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Respiratory
First Aid: Respiratory
| Question | Answer |
|---|---|
| These cells make up 97% of alveolar surfaces. | Type I pneumocytes |
| These cells secrete dipalmitoyl phosphatidylcholine. | Type II pneumocytes; secrete surfactant |
| How many lobes do the lungs have? | Right lung has 3 lobes, left lobe has 2 lobes and a lingula (thing that overlaps heart and used to be the middle lobe like a billion years ago) |
| During exercise what accessory muscles are used? | External intercostals for inspiration; abdominal muscles for expiration |
| This substance activates bradykinin. | Kallikrein |
| What is residual volume? | Air in lungs after maximal expiration |
| What is expiratory reserve volume? | Air in lungs after normal expiration |
| What is Tidal volume? | Air that moves into lung after expiration with quiet inspiration |
| What is Inspiratory reserve volume? | Air in excess of tidal volume on maximal inspiration |
| What is vital capacity? | VC = TV + IRV + ERV; Largest amount you could possibly inhale |
| What is functional reserve capacity? | FRC = ERV + residual volume |
| What is Total lung capacity? | TLC = IRV + TV + ERV + RV (residual volume) |
| What does it mean when the oxygen-hemoglobin dissociation curve shifts to the right? | Facilitates unloading of oxygen to tissue |
| What causes oxygen-hemoglobin dissociation curve to shift to the right? | High altitude, increased 2,3 DPG, Increased CO2/pH |
| What does an increase in V/Q ratio signify? | Ventilation is outmatching perfusion, typically a blockage of blood flow |
| What does a decrease in V/Q ratio signify? | That perfusion is outmatching ventilation, typically an airflow obstruction |
| What are the bodies responses to a high altitude? | Increase in hematocrit, increase in 2,3 DPG, increase in renal excretion of bicarbonate to compensate for respiratory alkalosis (can be augmented by acetazolamide) |
| Productive cough for 3 months, hypertrophy of mucus-secreting glands in bronchioles. Diagnosis? | Chronic bronchitis (Blue Bloater) |
| Dyspnea w/ decreased breath sounds, enlargement of air spaces on X-ray. Diagnosis | Emphysema (pink puffer); centriacinar caused by smoking, panacinar is alpha-1 antitrypsin deficiency |
| Cough, wheezing, and pulsus paradoxus, smooth muscle hypertrophy and Curshmann's spirals. Diagnosis? | Asthma; pulsus paradoxus (exaggeration of the difference in pulse strength during inspiration and expiration), Curshmann's spirals (desquamated epithelium) |
| Chronic necrotizing infection of bronchi leading to permanently dilated airways is associated with these syndromes. | Bronchiectasis; associated with CF and Kartagener's (poor ciliary motility, dynein defect) |
| Wegener's granulomatosis, Goodpasture's syndrome and Pneumoconiosis all cause this disorder. | Restrictive lung disease; pnemoconiosis is coal miner's silicosis, asbestosis; Goodpastures is autoimmune destruction of kidneys and lungs (anti-GBM); Wegener's is autoimmune vasculitis also effecting kidneys and lung (C-ANCA) |
| Neutrophilic destruction of alveolar walls leading to increased alveolar capilary permeabilty occurs in this syndrome. | ARDS (adult acute respiratory syndrome); results in intraalveolar hyaline membrane formation |
| How will FEV1, FVC, and TLC be affected in obstructive lung disease? | FEV1 and FVC will both be reduced but FEV1 more so FEV1/FVC is usually < 80. TLC will be increased |
| How will FEV1, FVC, and TLC be affected in restrictive lung disease? | FEV1 and FVC will be reduced, FEV1/FVC may be reduced or normal. TLC however will be markedly reduced |
| How do you distingush between central and obstructive sleep apnea? | Central: no respiratory effort; Obstructive: respiratory effort against airway obstruction |
| Diffuse pulmonary intersitital fibrosis with ferruginous bodies and Ivory white pleural plaques in lower lobes. | Asbestosis; other pneumoconioses (coal worker's silicosis) affect upper lobes |
| Absent breath sounds over right upper lobe, decreased resonance, decreased fremitus, tracheal deviation towards right upper lobe | Bronchial obstruction |
