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Respiratory

First Aid: Respiratory

QuestionAnswer
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