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17 Cards in this Set
- Front
- Back
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What is Light's criteria?
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Don't know
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Name 3 causes of transudative vs exudative effusions
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Don't know
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Explain the pathophysiology of emphysema
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- loss of elastin by a-antitrypsin deficiency, smoking, or other disesae
- leads to damage to alveolar wall - hyperinflated alveoli - there is loss of tethering, and alveoli get big and push on each other - small airways collapse or narrow - there is air trapping and hyperinflation - lungs become more compliant, but there is less area for gas diffusion - obstructive PFTs, decreased DLCO, increased TLC, RV, FRC |
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Explain the pathophysiology of chronic bronchitis
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- small airways are inflamed and fibrosed
- increased number and function of mucus glands, increased number of goblet cells - damaged cilia lead to reduced mucus clearance - leads to narrowed airways - increased resistance and work of breathing - hypoventilation and CO2 retention --> hypoxemia and hypercapnia and obstructive pattern PFTs - DLCO should be normal, - increased TLC, RV, FRC |
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Explain the pathophysiology of Asthma
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- hyperresponsiveness to allergen or other trigger
- transient and treatable - leads to inflammation, including more eosinophils - increased mucus production --> increased goblet cells - bronchoconstriction - narrowed airways --> increased resistance - and obstructive pattern PFTs -> during attack - DLCO should be normal - lung volume should be normal --> may be increased during dynamic hyperinflation - obstructive PFTs results should improve with bronchodilators |
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How to calculate O2 delivery to tissues?
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O2 Content x Cardiac output
O2 Content: 1.39 x Hb x SpO2 + 0.003 x PaO2 |
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How do you calculate A-a gradient?
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PAO2 = FiO2(Pb-Ph2o)-PACO2/R
(FiO2 normally 0.21, Pb = 760mmHg, Ph2o = 47, R=0.8) A-a gradient = PAO2 - PaO2 (measured on arterial blood gases) |
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What does the A-a gradient tell you?
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A-a gradient is increased if there is a shunt, diffusion impairment, or V/Q mismatch. (i.e. there is something wrong with the lungs). It is unchanged in the case of pure hypoventilation or low FiO2
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What are 5 main causes of hypoxemia?
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1. hypoventilation
2. V/Q mismatch 3. shunt 4. diffusion impairment 5. decreased inspired O2 (high altitude) |
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How do you treat latent TB?
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those 4-6 drugs...
1. isoniazid 2. rifampin 3. pyrazinamide 4. ethambutol 5. vitamin E? |
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CF Q
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CF A
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Describe the immune defences of the lung
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1. physical
- turbulent airflow - coughing - cilia beating - epithilium (epithial cell shedding) 2. chemical - mucus - NO - increased viscosity 3. cellular - macrophages - inflammatory |
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How does surfactant work?
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it is made up of phospholipids, lipids, and various proteins...
- decreased surface tension, preventing alveoli from collapsing - some immune functions |
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calculation question about pulmonary hypertension (know equations from
pHTN lecture - PAPmean and wedge pressure) |
not learned yet
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How are pulmonary function tests different in obstructive and restrictive lung diseases?
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Obstructive:
FVC decreased, FEV1 markedly decreased, FEV1/FVC decreased - lung volumes increased Restrictive - FVC, FEV1 decreased, but proportionally, so FEV1/FVC normal or increased - lung volumes decreased - DLCO ?? |
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Treatment "tree" for asthma?
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controllers (inhaled and oral corticosteroids & LTRA) and relievers (bronchodilators)
controllers: beclomethasone relievers: B-agonists, anticholinergics fast acting (salbutamol), fast acting long duration, long acting For persistent Asthma: Start on regular inhaled corticosteroids. If poorly controlled, increase dose of ICS, Add LTRA if < 5y/o., maybe long acting b-agonists if over 5y/o |
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Treatment pyramid for COPD?
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bronchodilators:
- beta agonists - anticholinergics - ?PDE inhibitors? anti-inflammatory: - oral and parenteral steroids - Anti IgE - mainly for asthma - leukotriene receptor antagonists - mainly for asthma - also flu and pneumococcal vaccines |
