Respiratory Random

Question 1

Collapsing pressure =

Answer 1

(2T)/r

Question 2

Surfactant synthesis starts at ___ and reaches mature levels at ____

Answer 2

26 weeks; 35 weeks

Question 3

Lecithin-to-sphingomylein ratio in amniotic fluid that indicates fetal lung maturity

Answer 3

greater than 2

Question 4

Inhalation obstruction (standing/supine)

Answer 4

Standing - lower part of right inferior lobe

Supine - upper part of right inferior lobe

Question 5

Pulmonary artery relation to bronchi at hilum

Answer 5

RALS
right - anterior
left - superior

Question 6

Diaphragm perforations

Answer 6

T8 - IVC
T10 - Eosophagus, CNX
T12 - Aorta, azygos vein, thoracic duct

Question 7

Common bifurcations

Answer 7

Internal carotid - C4
Trachea - T4
Aorta - L4

Question 8

Physiologic dead space (Vd) =

Answer 8

Vt x ((PaCO2 - PeCO2)/PaCO2

Question 9

Minute ventilation (Ve) =

Answer 9

Vt x respiratory rate (RR)

Question 10

Alveolar ventilation (Va) =

Answer 10

(Vt - Vd) x RR

Question 11

When is PVR at a minimum?

Answer 11

Functional residual capacity

Question 12

Taut vs Relaxed

Answer 12

deoxygenated vs oxygenated

Question 13

Cyanosis and Chocolate coloured blood

Answer 13

Methemoglobinemia

Question 14

Carboxyhemoglobin

Answer 14

CO + Hb

Question 15

Oxygen content of blood =

Answer 15

(O2 binding capacity x % sat) + dissolved O2

Question 16

Normal O2 binding capacity

Answer 16

20.1 mL O2/dL

Question 17

O2 delivery to tissues =

Answer 17

CO x O2 content of blood

Question 18

Diffusion (Vgas) =

Answer 18

A/T x Dk(P1-P2)

Question 19

Blood gas changes CBF

Answer 19

CO2 under 100

O2 under 50

Question 20

PVR =

Answer 20

P(pulm art) - P (L atrium) / CO

Question 21

Resistance =

Answer 21

8nl / 3.14 r^4

Question 22

Alveolar gas equation (PAo2) =

Answer 22

PIo2 - (PaCO2/R)
[at sea level breathing room air] = 150 - (PaCO2/0.8)
R = respiratory quotient = CO2 produced/O2 consumed

Question 23

Normal A-a gradient

Answer 23

10-15 mmHg

Question 24

V/Q mismatch (0 or infinity) does 100% O2 improve?

Answer 24

0 - no

infinity - yes

Question 25

Carbaminohemoglobin

Answer 25

HbCO2 (bound to Hb at N-terminus of globin chain not heme)

Question 26

Haldane effect

Answer 26

Oxygenation of Hb promotes H+ dissociation and CO2 formation, releasing it from RBCs

Question 27

Bohr effect

Answer 27

Metabolism shifts curve to right, unloading oxygen

Question 28

EPO compensation

Answer 28

by 10-14 days arterial O2 content can be restored to normal @ elevations up to 4000m

Question 29

Charcot-Leyden crystals

Answer 29

eosinophilic, hexagonal, double pointed needle-like crystals formed by breakdown of eosinophils in sputum

Question 30

Unique asthma findings

Answer 30

Pulsus paradoxus and decreased inspiratory/expiratory ratio

Question 31

Lymphocytes mediating asthma?

Answer 31

Th2

Question 32

Hypersensitivity pneumonitis

Answer 32

Mixed type III/IV HS rxn to environmental Ag causes restrictive lung disease within hours (chronic can cause interstitial fibrosis)

Question 33

Caplan syndrome

Answer 33

RA + pneumoconioses with intrapulmonary nodules

Question 34

Furruginous bodies

Answer 34

Asbestos bodies; golden brown fusiform rods (dumbells) in alveolar septum

Question 35

Anthracosis

Answer 35

Asymptomatic; sooty air; urban dwellers

Question 36

Silicosis unique

Answer 36

- Increases susceptibility to TB | - Eggshell calcification of hilar lymph nodes

Question 37

Maternal diabetes on surfactant

Answer 37

Increased fetal insulin inhibits surfactant production

Question 38

Therapeutic supplemental O2 in NRSD

Answer 38

RIB - Retinopathy of prematurity - Intraventricular hemorrhage - Bronchopulmonary dysplasia

Question 39

Normal pulmonary artery pressure and PH

Answer 39

10-14 mmHg | greater than 25

Question 40

Plexiform lesions

Answer 40

Tufts of capillaries with long-standing PH

Question 41

Idiopathic PAH inheritance

Answer 41

Inactivating mutation of BMPR2 gene (inhibits vasc SM prolif)

Question 42

Metastases FROM lung

Answer 42

Adrenals, brain, bone, liver

Question 43

Matastases TO lung

Answer 43

breast, colon, prostate, bladder

Question 44

Small cell (oat cell) carcinoma

Answer 44

- ACTH, SIADH, Ab's against pre-synaptic Ca channels or neurons (paraneoplastic myelitis/encephalitis) - Amplification of myc oncogenes - Neoplasm of neuroendocrine Kulchitsky cells - Chromogranin A (+), Synaptophysin (+)

Question 45

Adenocarcinoma

Answer 45

- Activating mutations KRAS, EGFR, ALK - Bronchoalveolar subtype = in situ - Mucin (+)

Question 46

Squamous Cell carcinoma

Answer 46

- Cavitation - Cigarettes - hyperCalcemia (PTHrP)

Question 47

Large Cell carcinoma

Answer 47

- Possibly beta-hCG

Question 48

Bronchial carcinoid tumor

Answer 48

Nest of neuroendocrine cells (chromogranin A (+))