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PULM ASSOCIATIONS

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laracrystalo's version from 2016-07-17 21:29

gas exchange

Question Answer
pulm hypoplasia in infant?diaphragmatic hernia (bowels in chest)
diaphragm attached to which rib?12th
referred pain from diaphragm?shoulders
what does CO2 do to cerebral perfusion?dilates cerebral blood vessels--> increased cerebral blood flow --> causing headaches
absence of CO2 and cerebral perfusion?constricts cerebral blood vessels --> increasing cerebral vascular resistance
give O2 too fast to a COPD patient?respiration rate would increase bc CO2 would actually rise
nasal polyps in adultNSAID allergy (overproduction of lukotrienes)
nasal polyps in kidscystic fibrosis
thumb sign on CXRH. flu epiglottitis
steeple sign on CXRparainfluenza croup (laryngotracheal bronchitis)
multiple laryngeal polyps?HPV
single laryngeal polypmechanical strain from vocalists
infant with inspiratory stridormost commonly larygomalacia (larynx is too soft)
autopsy of infant shows cor pulmonate, RVH, extra medullary hematopoiesisprobably died of SIDS
increased percussionpneumothorax
decreased percussionpleural effusion or consolidation/pneumonia/atelectasis
decreased fremituspneumothorax, pleural effusion
increased fremitusconsolidation/pneumonia/atelectasis
decreased breath soundsall problems (pneumothorax, pleural effusion, consolidation)
aspiration when standing --> which lobe?anterior/inferior R lower lobe
aspiration when supine --> which lobe?apical/superior R lower lobe > apical/superior L lower lobe
how does bronchiectasis normally present?hemoptysis
where is bronchiectasis seen?tumor obstruction, ABPA, CF, Kartageners
centriacinar emphysemasmoking!
panacinar emphysemaalpha1 antitrypsin
paraseptal emphysemablullae --> rupture and cause spontaneous pneumothorax in tall thin men
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what kind of hypoxemia is this?

Question Answer
opiateshypoventilation of central origin
myasthenia gravishypoventilation of peripheral origin
rib fracturehypoventilation of peripheral origin
morbid obesityhypoventilation of peripheral origin
high altitudehypoventilation of peripheral origin
pulmonary embolismV/Q mismatch decreased perfusion (low Q) (dead space infinity)
pneumoniadecreased diffusion capacity
sarcoidosisdecreased diffusion capacity
asbestosdecreased diffusion capacity
hyaline membrane diseasedecreased diffusion capacity
emphysemadecreased diffusion capacity and V/Q mismatch
asthmaV/Q mismatch
bronchiectasisV/Q mismatch
bronchopneumoniaV/Q mismatch
foreign body aspirationV/Q mismatch (shunt 0)
granulomatous diseasesV/Q mismatch
COPDV/Q mismatch
pulmonary edema mechanismincreased hydrostatic pressure or decreased oncotic pressure
high A-a gradientV/Q mismatch, diffusion limitation, R -->L shunt
normal A-a gradienthigh altitude, hypoventilation
causes for hypoxiaanemia, CO poison, hypoxemia
hypoxia definitiondecreased O2 delivery to tissues
hypoxemia definitiondecreased PaO2
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obstructive or restrictive?

Question Answer
increased TLCobstructive
increased FRCobstructive
increased RVobstructive
decreased FEV1/FVCobstructive
decreased TLCrestrictive
decreased FRCrestrictive
increased FEV1/FVCrestrictive
breath fast and shallowrestrictive
breath slow and deepobstructive
scoop out line on graphobstructive
increased to normal FEV1restrictive
best parameter to measure severity of longstanding disease?FEV1/FVC
alveoli get largerobstructive
alveoli get smallerrestrictive
chronic bronchitisobstructive
emphysemaobstructive
asthmaobstructive
bronchiectasisobstructive
old ageobstructive
CFobstructive
sarcoidrestrictive
bronchospasmobstructive
ARDSrestrictive
fibrosisrestrictive
goodpasturerestrictive
langerhans cell histiocytosisrestrictive
pneumoconiosesrestrictive
what are charcot leyden crystals?degenerated eosinophils seen in asthma
what are curschmann spirals?shed epithelium from mucus plugs in asthma
extrinsic asthmaallergic or atopic type I HSR but eosinophils are impicated, also NSAID allergy
intrinsic asthmanon-allergic. usually adults, triggered by infection, exercise, cold air, no hypersensitivity but mast cells are implicated. Sensitive to histamine
type II pneumocyte hyperplasiarestrictive lung disease
histology of sarcoidosisnoncaseating granulomas, macrophages, CD4+ cells
factors that increase the risk of NRDSprematurity, diabetic moms (insulin from fetal hyperglycemia decreases surfactant), cesarian delivery
obstructive with normal DLCO?chronic bronchitis
obstructive with decreased DLCO?emphysema
obstructive with normal or increased DLCO?asthma
restrictive with decreased DLCOILD and sarcoidosis
scooped out graphobstructive
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CANCER

Question Answer
SIADHsmall cell
cushingsmall cell (ectopic ACTH)
PTHrpsquamous cell
Lambert-Eatonsmall cell (but any lung cancer)
Horner's syndromepancoast tumor invasion of superior cervical ganglion
erythema/swelling of face, increased JVP when supineSVC syndrome from invasion of central tumors in up role of lung
chylothoraxthoracic duct invasion
lytic bone lesionslung cancer mets to bone
Blastic bone lesionsprostate cancer mets to bone
both lytic and blastic bone lesionsbreast cancer to bone
chronic hemoptysisadenocarcinoma
sudden fatal hemoptysiscentral tumors
small blue cell tumorsmall cell
L-mycsmall cell
keratin pearlssquamous cell
most associated with asbestossquamous cell
increased 5HT and 5-HIAAcarcinoid
k-rasadenocarcinoma
cancer lines alveoli wallsbronchioalveolar
subtype of adenocarcinomabronchioalveolar
undifferentiated giant cellslarge cell
kulchitsky cellssmall cell
only chemo therapy for treatmentsmall cell
chromogrannin +small cell, carcinoid
mucin +adenocarcionoma
most common in nonsmokersadenocarcinoma
aerogenous spreadadenocarcinoma
desmosomessquamous cell
beta HCGlarge cell
shoulder painpan coast tumor
hemorrhagic pulmonary embolismmesothelioma
most common overalladenocarcinoma
hypercalcemiasquamous cell
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pneumoconiosis

Question Answer
shipyard workersasbestosis
pleural plaqueasbestosis
bronchogenic carcinomaasbestosis synergistic effect with tobacco
mesotheliomaasbestosis
psammoma bodiesmesothelioma
associated with TBsilicosis
looks like sarcoidosisberryliosis
ferruginous bodiesasbestosis (stain with iron)
bottom of lungasbestosis
miningsilicosis, coal workers lung
stonecuttingsilicosis
glass productionsilicosis
multiple calcified nodules in upper lung lobessilicosis
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