in MALE smokers
SCC | - squamous, sentral, smoking
49
Male smoker with hyperCa, keratin pearls and intracellular bridges
SCC - PTHrP - Central
50
Most common lung tumor on non-smoker and FEMALE smokers
Adenocarcinoma - Peripheral - Pleural effusion - Glands or mucin
51
Columnar cells along bronchioles and alveoli, pneumonia - like consolidation
Bronchoialveolar carcinoma - Peripheral - Excellent prognosis - NOT smoking related* - Clara cells
52
Chromogranin +, collar button lesion, polyp-like mass in bronchus
Carcinoid
53
Peripheral lung cancers
Adenocarcinoma | Bronchioalveolar
54
Mets of lung cancer
ADRENAL gland
55
Trachea shift TO side of collapse
Spontaneous (bleb) - paraseptal emphysema - apical bullae rupture in young healthy person
56
Trachea shift OPPOSITE collapse
Tension
57
TOC for PE
helical CT
58
Hyperlucency in CXR
Emphysema | - pink puffers
59
No breath sounds, resonance, tactile fremitus
Obstruction
60
Dullness for percussion, dec tactile fremitus
Pleural effusion
61
Dullness to percussion, inc tactile fremitus
Pneumonia
62
Hyperresonant, dec fremitus
Pneumothorax
63
Sheets of tumor cells w/ nuclear molding, "salt and pepper"
Small cell lung carcinoma | "Kulchitsky cells"
64
Winter's forumla for compensation
Expected PCO2 = 1.5 x HCO3- +8 +/-2

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