First Aid: Respiratory Pathology 1

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created 7 years ago by jgaversa5
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1

what types of things can cause emboli

fat
air
thrombus
bacteria
amniotic fluid
tumor

embolus moves like a FAT BAT

2

what are fat emboli associated with

long bone fractures and liposuction

3

what can amniotic fluid emboli lead to

DIC, especially postpartum

4

what will the symptoms of pulmonary embolism be

chest pain
tachypnea
dyspnea

5

how many pulmonary emboli arise from deep leg veins

95%

6

what is the imaging test of choice for PE

helical CT

7

where will the pulmonary embolism settle if it is saddle

pulmonary artery R and L

8

what will lines of zahn look like

interdigitating areas of pink and red

9

what do lines of zahn represent

layers of RBCs, platelets, and fibrin laid down if thrombus formed before death

10

what predisposes people to DVT

virchow's triad: stasis, hypercoagulability, endothelial damage

11

what is homans' sign

dorsiflexion of the foot due to a tender calf muscle: indicative of DVT

12

what do you do for DVT

prevent and treat with heparine

13

what happens in COPD

obstruction of air flow resulting in air trapping in the lungs

14

what happens in COPD at high lung volumes

airways close prematurely

15

what happens to reserve volume and FVC in COPD

increased reserve volume and decreeased functional vital capacity

16

what happens to the functional pulmonary tests in COPD

much decreased FEV1 and somewhat FVC decrease: FEV1/FVC is MUCH decreased

17

what happens to V/Q in pulmonary function tests

decreased

18

what are the types of COPD

chronic bronchitis
emphysema
asthma
bronchiectasis

19

what is the pathology of chronic bronchitis

hypertrophy of mucus secreting glands in the bronchioles

20

what is the pathology of emphysema

enlargement of air spaces and decreased recoil resulting from destruction of alveolar walls leading to increased compliance

21

what is the pathology of asthma

bronchial hyperresponsiveness causes reversible bronchoconstriction; smooth muscle hypertrophy and Curschmann's spirals (shed epithelium from mucus plugs)

22

what is the pathology of bronchiectasis

chronic necrotizing infection of bronchi leading to permanently dilated airways, purulent sputum, recurrent infections, and hemoptysis

23

what COPD is highlighted by a Reid index of over 50%

chronic bronchitis

24

what is the reid index

gland depth/total thickness of bronchial wall

25

what will someonen with chronic bronchitis present with

productive cough for over 3 straight months in 2 or more years

26

what type of airway disease is chronic bronchitis

small airway disease

27

what are the findings on physical exam of chronic bronchitis

wheezing, crackles, cyanosis (early onset hypoxemia due to shunting) and late-onset dyspnea

28

who are the "blue bloaters"

chronic bronchitis

29

what activities are up in emphysema

elastase activiity increased
increased lung compliance due to loss of elastic fibers

30

what will emphysema exhalation look like

through pursed lips

31

why will emphysema show pursed lips

increased airway pressure and prevent airway collapse during expiration

32

what can trigger asthma

viral URIs, allergens, and stress

33

how do you test for asthma

methacholine challenge

34

what are the general findings on PE of asthma

cough
wheezing
tachypnea
dyspnea
hypoxemia
decreased I/E ratio
pulsus paradoxus
mucus plugging

35

what is bronchiectasis associated with

bronchial obstruction, poor ciliary motility (smoking), kartagener's syndrome

36

what can bronchiectasis lead to

aspergillosis

37

what is the ultimate defect in restrictive lung disease

decreased lung volumes (FVC and TLC)

38

what are the pulmonary function tests like in restrictive lung disease

FEV1/FVC around 80% (high)

39

what are the types of restrictive lung diease

poor breathing mechanics (extrapulmonary, peripheral hypoventilation)

interstitial lung diseases (pulmonary, lowered diffusing capacity)

40

what types of things can cause poor breathing mechanics and examples of each

poor muscular effort (polio, myasthenia gravis)

poor structural apparatus (obesity, morbid obesity)

41

what are some examples of interstital lung diesases

ARDS
HMD
pneumoconioses
sarcoidosis
idiopathic pulmonary fibrosis
goodpasture's syndrome
wegener's
eosinophilic granuloma
drug toxicity

42

what are some pneumoconioses

coal miner's disease
silicosis
asbestos

43

what is associted with sarcoisis

bilateral hilar lymphadenopathy, noncaseating granulmoa with increased ACE and calcium

