Test your basic knowledge |

Respiratory

Instructions:

Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can study here.
Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. What does ACE do
Bronchial hyperresponsiveness causes reversible bronchocxn - smooth muscle hypertrophy and curschmann's spirals
Inc production
Angio I to angio II - inactivates bradykinin (ACEi inc bradykinin and cause cough - angioedema)
Lower portion of right inferior lobe

2. What happens to O2 content and O2 sat as Hb falls
Person stops breathing for at least 10 seconds repeatedly during sleep
Bilateral hilar lymphadenopathy - noncaseating granuloma - inc ACE and calcium
Dec - no change
IRV + TV

3. What is the relation fo the pulmonary artery to the bronchus at each lung hilus
Inc EPO causing inc hemotocrit and hemoglobin - chronic hypoxia
RALS - righ anterior - left superior
Dec
Inspiration by external intercostals - scalenes - sternomastoids; expiration by rectus abdominus - internal/external obliques - transversus abdominus - internal intercostals

4. What do hemoglobin modifacations lead to...
<75
Methylene blue
Tissue hypoxia from dec O2 sat and dec O2 content
Air in excess of tidal volume that moves into lung on maximal inspiration

5. What is the course of of pulm HTN
Exposed collagen fibers provides impetus for clotting cascade
RV + ERV - volume in lungs after nl expiration
Strep pneumo most often - or klebsiella - intra - alveolar exudate leading to consolidation; can involve entire lung
Severe respiratory distress - cyanosis and RVH - death from decompensated cor pulmonale

6. What is are the symptoms of a pulmonary embolism
0 - negative - prevents pneumothorax
Decrease in both - though in obstructive FEV1 is more dramatically reduced resulting in FEV1/FVC ration < 80%
Localized collection of pus within parenchyma - usually resulting from bronchial obstruction - apsiration of oropharyngeal contents
Chest pain - tachypnea and dyspnea

7. Malignancy associated with asbestosis - results in hemorrhagic effusions and pleural thickening - cancer - location - histo finding
Mesothelioma - pleura - psammoma bodies
Pleural effusion
In between perfusion limited and diffusion limited
COPD and destruction of lung parenchyma - mitral stenosis - recurrent thromboemboli - autoimmune dz - left to right shunt - sleep apnea - or living at high altitude

8. What causes neonatal RDS
Right lung = 3 lobes - left lung = 2 lobes; lingula is homologue of right middle lobe in the left lung
Defect in coagulative cascace proteins
Opposites
Surfactant def leading to inc surfact tension and alveolar collapse

9. Which muscles are involved in quiet breathing and What part of respiration do the control
Bronchial hyperresponsiveness causes reversible bronchocxn - smooth muscle hypertrophy and curschmann's spirals
Type II pneumocytes - dec alveolar surface tension - inc compliance - dec work of inspiration
Ratio from apex to base becomes more uniform
Inspiration by diaphragm - expiration is passive

10. What enzyme increases activity in emphysema
Elastase
High alveolar pressure compresses capillaries
Angio I to angio II - inactivates bradykinin (ACEi inc bradykinin and cause cough - angioedema)
Dec O2 delivery to tissues - dec cardiac output - anemia - CN poisoning - CO poisoning

11. What is the cycle of idiopathic pulmonary fibrosis
Dec
Anatomic dead space and smooth muscle
2alpha and 2 gamma subunits - lower affinity for 2 -3 BPG
Repeated cycles of lung injury and wound healing with inc collagen

12. What is fetal hemoglobin made of and why does it have a higher affinity for O2
Right
Heparin
Viral - URIs - allergens and stress
2alpha and 2 gamma subunits - lower affinity for 2 -3 BPG

13. What happens with the O2 curve shifts to the right and What does it facilitate
Dec affinity of hemoglobin for O2 - facilates unloading of O2 to tissue
Retinopathy of maturity
Air in lung after maxmimal expiration - cannot be measured on spirometry
Severe respiratory distress - cyanosis and RVH - death from decompensated cor pulmonale

14. What is the imaging test of choice for PE
Volume of inspired air that does not take part in gas exchange - anatomical dead space of conducting airways plus fxnal dead space in alveoli
Stasis - hypercoagulability - endothelial damage
Inc resistance leading to inc pressure
CT angio

15. Synthesis of what substance increases with altitude and What does that do for the O2 sat curve
Airway obstruction (shunt) 100% O2 does not improve PO2
Inc 2 -3- DPG - righward shift
Adrenals - brain (epilepsy) - bone (pathologic lesions) - liver (jaundice - hepatomegaly)
Air in lung after maxmimal expiration - cannot be measured on spirometry

16. A carcinoma in the apex of the lung can cause what syndrome and What is the tumor called

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183

17. What is the order of decreasing pressures among the alveola - capillaries and veins in zone 2 of the lungs
TB - apex
Nl = 10-14 - pulm HTN at or above 25 or above 35 during exercise
Pa > PA > Pv
Productive cough for greater than 3 months in at least 2 years

