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Pulmonary
PASS program drill notes
| Question | Answer |
|---|---|
| List four types of cells in the lungs: | Goblet: Mucus production Type I Pneumocyte ==> macrophage (95%) Type II Pneumocyte ==> produce surfactant Clara cell/Dust ==> macrophages; ingest dust particles |
| What is the histology of the trachea? | Top 1/3 => Stratified Squamous epithelium (protects against abrasion) Middle 1/3 => Mixture Lower => Tall columnar Pseudo-stratified ciliate epithelium |
| What are the muscles needed to breathe in? | Innermost intercostals (contralateral chest wall) External intercostals (ipsilateral chest wall) Diaphragm |
| What are the muscles needed to force air in? | Scalene SCM = Sternocleidomastoid Trapezius Pectoralis Major/Minor |
| What are the muscles needed to breathe out? | Passive = recoil |
| What are the muscles needed to force air out? | Internal/External oblique Rectus abdominus Transverse abdominus Quadratus lumborum |
| What is the difference between a carotid body and a carotid sinus? | Carotid body ===> chemoreceptor Carotid sinus ===> baroreceptor |
| What color is air on an x-ray? | Black "radiolucent" |
| What color is fluid/solid on x-ray? | White "radiopaque" |
| What disease has a steeple sign on film? | Croup |
| What disease has a thumb sign on neck film? | Epiglottitis |
| What is a "blue bloater"? | Bronchitis (chronic) |
| What is a "pink puffer"? | Emphysema |
| What diseases have pulmonary eosinophilia? | Aspergillosis, Strongyloides |
| What drugs cause pulmonary eosinophilia? | Nitrofurantoin, Sulfonamides |
| What are the risk factors for lung cancer? | Smoking, Radon, 2nd hand smoke, pneumoconiosis (except anthracosis) |
| What diseases have hemoptysis? | Bronchiectasis, bronchitis, pneumonia, TB, lung cancer |
| Where is a Bokdalek hernia? | Back of diaphragm |
| Where is the Morgagni hernia? | Middle of diaphragm |
| What diseases have respiratory acidosis? | Obstructive lung disease |
| What diseases have respiratory alkalosis? | Restrictive lung disease (anxiety, pregnancy, gram (-) sepsis, PE) |
| What diseases have metabolic alkalosis? | Low volume State (vomiting, diuretics, GI blood loss) |
| What diseases have metabolic acidosis? | Acid production (MUDPILES, RTA II, diarrhea) |
| What is the obstructive pattern of blood gases? | ↑ pCO2 --> ↓pH, ↑RR --> ↑pO2 |
| What is the restrictive pattern of blood gases? | ↓ pCO2 --> ↑RR --> ↓pCO2 --> ↑pH |
| What does stridor tell you? | Extrathoracic narrowing => narrows when breath in => neck x-ray |
| What does wheezing tell you? | Intrathoracic narrowing => narrows when breathe out => chest x-ray |
| What does rhonchi tell you? | Mucus in airway => obstructive lung disease |
| What does grunting tell you? | Blows collapsed alveoli open => restrictive lung disease |
| What does dull percussion tell you? | Something b/w airspace and chest wall absorbing sound (fluid or solid) |
| What does hyperresonance tell you? | Lungs hyperinflated with air |
| What does tracheal deviation tell you? | Away from pneumothorax OR toward atelectasis "air-phobic" |
| What does fremitus, egophony, and | Consolidation ==> pathognomonic for pneumonia |
| What is Restrictive lung disease? | Small stiff lungs, trouble breathing in |
| What is Obstructive lung disease? | Big mucus-filled lungs, trouble breathing out |
| What is Epiglottitis? | X-ray thumb sign, drooling |
| What is Croup? | X-ray steeple sign, barking cough |
| What is Tracheitis? | Look toxic, grey pseudomembrane, leukocytosis |
| What is Asthma? | Wheeze on expiration, IgE, eosinophils |
| What is Bronchiolitis? | Asthma in kids < 2 y/o |
| What is Maxillary Sinusitis? | Teeth pain worse with bending forward |
| What is Bronchiectasis? | Bad breath, purulent sputum, hemoptysis |
| What is Chronic bronchitis? | Lots of sputum, "blue bloater" |
| What is Emphysema? | Restrictive to obstructive pattern, "pink puffer" |
| What is Laryngomalacia? | Epiglottis rolls in from side-to-side |
| What is Pneumonia? | Consolidation of airway |
| What is Pneumothorax? | Air outside of lungs; hyperresonance on same side |
| How do you detect Pulmonary Embolus? | Tachypnea, increased V/Q scan, EKG: S1Q3T3 |
| What is Tamponade? | Decreased breath sounds/BP; increased JVD; fluid in pericardial sac |
| What is Tracheomalacia? | Soft cartilage, stridor since birth |
| What is Cystic Fibrosis? | Meconium ileus, steatorrhea, bronchiectasis |
| What is Aspergillosis? | Allergy to mold, dead plants, compost piles |
| Who gets Asbestosis? | Shipyard workers, pipe fitters, brake mechanics, insulation installers |
| Who gets Silicosis? | Sandblasters, glassblowers |
| Who gets Byssinosis? | Cotton workers |
| Who gets Berylliosis? | radio, TV welders, those working with bulbs, NASA |
| What is Anthracosis? | Coal workers, massive fibrosis |
| What is Sarcoidosis? | Non-caseating granulomas, eggshell calcification of lymph nodes |
| What is Carcinoid syndrome? | Flushing, wheezing, diarrhea |
| What is Small cell CA? | At carina, malignant, Cushing's, SIADH, SVC syndrome |
| What is Large cell CA? | Large stuff |
| What is Squamous cell CA? | Smoker, high PTH, high Ca2+ |
| What is Bronchoalveolar CA? | Looks like pneumonia, due to pneumoconiosis |
Created by:
rakomi
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