44

what is idiopathic pulmonary fibrosis

repeated cycles of lung injury and wound healing with increased collagen

45

what is an example of eosinophilic granulmoa

histiocytosis X

46

what is an example of drug toxicity causing restrictive lung disease

bleomycin
busulfan
amiodarone

47

what can coal miner's disease result in

cor pulmonale
caplan's syndrome (RA involvement)

48

what is sarcoidosis assd with

foundries, sandblasting, ines

49

what happens in sarcoidosis

MPs respond to silica and release fibrogenic factors leading to fibrosis

50

how might sarcoidosis lead to TB susceptibility

disrupt phagolysosomes and impair MPs

51

what is asbestosis assd with

shipbuilding, roofing, and plumbing

52

what type of plaque does asbestosis result in

ivory white calcified pleural plaque

53

what cancers are increased in incidence in asbestosis

bronchogenic carcinoma and mesothelioma

54

what lobes are affected in coal miners

upper lobes

55

what lobes are affected in sarcoidosis

uppper lobes

56

what type of alteration is present in sarcoid

eggshell calcification of hilar LNs

57

what lobes are affected in asbestosis

lower lobes

58

what are asbestos bodies

golden brown fusiform rods resembing dumbbells located inside MPs

59

what is neonatal respiratory distress syndrome

surfactant deficiency leading to increased surface tension resulting in avlolar collapse

60

what is surfactant made by

type 2 pneumnocytes

61

when is surfactant made

most abundantly after 35th week of gestation

62

what is the L:S ratio in the amniotic fluid in neonatal respiratory distress syndrome

less than 1.5

63

what does a neonatal respiraotry discress syndrome lead to ask a result of persistently low O2 tension

PDA

64

what can therapeutic supplemental O2 result in

retinopathy of prematurity

65

what is surfactant

dipalmitoyl phosphatidylcholine

66

what are some risk factors of NNRDS

prematurity
maternal diabetes (elevated insulin)
caesarean delivery (decreased release of fetal glucocorticoids)

67

what is the treatment for NNRDS

maternal steroids before birth, artificial surfactant for infant, thyroxine

68

what can cause ARDS

trauma
sepsis
shock
gastric aspiration
uremia
acute pancreatitis, amniotic fluid embolism

69

what is the type of damage encountered in ARDS

DAD

70

what does DAD lead to in ARDS

alveolar capillary permeaiblity increase which leads to protein rich leakage into the alveoli

leads to formation of intra-alveolar hyaline membrane: initial damage due to release of neutrophilic substances toxict to alveolar wall, activation of coagulation cascade, and oxygen derived free radicals

71

what is sleep apnea

person stops breathing for at least 10 seconds repeatedly during sleep

72

what is central sleep apnea vs. obstructive

no respiratory effort vs resp effort vs airway obstruction

73

what is sleep apnea associated with

obesity, loud snoring, systemic/PHTN, arrythmias, SCD

chronically being tired

74

what is treatment for sleep apnea

weight loss
CPAP
surgery

75

what do people normally have as a result of sleep apnea

hypoxia leads to EPO leads to erythrocytosis

76

what is a normal FEV1/FVC

0.8

77

what is the main factor in restrictive respiratory disease

decerased TLC

78

what will breath sounds be like over the affected area in bronchial obstruction

absent or decreased

79

what will resonanct be like in bronchial obstruction

decreased

80

what will fremitus be like in bronchial obstruction

decreased

81

where will tracheal deviation be like in bronchial obstruction

toward side of lesion

82

what will breath sounds be like over a pleural effusion

decreased over the area

83

what will resonance be like in pleural effusion

dullness

84

what will fremitus be like in pleural effusion

decreased

85

what will a lobar pneumonia do for breath sounds

may have bronchial breath sounds over lesion

86

what will lobar pneumnoia sound like resonance

dullness

87

what will fremitus be like in lobar pneumonia

increased

88

what will breath sounds be like in tension pneumo

decreaseed

89

what will resonance be like in tension pneumo

hyperresonant

90

what iwll fremitus be like in tension pneumo

absent

91

where will tracheal deviation be in tension pneumo

away from lesion

92

what would breath sounds show in spont pneumo

decreased

93

what would resonance be in spont pneumo

hyperresonant

94

what would fremitus be in spont pneumo

decreased

95

where would tracheal deviation be in spont pneumo

toward side of lesion