First Aid 2012: Respiratory

Front 1

Goblet cells extend to what area in the lung?

Back 1

just to bronchi

Front 2

Type I pneumocytes are what cell type?

Back 2

Squamous; thin for optimal gas diffusion

Front 3

What lung cells proliferate after lung damage?

Back 3

Type II pneumocytes

Front 4

Aspirating a peanut while sitting upright will likely lodge in what part of lung? how about supine?

Back 4

upright- lower portion of right inferior lobe

supine- superior portion of right inferior lobe

Front 5

What is the relation of the pulmonary artery to the bronchus at each lung hilus?

Back 5

Right-Anterior
Left- Superior

RALS

Front 6

What are the muscles used in inspiration during exercise?

Back 6

external intercostals, scalenes, sternocleidomastoids

Front 7

What is deficient in neonatal RDS?

Back 7

surfactant (lecithin)

Front 8

What is the formula for physiological dead space?

Back 8

tidal volume X (PaCO2-PeCO2)/PaCO2

pe=expired air

Front 9

At FRC, what is the

Airway pressure
alveolar presssure
intrapleural pressure

Back 9

airway and alveolar- zero

intrapleural- negative, prevents pneumothorax

Front 10

methemoglobin can be treated with what?

Back 10

methylene blue

Front 11

when treating cyanide poisoning, first use _____ then use ____ so it is renally excreted

Back 11

nitrites (to oxidize hemo to methemoglobin)

then thiosulfate (binds to cyanide)

Front 12

The fact that hemoglobin has an increased affinity for O2 each time it binds an O2 is referred to as what

Back 12

positive cooperativity

Front 13

An increase in what causes a right shift in the hemoglobin dissociation curve

Back 13

CO2
BPG
exercise
acid-altitude
temperature

Front 14

What is a primary cause of pulmonary hypertension?

Back 14

BMPR2 gene mutation, normally inhibits vascular smooth muscle proliferation

Front 15

What are secondary causes of pulmonary hypertension?

Back 15

COPD, mitral stenosis, recurrent thromboemboli, autoimmune disease(systemic sclerosis) left to right shunt, sleep apnea or living at high altitude (hypoxic vasoconstriction)

Front 16

formula for pulmonary vascular resistance

Back 16

P of pulmonary artery- P of left atrium
_______________________
CO

Front 17

Two causes of hypoxemia with a normal A-a gradient?

Back 17

high altitude, hypoventilation

Front 18

Majority of CO2 in blood is carried by what?

Back 18

Bicarbonate

Front 19

Sarcoidosis involves what

Back 19

increase in ACE, and calcium
bilateral hilar lypmphadenopathy
noncaseating granuloma

Front 20

What three drugs can cause a restrictive lung disease?

Back 20

Bleomycin, busulfan, amiodarone

Front 21

What is that pathophysiology of hyaline membrane disease?

Back 21

neutrophilic substances, activation of coagulation cascade and free radicals...causes diffuse alveolar damage...increase alveolar capillary permeability...protein-rich leakage into alveoli

results in formation of hyaline membrane

Front 22

What disease?

Back 22

Hyaline membrane disease...Neonatal ARDS

Front 23

What disease? Hint: immunocompromised person

Back 23

Coccidiomycosis

Front 24

???

Back 24

tension pneumothroax...mediastinal shift away from affected lung

Front 25

What is Caplan's syndrome?

Back 25

coal miner's pneumoconioses with rheumatoid involvement

Front 26

Describe the lung region involved for the following:

Coal miner's pneumoconioses
Silicosis
Asbestosis

Back 26

Coal miner's- upper lobes

silcosis- upper lobes, and "eggshell" calcification of hilar lymph nodes

abestosis- lower lobes

Front 27

fremitus is an indication of?

Back 27

pneumomonia (lobar)

Front 28

Complications from lung cancer (SPHERE)

Back 28

Superior vena cava syndrome
Pancoast tumor
Horner's syndrome
Endocrine (paraneoplastic)
Recurrent laryngeal symptoms
Effusions

Front 29

???

Back 29

Squamous cell carcinoma---"keratin pearls"

Front 30

Small cell carcinoma location and histology?

Back 30

Central

neurodendocrine cells of kulchitsky (Small dark blue)
assoc with ACTH Or ADH and possibly Lambert EatonM

Front 31

Most common lung cancer in females and nonsmokers?

Back 31

Adenocarcinoma

affects peripheral (clara to type II pneumocytes)

Front 32

Squamous Cell CA location and characteristics?

Back 32

Central

cavitation, linked to smoking, parathyroid like activity

Front 33

Psammoma bodies seen in what type of lung cancer?

Back 33

mesothelioma

Front 34

Patient presents with facial plethora, neck (JVD) and edema of upper extremities, what are you thinking?

Back 34

Superior Vena Cava syndrome

Front 35

H1 blockers..name them

Back 35

1st gen-diphenhydramine, dimenhydrinate, chlorpehniramine


2nd- loratadine, fexofenandine, cetirizine

Front 36

Beta-2 agonists used for asthma

Back 36

relac bronchial smooth muscle

albuterol- actue exacerbation

salmeterol- long term prophylaxis

Front 37

salmeterol ADR

Back 37

tremor, arrythmia

Front 38

theophylline MOA

Back 38

bronchodilation via
inhibiting phosphodiesterase, which decreases cAMP hydrolysis

Front 39

Ipratropium bromide MOA

Back 39

competiive blocking of muscarinic receptors, prevents bronchoconstriction (asthma as well as COPD

Front 40

What is the first line therapy for chronic asthma?

Back 40

corticosteroids---beclomethasone, prednisone

inhibits NF-kB, which then decreased TNF alpha production, decrease inflammation

Front 41

Zileuton MOA

Back 41

blocks 5-lipoxygenase pathway...blocks conversion of arachidonic acid to leukotrienes

Front 42

Cromolyn MOA

Back 42

prevents release of mediators from mast cells (Leukotrienes, histamine)

Front 43

Montelukast and Zafirlukast MOA

Back 43

block leukotriene receptors...really good for aspirin induced asthma

Front 44

What can loosen mucus plugs in CF patients?

Back 44

N-acetylcysteine

Front 45

Guafenesin MOA

Back 45

remove excess sputum but doesnt suppress cough reflex

Front 46

Bosentan

Back 46

MOA: antagonizes endothelin-1 receptors, which decreases PVR

use: pulmonary HTN

Front 47

Dextromethorphan

Back 47

antitussive (antagonizes NMDA receptors)
synthetic codeine analog

Front 48

Organisms that cause bronchopenumonia

Back 48

S. aureus, H. flu, klebsiella, s. pygoenes

Front 49

Organisms that cause lobar pneumonia

Back 49

pneumococcus (most common), Klebsiella

Front 50

Organisms that cause interstitial pneumonia

Back 50

RSV, adenoviruses, mycoplasma, legionella, chlamydia

Front 51

What is the most common cause?

Back 51

Virus-- RSV, adenovirus

interstitial pneumonia

Front 52

What is the most likely causative agent?

Back 52

Pneumococcus...(s. pneumoniae)