18. What does kallikrein do
Hypoxic vasocxn shifts blood away from poorly ventilated regions of lung to well ventilated regions of lung
Mesothelioma - pleura - psammoma bodies
Activates bradykinin
Type II pneumocytes - dec alveolar surface tension - inc compliance - dec work of inspiration

19. increases In what substances favor the taut form of hemoglobin and which direction does that shift the O2 dissociation curve
FRC - inward pull of lung balanced by outward pull of chest wall
Inc shear stress leading to endothelial injury
4 polypeptide subunits - 2 alpha and 2 beta
Cl - - H+ - CO2 - 2 -3- BPG - temperature - shifts to the right

20. What is used to treat methemoglobin
R = 8nl/pir^4 - n=viscosity - l = length - r = vessel radius
Hypoxic vasocxn
Right lung - right main stem bronhus is wider and more vertical
Methylene blue

21. What is the criteria for chronic bronchitis
Dipalmatoyl phosphatidylcholine - decreases surface tension
Productive cough for greater than 3 months in at least 2 years
Horners syndrome from affect of cervical sympathetic plexus - pancoast's tumor
Histiocytosis X - Langerhans cells

22. What are the potential TX for sleep apnea
Weight loss - CPAP - surgery
4 polypeptide subunits - 2 alpha and 2 beta
ARDS - neontatal RDS - pneumoconiosis - sarcoidosis - idiopathic pulmonary fibrosis - goodpasture's - wegeners - eosinophilic granuloma - or drug toxicities
Vgas = (A/T) [Dk(P1- P2)] - A = area - T= thickness ; A dec in emphysema and T inc pulmonary fibrosis

23. Define vital capacity (VC)
Type II pneumocytes - dec alveolar surface tension - inc compliance - dec work of inspiration
PA02 = 150 - PACO2/0.8
Everything but RV - TV + IRV + ERV
Vgas = (A/T) [Dk(P1- P2)] - A = area - T= thickness ; A dec in emphysema and T inc pulmonary fibrosis

24. Define functional residual capacity (FRC)
Large cell carcinoma - pleomorphic giant cells with leukocyte fragments in cytoplasm - removed surgically and less responsive to chemotherapy
RV + ERV - volume in lungs after nl expiration
Lung cancer
Obesity - loud snoring - systemic/pulmonary HTN - arrhythmias and possible sudden death

25. What is an association and potential complication of paraseptal emphysema
Bronchial obstruction - toward side of lesion
Bullae - rupture leading to spontaneous pneumothorax often in young - otherwise healthy males
Hypertrophy of mucus secreting glands in the bronchioles
Inc EPO causing inc hemotocrit and hemoglobin - chronic hypoxia

26. What are the 9 interstitial lung diseases

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183

27. What is another name for neonatal RDS
Type II cells
Alchoholics or epileptics
Prostaglandins - histamine - ACE - kallikrein
Hyaline membrane disease

28. What ratio is used to measure lung maturity and What is the value is neonatal RDS
Horners syndrome from affect of cervical sympathetic plexus - pancoast's tumor
L/S < 1.5
Inc to meet O2 demand
Type II pneumocytes - after week 35

29. How does mitral stenosis cause pulm HTN
Inc resistance leading to inc pressure
Apex = 3 (wasted ventilation) Base = 0.6 (wasted perfusion)
Inc airway pressure to prevent airway collapse during exhalation
Superior portion of right inferior lobe

30. What cellular changes occur at high altitude
Hypoxemia because of shunting - V/Q mistmatch - fibrosis
Air in excess of tidal volume that moves into lung on maximal inspiration
Inc mitochondria
Hyaline membrane disease

31. What happens to diffusing capacity in interstiial lung diseases
Taut form - low affinity for O2; relaxed form has high affinity for O2 (300x)
Lowered
Chest pain - tachypnea and dyspnea
Elastase

32. What reaction and enzyme create bicarb and Where does it happen
CO2 is absorbed into the RBC - carbonic anydrase catalyzes the rxn of CO2 + H2O to yield H2CO3 - which readily dissociateds into H+ and HCO3-
Steroids to mom - artificial surfactant and thyroxine to neonate
Bullae - rupture leading to spontaneous pneumothorax often in young - otherwise healthy males
Volume of inspired air that does not take part in gas exchange - anatomical dead space of conducting airways plus fxnal dead space in alveoli

33. What are the findings of chronic bronchitis
Centriacinar
Superior portion of right inferior lobe
Drainage
Wheezing - crackles - cyansosis - late - onset dyspnea - blue bloater

34. What organisms cause interstitial PNA and What are the characteristics
Lost with alveolar walls
RSV - adenovirus - mycoplasma - legionella - chlamydia; diffuse patchy inflammation localized to interstitial areas at alveolar walls; distrubtion involving 1 or more lobes
Clara cells - type II pneumocytes; multiple densitites on CXR
Decrease in both - though in obstructive FEV1 is more dramatically reduced resulting in FEV1/FVC ration < 80%

