Maternal DM (high
Neonatal Respiratory
insulin) or C-
Distress: Etiology + Tx
section (low
cortisol)
TX: dexamethasone before birth
Amniocentesis of Phospholipids
Lung maturity determined
with (*type II pneumocytes) L >> S
Type I pneumocytes Squamous gas diffusion
macrophage: lysosomes
Elastase in lungs
PMN: azuronphilic granules
Elastin stretches and recoils Lysine interchain crosslinks
due to
air pressure and Air pressure = 0
intrapleural Intrapleural
pressure at FRC pressure = -5
Pulm Vasc Resistance is Exhale of Tidal Volume
lowest during
LHF, pulmonary
Lung Compliance is
decreased by edema,
pulmonary
fibrosis
Lung Compliance is emphysema, age
increased by
DECRE
Obesity affects ERV and FRC
ASE
ERV &
FRC
Blood flow/min (pulmonary v pulmonary = systemic
systemic)
Bronchial
Anatomic pulmonary
circulation causes
shunting
decreased PO2 in
LA/LV than in
pulmonary
capillaries
More ventilation is at the BASE
basic, cold, low 2,3 BPG
O2-Hgb dissociation LEFT
shift low pO2 (compensatory erythrocytosis)
low pH, high
O2-Hgb dissociation RIGHT
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shift 2,3BPG, high T
HOT, ACIDIC
carbonic anhydrase
Cl shift
CO2 transport to lungs
Haldane: CO2
released to lung
(Bohr: O2 release to
tissue)
carboxyhem
CO poisoning causes
oglobin no
affect on
PaO2
Cyanide poisoning causes lactic acidosis
Amyl nitrite -->
How to treat cyanide
poisoning Methemoglobin THEN
Thiosulfate
(hydroxycobalamin)
5-15
Normal A-a gradient
Hypoventilation: Heroin OD or high altitude
Diffusion impairment (fibrosis)
Increased A-a gradient R-L shunt (aspiration, ARDS)
V/Q mismatch (pulmonary edema
ACE
AT --> AT II
(- high in
where and how
sarcoidosis) In
small
pulmonary bV
C5a induces what PMN influx (ie: in lungs)
BP cuff - appear and
Korotkoff sound
disappear in
inflation/deflation
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10mmHg
Pulsus Paradoxus
difference in
Korotkoff
sound
Pulsus Paradoxus occurs in Cardiac Tamponade
JVP rises during inspiration
Kussmaul sign
Constrictive Pericardiditis
Airway widening due to radial traction from fibrosis
Restrictive/Interstitial increase Aa
Lung Disease: A-a, FVC, decreased FVC
FEV1, EFR & FEV1
Increased
EFR
Th1 noncaseating
granulmona bilateral
Sarcoidosis
hilar adenopathy
increased ACE
increased IL2, IFNg
1-a-hydroxylase in macrophages: vit D --> HyperCa
Hyper Ca causes stones, thrones, groans, psych overtones
PTH independent
conversion of Calcifediol to
1-a-hydroxylase in
macrophages calcitriol (bioactive Vit D)
Vit D --> Hyper Ca
Honeycomb pattern
Idiopathic pulmonary fibrosis loss of Type 1 pneumocytes
hyperplasia Type II pneumocytes
HS II
Goodpasture
Auto-Ab against BM destroys lung alveoli (restrictive) and
renal glomeruli
DECREASED FEV1,
Obstructive Lung Disease
Decreased FVC increased
RV, FRC, TLC
**different shape
PMN, mo, CD8
COPD V/Q mismatch: O2 induced
hypercapnia; physio dead
space
Myeloperoxidase causes Green sputum/pus
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COPD patient
Do not give O2 supplement
Decreased
to
stimulation of
carotid bodies = decreased RR
Fluticasone
TX COPD with
(glucocorticoid)
inhibit cellular
reaction
Serine protease inhibitor
a1-antitrypsin deficiency LIVER
LUNG: inc PMN elastase --> emphysema
Methacholine (maCh) challenge
= induce
Asthma dx
bronchoconstriction
to reduce FEV1
+ test = Airways ARE reactive
B2 agonist MOA B2 (Gs) --> AC --> increase cAMP
inhibit cytokine
Corticosteroid MOA
synthesis suppress
T lymphocyte
inhibit Vagal via ACh
mACh Antagonist ("tropium")
MOA --> decreased Ca
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