respiratory

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Author:
icbcc
ID:
59543
Filename:
respiratory
Updated:
2011-01-12 23:40:36
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usmle
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Description:
respiratory(goljan)
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  1. increased A-a gradient
    hypoxemia of pulmonary origin
  2. normal A-a gradient
    hypoxemia of extra-pulmonary origin
  3. Pao2
    =%02(713)-arterial Pco2/0.8
  4. A-a gradient
    >30
  5. Hypoxemia+increased A-a gradient
    • ventilation
    • perfusion
    • diffusion defects;
    • right-to-left cardiac shunts
  6. Hypoxemia + normal A-a:
    • depress respiratory center,
    • upper airway obstruction,
    • chest bellows disease
  7. Volumes nol diiectly
    measured by spirometry:
    TLC, FRC, RV
  8. RV
    =FRC-ERV
  9. TLC and RV:
    TLC end of maximal inspiration; RV end of maximal expiration
  10. Obstructive pattern:
    • nonuniform emptying;
    • expiratory curve shift lo
    • left of normal curve
  11. Restrictive parenchymal:
    • expiratory curve shifted to
    • right of normal curve
  12. Choanal atresia:
    newborn cannot breathe through the nose; cyanosis when breast-feeding
  13. obstructive sleep apnea
    respiratory acidosis and hypoxemia
  14. OSA(risk and Ds)
    • risk for developing cor pulmonale
    • polysomnography for Ds
  15. Sinus infections
    • maxillary in adults
    • ethmoid is children
  16. nasopharyngeal carcinoma
    association with EBV
  17. laryngeal carcinoma
    • most on true vocal cords
    • squamous cancer
  18. resorption atelectasis
    • airway obstruction by thick secretions;
    • MCC of fever 24-36 hours after surgery
  19. compression atelectasis
    air under pressure or fluid in pleural cavity
  20. surfactant 1.(inhibition and increase of synthesis)
    2. function
    • 1cortisol increases synthesis
    • insulin inhibits synthesis
    • 2. decrease surface tension
  21. Hypoglycemia in newborn:
    due to excess insulin in response to fetal hyperglycemia
  22. ARDS:
    • severe hypoxemia,
    • PA wedge pressure < 18mm Hg,
    • increased A-a gradient
  23. TB:
    • acid-fastness due to mycolic acid
    • cord factor is virulence faclor
  24. Source of pulmonary thromboemboli:
    femoral veins
  25. Bronchial arteries
    protect lungs from infarction
  26. Bronchial arteries arise
    from aorta and intercostalarteries
  27. Pulmonary infarction:
    • dyspnea and tachypnea most common symptom and sign;
    • respiratory alkalosis;
    • hypoxemia
  28. Main cause of secondary PH;
    respiratory acidosis and hypoxemia
  29. Cor pulmonale
    PH and RVH
  30. goodpasture syndrome:
    hemoptysis followed by renal failure
  31. Restrictive lung disease
    • decreased compliance
    • increased elasticity
  32. restrictive lung disease
    • decreased volumes/capacities
    • normal to increased FEV1/FVC ratio
  33. Particles size 1-5 mm:
    bifurcation respiratory bronchioles and alveolar ducts
  34. <0.3 mm
    alveoli
  35. Caplan syndrome:
    pneumoconiosis and cavitating rheumatoid nodules
  36. Silicosis:
    • opacities contain collagen and quartz;
    • inc. risk lung cancer and TB
    • "egg-shell" calcification in hilar nodes
  37. Ferruginous bodies:
    iron coated asbestos fibers
  38. Bronchogenic carcinoma:
    most common asbestos related cancer
  39. Malignant mesothelioma:
    arises from serosa of pleura; encases the lung
  40. Sarcoidosis:
    • CD4 Th cells interact wilh unknown antigen
    • noncaseating granulomas
  41. Sarcoidosis:
    • inc.ACE
    • hypercalcemia due to hypervitaminosis D
    • diagnosis of exclusion; rule out other granulomatous diseases
  42. Idiopalhic pulmonary fibrosis:
    • alveolitis leading to interstitial fibrosis;
    • honeycomb lung
  43. Collagen vascular diseases with interstitial
    fibrosis:
    • systemic sclerosis,
    • SLE,
    • RA
  44. Pleural effusion in young woman:
    consider SLE
  45. Farmer's lung:
    • antigen is thermophilic actinomyces moldy hay
    • type III and IV hypersensitivity
  46. Silo filler's disease:
    Inhalation of gases(oxides of Nitrogen]
  47. Byssinosis:
    • contact with cotton, linen, hemp products;
    • "Monday morning blues"
  48. Drugs interstitial fibrosis
    • amiodarone,
    • bleomycin,
    • cyclophosphamide,
    • melholrexate
  49. Centriacinar emphysema:
    • destruction of the distal terminal bronchioles and RBs;
    • upper lobe
  50. Panacinar emphysema:
    • targets distal terminal bronchioles and the entire respiratory unit;
    • lower lobe
  51. Panacinar emphysema;
    loss of alpha1-globulin peak on SPE
  52. Emphysema;
    • inc.TLC,RV;
    • dec.FEV1/FVC
  53. Emphysema:
    normal to low arterial Pco2, (respiratory alkalosis)
  54. IL-4:
    IL-5:
    • isolype switching to IgE production;
    • production and activalion of eosinophils

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