35. Peripheral mass develops in site of prior pulmonary inflammation or injury - cancer and epi
Inc due to inc CO
Adenocarcinoma of lung - bronchial - most common cancer in females and non smokers
Carcinoid - carcinoid
Dec protein - CHF - nephrotic syndrome - hepatic cirrhosis

36. What does each bronchopulmonary segment have in the center and along its border
CO x O2 content of blood
Angio I to angio II - inactivates bradykinin (ACEi inc bradykinin and cause cough - angioedema)
Tert (segmental) bronchus - 2 arteries (bronch/pulm) - veins and lymph drain along the borders - arteries run with airways
S. aureus - H flu - Klebsiella - S pyogenis; acute inflmmatory infiltrates from bronchioles into adjacent alveoli; pathy distribution involving 1 or more lobes

37. What doe FAT BAT stand for
4 polypeptide subunits - 2 alpha and 2 beta
It binds to Hb -
Fat - Air - Thrombus - Bacteria - Amniotic fluid - Tumor - embolus types
Centriacinar

38. At What terminal does CO2 bind the globin molecule
Acute/chronic inc in vent
IVC at T8 - esophagus and vagus at T10 - aorta - thoracic ducts - azygous at T12 - I ate 10 eggs at 12
N- terminus - carbaminohemoglobin
Heparin

39. What is the characteristic lymphatic pleural effusion
Dorsiflexion of food leads to tender calf muscle
Milky fluid with inc TGs
Inc resistance leading to inc pressure
Productive cough for greater than 3 months in at least 2 years

40. What changes in CO2 occur during exercise
Large cell carcinoma - pleomorphic giant cells with leukocyte fragments in cytoplasm - removed surgically and less responsive to chemotherapy
Inc production
Carcinoid - carcinoid
Inoperable - responsive to chemotherapy

41. What are mucus secretion swept out by
TB - silica disrupt phagolysosomes and impair MACS
Prostaglandins - histamine - ACE - kallikrein
Ciliated cells
Inc 2 -3 DPG - binds to Hb so the Hb releases more O2

42. What happens to lung volumes in restrictive lung disease
Incr - right - dec - left
Localized collection of pus within parenchyma - usually resulting from bronchial obstruction - apsiration of oropharyngeal contents
Bicarb (90%) - bound to globin (5%) and dissolved (5%)
Dec

43. What is the formula for O2 content
Large cell carcinoma - pleomorphic giant cells with leukocyte fragments in cytoplasm - removed surgically and less responsive to chemotherapy
O2 binding x O2 sat + dissolved O2
IVC at T8 - esophagus and vagus at T10 - aorta - thoracic ducts - azygous at T12 - I ate 10 eggs at 12
Acetazolamide - inhibits CA and acidifies the blood

44. In which zone of the lung is PA > Pa > Pv
Vd = Vt x[(PaCO2 - PeCO2)/PaCO2]
Zone 1
R = 8nl/pir^4 - n=viscosity - l = length - r = vessel radius
Repeated cycles of lung injury and wound healing with inc collagen

45. Why do pts with emphysema exhale through pursed lips
No respiratory effort
Dec - because physiologic shunt dec O2 extraction from ratio
Inc airway pressure to prevent airway collapse during exhalation
Adrenals - brain (epilepsy) - bone (pathologic lesions) - liver (jaundice - hepatomegaly)

46. What effects do O2 and CO2 have on pulm circulation - in relation to the other
RSV - adenovirus - mycoplasma - legionella - chlamydia; diffuse patchy inflammation localized to interstitial areas at alveolar walls; distrubtion involving 1 or more lobes
Opposites
Retinopathy of maturity
Upper lobes - cor pulmonale - caplan's syndrome

47. What is sleep apnea associated with
Obesity - loud snoring - systemic/pulmonary HTN - arrhythmias and possible sudden death
Adrenals - brain (epilepsy) - bone (pathologic lesions) - liver (jaundice - hepatomegaly)
Bleomycin - busulfan - anmiodorone
Fe 2+

48. What organism causes a lobar PNA and What are the characteristics
Lost with alveolar walls
Hypoxemia because of shunting - V/Q mistmatch - fibrosis
Strep pneumo most often - or klebsiella - intra - alveolar exudate leading to consolidation; can involve entire lung
Coal miner's - silicosis - abestosis

49. If you aspirate a peanut while upright - where will it go
Lower portion of right inferior lobe
Mesothelioma - pleura - psammoma bodies
Inc
Dec - no change

50. What are curschmann's spirals
Zone 3
Inc airway pressure to prevent airway collapse during exhalation
Stasis - hypercoagulability - endothelial damage
Shed epithelium from mucus plugs