Comlex Review Respiratory

Front 1

Most distal portion of conducting zone

Back 1

Terminal bronchioles

Front 2

What is anatomic dead space?

Back 2

Place where there is air in the body but no gas exchange. The conducting zone is this.

Front 3

Parts of the respiratory zone

Back 3

Respiratory bronchioles alveolar ducts, and alveoli

Front 4

Where does cartilage stop in the respiratory tree?

Back 4

The bronchi are the most distal structures that have it.

Front 5

Total Dead Space

Back 5

Anatomic + Physiologic Dead Space

Front 6

Pseudostratified ciliated columnar cells

Back 6

Extend into the terminal bronchiole and communicate via gap junctions.

Front 7

Goblet cells

Back 7

Extend to the bronchi

Front 8

Indicates fetal lung maturity

Back 8

Lecithin to sphingomyelin ratio of >2.0

Front 9

Collapsing Pressure in Airways

Back 9

Surface tension divided by radius

Front 10

Treatment to mother if lecithin:sphingomyelin <2

Back 10

Glucocorticoids

Front 11

Other things that stimulate surfactant production

Back 11

Thyroxin
Prolactin

Front 12

Identification of Type II pneumocyte

Back 12

Lamellar bodies on EM

Front 13

Aspiration while upright

Back 13

Lower portion of right inferior lobe

Front 14

Aspiration while supine

Back 14

Superior portion of right inferior lobe

Front 15

Structures perforating the diaphragm

Back 15

"I ate ten eggs at twelve"
T8: IVC
T10: esophagus, vagus
T12: Aorta, thoracic duct, azygous (red, white, blue)

Front 16

Muscles of inspration during exercise

Back 16

External intercostals, scalenes, sternomastoids (remember "ecSternalS"

Front 17

Muscles of expiration during exercise

Back 17

recturs abdominis, internal/external obliques, transversus abdominis, internal intercostals

Front 18

Prostaglandins in lung

Back 18

Vascular dialators, smooth muscle relaxors, act to decrease tone to relax bronchi

Front 19

Bradykinin effects

Back 19

vasodilation, permeability, pain

Front 20

What factors activate bradykinin?

Back 20

Kallikrein
ACE Inhibitors

(ACE inactivates it, therefore ACEI activate)

Front 21

Largest contributor to physiologic dead space

Back 21

Apex of lung

Front 22

Functional Residual Capacity

Back 22

Inward pull of lung is balanced by outward pull of chest wall. System pressure is atmospheric; airway and alveolar pressures are 0; intra pleural pressure is negative

Front 23

Factors leading to Taut form of hemoglobin

Back 23

Increased chloride, H+, CO2, 2,3 BPG and temperature

Front 24

Fetal hemoglobin higher affinity for O2

Back 24

Due to lower affinity for 2,3 BPG

Front 25

Methemoglobin

Back 25

Oxidized form of hemoglobin that does not bined to O2 as readily, but has increased affinity for CN-

Front 26

Methemoglobinemia treatment

Back 26

Methylene Blue

Front 27

Treatment for cyanide poisoning

Back 27

Nitrites and thiosulfate

Front 28

Caboxyhemoglobinemia

Back 28

Hemoglobin binds CO instead of O2

Front 29

Cor pulmonale

Back 29

Hypoxic vasoconstriction happens throughout lung due to poor ventilation; leads to right ventricular failure.

Front 30

Pulmonary hypertension definition

Back 30

>25mmHg
>35mmHg during exercise

Front 31

Primary pulmonary hypertension

Back 31

BMPR2 Gene inactivating mutation
(Leads to excess vascular smooth muscle proliferation)

Front 32

Approximation of PAO2

Back 32

150 - (PaCO2 / 0.8)

Front 33

Normal A-a gradient

Back 33

10-15mmHg

Front 34

Pulmonary HTN treatment

Back 34

-Bosentan, ambrisentan
-Prostaglandin analog
-Sildenafil
-Dihydropyridine CCBs (nifedipine)

Front 35

V/Q At apex

Back 35

V/Q=3

Front 36

V/Q At base

Back 36

V/Q=0.6

Front 37

Shunt

Back 37

Airway obstruction not correctable by 100% O2

Front 38

FEV1:FVC Ratio > 0.8

Back 38

Restrictive lung disease

Front 39

Mediators involved in Idiopathic Pulmonary Fibrosis

Back 39

TGF- beta
IL-10

Front 40

Idiopathic Pulmonary Fibrosis

Back 40

Repeated cycles of lung injury and wound healing with increased collagen. End stage "honeycomb" lung