| Decreased breath sounds over right upper lobe, dullness on resonance, decreased fremitus. | Dullness on resonance is probably fluid (pneumonia or effusion), decreased fremitus however indicates either effusion or pneumothorax |
| Bronchial breath sounds over right upper lobe, dullness on resonance, increased fremitus. | Pneumonia |
| Decreased breath sounds over right upper lobe, hyperresonant, absent fremitus, deviation of trachea towards left. | Pneumothorax |
| Centrally located lung carcinoma with Hilar mass arising from bronchus. | Squamous cell carcinoma |
| Peripheral lung carcinoma with multiple densities on X-ray. | Adenocarcinoma |
| Central lung carcinoma with small dark blue cells seen on biopsy. | Small-cell (oat cell) carcinoma; small dark blue cells are Kulchitsky cells, neuroendocrine cells capable of producing ACTH or ADH; may lead to Lamber-Eaton syndrome |
| Patient with a chest mass in lung apex with constricted right pupil with droopy right eyelid. Diagnosis? | Pancoast's tumor; Horner's syndrome (ptosis, miosis, anhidrosis) |
| What is the most common agent of lobar pneumonia? | Pneumococcus |
| What are the most common agents of Bronchopneumonia? | S. aureus, H. Flu, kliebsella, S. pyogenes |
| What are the most common agents of interstitial pneumonia? | Viruses (RSV, adeno), mycoplasma, and legionella |
| What are the histamine blockers that are known for sedation? | Diphenhydramine, dimenhydrinate, chlorpheniramine (1st generation H1 blockers); treat allergies and motion sickness |
| What are the histamine blockers that are less sedating? | Loratadine, fexofenadine, desloratadine (2nd generation H1 blockers); treat allergies |
| This non-specific beta agonist is used to treat asthma but has the adverse effect of bradycardia. | Isoproterenol |
| This beta 2 agonist relaxes bronchial smooth muscle and is useful for acute exacerbation. | Albuterol |
| This beta 2 agonist relaxes bronchial smooth muscle providing long acting prophylaxis. | Salmeterol |
| This phosphodiesterase inhibitor decrease cAMP hydrolysis to promote bronchodilation. | Theophylline |
| This agent blocks muscarinic receptors preventing bronchoconstriction in asthmatics. | Ipratropium |
| This agent prevents release of mediators from mast cells for asthmatic prophylaxis. | Cromolyn |
| This drug blocks leukotriene receptors and is useful for aspirin-induced asthma. | Zafirlukast, montelukast |
| This asthma drug is a 5-lipoxygenase pathway inhibitor blocks leukotriene synthesis. | Zileuton |
| This expectorant is mucolytic, loosening mucus plugs in CF patients. | N-acetylcystine |
| This expectorant removes excess sputum but does not suppress cough reflex. | Guaifenesin (Robitussin) |
| What are the histamine blockers that are known for sedation? | Diphenhydramine, dimenhydrinate, chlorpheniramine (1st generation H1 blockers); treat allergies and motion sickness |
| What are the histamine blockers that are less sedating? | Loratadine, fexofenadine, desloratadine (2nd generation H1 blockers); treat allergies |
| This non-specific beta agonist is used to treat asthma but has the adverse effect of bradycardia. | Isoproterenol |
| This beta 2 agonist relaxes bronchial smooth muscle and is useful for acute exacerbation. | Albuterol |
| This beta 2 agonist relaxes bronchial smooth muscle providing long acting prophylaxis. | Salmeterol |
| This phosphodiesterase inhibitor decrease cAMP hydrolysis to promote bronchodilation. | Theophylline |
| This agent blocks muscarinic receptors preventing bronchoconstriction in asthmatics. | Ipratropium |
| This agent prevents release of mediators from mast cells for asthmatic prophylaxis. | Cromolyn |
| This drug blocks leukotriene receptors and is useful for aspirin-induced asthma. | Zafirlukast, montelukast |
| This asthma drug is a 5-lipoxygenase pathway inhibitor blocks leukotriene synthesis. | Zileuton |
| This expectorant is mucolytic, loosening mucus plugs in CF patients. | N-acetylcystine |
| This expectorant removes excess sputum but does not suppress cough reflex. | Guaifenesin (Robitussin) |
Created by:
rahjohnson
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