Front 41

Coal Workers Pneumoconiosis types

Back 41

Anthracosis
Simple CWP
Complicated CWP

Front 42

Coal Workors Pneumoconiosis Cancer Risk

Back 42

No increased cancer risk

Front 43

Coal Workers Pneumoconiosis associated with Rheumatoid Arthritis

Back 43

Caplan Syndrome

Front 44

Pneumoconiosis that increases risk of TB

Back 44

Silicosis (fibrotic nodules found in the upper lung)

Front 45

Silica mechanism of destruction

Back 45

Impairs phagolysosome formation by macrophages

Front 46

Workers affected by berylliosis

Back 46

Beryllium miners and aerospace industry folks

Front 47

Asbestosis carcinoma types

Back 47

Lung carcinoma
Mesothelioma

Lung carcinoma more common than mesothelioma in exposed individuals.

Front 48

Noncaseating granulomas in multiple organs; classically seen in African American females

Back 48

Sarcoidosis

Front 49

Sarcoidosis Clinical features

Back 49

Dyspnea or cough, elevated serum ACE, Hypercalcemia

Front 50

Restrictive lung disease associated with Bell's Palsy

Back 50

Sarcoidosis

Front 51

Dyspnea or cough with Schaumann and asteroid bodies on H&E

Back 51

Sarcoidosis

Front 52

Asbestosis finding on H&E

Back 52

Ferruginous bodies (asbestos bodies)- long, glolden brown fibers

Front 53

Asbestosis location

Back 53

Lower lung, pleura

Front 54

Pulmonary hypertension key finding seen with long standing disease

Back 54

Plexiform lesions

Front 55

ARDS CXR findings

Back 55

"White out"

Front 56

Cells/factors involved in ARDS

Back 56

Neutrophil induced protease mediated damage to type I and II pneumocytes

Free radical damage of type I and II pneumocytes

Front 57

Noenatal RDS associated with

Back 57

Prematurity
Caesarian section delivery
Maternal Diabetes

Front 58

Central Sleep Apnea

Back 58

No respiratory effort

Front 59

Obstructive sleep apnea

Back 59

Respiratory effort against airway obstruction

Front 60

Treatment for central sleep apnea

Back 60

caffeine

*central seep apnea common in premature infants

Front 61

Treatment for sleep apnea

Back 61

Weight loss, CPAP, surgery,
Modafinil to stay awake

Front 62

Mechanism for sleep apnea leading to HTN, pulmonary HTN

Back 62

Hypoxia-->Erythropoietin release-->erythrocytosis

Front 63

Chemicals in cigarette smoke that are particularly mutagenic.

Back 63

Polycyclic aromatic hydroarbons
Arsenic

Front 64

2nd most common cause of lung carcinoma in the US

Back 64

Radon exposure

Front 65

Imaging seen with lung cancers

Back 65

"Coin lesion" on chest X Ray

Front 66

Components of bronchial hamartoma

Back 66

Benign tumor composed of lung tissue and cartilage

Front 67

Lung cancer that can produce ADH, ACTH, or Eaton Lambert syn

Back 67

Small Cell Carcinoma

Front 68

Lung cancer arising from clara cells

Back 68

Bronchioloalveolar Carcinoma

Front 69

Lung cancer classic presentation is female nonsmoker

Back 69

Adenocarcinoma

Front 70

Metastatsis to lung most common sources

Back 70

Breat and colon

Front 71

Carcinoid tumor of the lung charateristic histology

Back 71

Chromogranin positive well differentiated neuroendocrine cells

Front 72

Spontaneous pneumothorax most common cause

Back 72

Rupture of emphysematous bleb

Front 73

Unique site of distant metastasis of lung cancer

Back 73

Adrenal gland

Front 74

Side of tracheal deviation in spontaneous pneumothroax

Back 74

Toward the side of collapse

Front 75

Side of tracheal deviation in tension pneumothorax

Back 75

Away from the penetrating injury

Front 76

Makes up the diaphragm embryologically

Back 76

Septum transversum

Front 77

Most common diaphragmatic hernia (and where it occurs)

Back 77

Hital hernia- stomach herniates upward through the esophageal hiatus of the diaphrm (at T10)

Front 78

Molecule that directly affects respiration at the brainstem

Back 78

H+

Front 79

How does oxygen affect respiration?

Back 79

Chemoreceptors in the carotid body signal the medullary body via CN IX. Chemoreceptors in the aortic body signal the medulla via CN X.

Front 80

Components of the diffusion barrier in the lung

Back 80

Type I pneumocytes, basement membrane, endothelial cell

Front 81

Mechanism of action of Bosentan

Back 81

Competitively antagonizes endothelin-1 receptor.

Front 82

Normal Hb amount in blood

Back 82

15g/dL

Front 83

What effector increases the concentration of hemoglobin in RBCs?

Back 83

Prostaglandins

Front 84

Nitrogen narcosis

Back 84

N2 dissolves in neural membranes, reduces neuronal excitability. Looks similar to alcohol intoxication

Front 85

Decompression sickness

Back 85

N2 dissolved at depth. Comes out of solution as you rise--occluding blood vessels

Front 86

Indications for hyperbaric oxygen treatment

Back 86

Decompression sickness
Gas gangrene
Arterial gas embolism
CO Poisoning
Osteomyelitis
MI

Front 87

Postpartum women are at risk for DVT and DIC

Back 87

Amniotic fluid emboli

Front 88

Imaging test of choice for PE

Back 88

Helical CT

Front 89

Treatment for DVT

Back 89

Heparin and Warfarin (Coumadin)

Front 90

Diagnosis of DVT

Back 90

Ultrasound (Duplex scan)

Front 91

Virchow's triad

Back 91

Endothelial damage
Hypercoagulability
Venous stasis

Front 92

Four Obstructive Pulmonary Diseases

Back 92

Chronic Bronchitis
Asthma
Emphysema
Bronchiectasis

Front 93

Pancoast tumor symptoms

Back 93

Ptosis, miosis, anhidrosis (Horner's syndrome)

Front 94

Most common lobar pneumonia bacteria

Back 94

Streptococcus pneumoniae

Front 95

Bronchopneumonia organizms

Back 95

S. aures, H. flu, Klebsiela, S. pyogenes, Pseudomonas, Moraxella, Legionella

Front 96

Interstitial pneumonia most common

Back 96

Mycoplasma

Front 97

Common cause of pneumonia in immunocompromised patiens

Back 97

Pneumocystis jiroveci

Front 98

Most common cause of atypical/walking pneumonia

Back 98

Mycoplasma pneumoniae

Front 99

Common causative agent for pneumonia in alcoholics

Back 99

Klebsiella

Front 100

Intersticial pneumonia in bird handlers

Back 100

Chlamydia psittaci

Front 101

Pneumponia with history of exposure to bats and bat droppings

Back 101

Histoplasma

Front 102

Pneumonia in pt from Southwest USA

Back 102

Coccidioides

Front 103

Pneumonia with current jelly sputum

Back 103

Klebsiella pneumonia

Front 104

Q fever

Back 104

Coxiella burnetti

Front 105

Pneumonia from airconditioners

Back 105

Legionella pneumophila

Front 106

Most common pneumonia in children 1yo or younger

Back 106

RSV

Front 107

Most common cause of pneumonia in the neonate

Back 107

Group B Streptococcus (Strep Agalacticae)

Front 108

Most common cause of pneumonia in children and young adults

Back 108

Mycoplasma pneumoniae

Front 109

Common cause of pneumonia in patients with other health problems

Back 109

Klebsiella pneumoniae

Front 110

Most common cause of viral pneumonia

Back 110

RSV

Front 111

Causes wool-sorter's disease (a life threatening pneumonia)

Back 111

Bacillus anthracis

Front 112

Common bacterial cause of COPD exacerbation

Back 112

Haemophilus influenzae

Front 113

common pneumonia in ventilator patients and those with cystic fibrosis

Back 113

Pseudomonas aeruginosa

Front 114

Pontiac fever

Back 114

Legionella

Front 115

Caseous necrosis

Back 115

Tuberculosis

Front 116

Silver stain gram negative rods

Back 116

Legionella pneumophila