Notes in 03 Respiratory Pathophysiology

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Published	12/13/2023	What is the normal respiratory rate? {{c1::12-20 bpm}}
Published	12/13/2023	The internal carotid arteries are branches of the {{c1::common carotid}} arteries.
Published	12/13/2023	The {{c1::Circle of Willis}} is an anastamotic ring formed by the {{c2::internal carotid}} arteries and {{c3::basilar}} artery.
Published	12/13/2023	Vasoactive intestinal polypeptide (VIP) causes {{c1::relaxation}} of bronchial smooth muscle.
Published	12/13/2023	Vasoactive intestinal polypeptide (VIP) increases production of {{c1::nitric oxide}} to produce smooth muscle relaxation.
Published	12/13/2023	In smooth muscle, Ca2+ activates {{c1::myosin light chain kinase}}, leading to {{c1::contraction}}.
Published	12/13/2023	{{c1::IP3 phosphatase}} deactivates IP3 to {{c2::IP2}}.
Published	12/13/2023	What fibers release chemicals that cause bronchoconstriction?{{c1::C-fibers (non-cholinergic)}}
Published	12/13/2023	What second messengers are responsible for bronchoconstriction?{{c1::IP3 and Ca2+::2}}
Published	12/13/2023	What second messengers are responsible for bronchodilation?{{c1::cAMP and protein kinase A::2}}
Published	12/13/2023	Platelet activating factor {{c1::constricts::constricts/dilates}} bronchiolar smooth muscle via the PAF receptor.
Published	12/13/2023	Bradykinin {{c1::constricts::constricts/dilates}} bronchiolar smooth muscle via the Bradykinin-2 receptor.
Published	12/13/2023	Neurokinin A {{c1::constricts::constricts/dilates}} bronchiolar smooth muscle via the Neurokinin-2 receptor.
Published	12/13/2023	Substance P {{c1::constricts::constricts/dilates}} bronchiolar smooth muscle.
Published	12/13/2023	Calcitonin gene related peptide {{c1::constricts::constricts/dilates}} bronchiolar smooth muscle via the CGRP receptor.
Published	12/13/2023	How do albuterol, metaproterenol, and salmeterol affect the heart rate?{{c1::Increased}}
Published	12/13/2023	Atropine and glycopyrrolate are {{c1::M3}} receptor antagonists that cause broncho{{c2::dilation}}.
Published	12/13/2023	What drug class treats asthma by blocking production of arachidonic acid?{{c1::Inhaled corticosteroids}}
Published	12/13/2023	One side effect of inhaled corticosteroids is {{c1::dysphonia}} due to myopathy of {{c2::laryngeal}} muscles.
Published	12/13/2023	The best test of airflow in small airways is the {{c1::FEF25-75%. }}
Published	12/13/2023	The best test of respiratory endurance is the {{c1::maximum voluntary ventilation}}.
Published	12/13/2023	The normal forced vital capacity in males is {{c1::4.8}} L.
Published	12/13/2023	The normal forced vital capacity in females is {{c1::3.7}} L.
Published	12/13/2023	The normal maximum voluntary ventilation (MVV) in females is {{c1::80}}-{{c1::120}} L.
Published	12/13/2023	The normal maximum voluntary ventilation (MVV) in males is {{c1::140}}-{{c1::180}} L.
Published	12/13/2023	The normal diffusing capacity (DLCO) is {{c1::17}}-{{c1::25}} mL/min/mmHg.
Published	12/13/2023	On a flow-volume loop, the width of a loop represents the {{c1::vital capacity}}.
Published	12/13/2023	On a flow-volume loop, the top portion represents {{c1::expiration}}.
Published	12/13/2023	On a flow-volume loop, the bottom portion represents {{c1::inspiration}}.
Published	12/13/2023	Does asthma increase the risk of postoperative pulmonary complications?{{c1::No}}
Published	12/13/2023	Does CHF increase the risk of postoperative pulmonary complications?{{c1::Yes}}
Published	12/13/2023	Does COPD increase the risk of postoperative pulmonary complications?{{c1::Yes}}
Published	12/13/2023	What type of surgery is associated with the highest risk of postoperative respiratory failure?{{c1::Aortic surgery}}
Published	12/13/2023	What lab test is predictive of postoperative respiratory failure?{{c1::Albumin < 3.5 g/dL}}
Published	12/13/2023	What is the half-life of carbon monoxide?{{c1::4-6 hours}}
Published	12/13/2023	Smoking depresses {{c1::mucociliary}} clearance and {{c2::sputum}} production.
Published	12/13/2023	Does smoking cause enzyme induction?{{c1::Yes}}
Published	12/13/2023	What airway complication can be caused by smoking?{{c1::Airway hyperreactivity}}
Published	12/13/2023	Smoking can cause episodic chest pain due to {{c1::coronary vasoconstriction}}.
Published	12/13/2023	What peak airway pressure is required to open atelectatic regions of the lung?{{c1::30 cm H2O}}
Published	12/13/2023	How is a recruitment maneuver performed?{{c1::Increase PIP to 40 cm H2O for 8-10 seconds}}
Published	12/13/2023	How does a fixed lesion affect a flow-volume loop?{{c1::Flattened on boths ides}}
Published	12/13/2023	The biggest risk factor for developing asthma is {{c1::atopy}}.
Published	12/13/2023	{{c1::Eosinophilia::WBCs}} is associated with asthma.
Published	12/13/2023	Bronchospasm after airway manipulation is due to {{c1::vagal stimulation}}.
Published	12/13/2023	What EKG finding is seen in patients with asthma?{{c1::right axial deviation}}
Published	12/13/2023	Are PFTs predictive of postoperative pulmonary complications?{{c1::No}}
Published	12/13/2023	What airway device is preferred for patients with reactive airway disease (e.g. asthma)?{{c1::LMA}}
Published	12/13/2023	HME (passive humidifiers) are particularly effective in patients with {{c1::exercise-induced}} asthma.
Published	12/13/2023	What medication is used to treat GERD-induced asthma?{{c1::H2 antagonists}}
Published	12/13/2023	Stimulation of presynaptic H2 receptors {{c1::decreases}} histamine release.
Published	12/13/2023	Can hydrocortisone be used to treat acute bronchospasm?{{c1::No}}
Published	12/13/2023	What methylxanthine is administered for acute bronchospasm?{{c1::Aminophylline}}
Published	12/13/2023	What type of surgery can help restore normal lung function in patients with COPD?{{c1::Lung volume reduction}}
Published	12/13/2023	{{c1::α1-antitrypsin}} is produced by the liver.
Published	12/13/2023	{{c1::α1-antitrypsin}} inhibits the enzyme {{c2::alveolar elastase}}.
Published	12/13/2023	What inhaled anesthetic can cause a pneumothorax in patients with COPD?{{c1::Nitrous oxide}}
Published	12/13/2023	How should the inspiratory flow rate be adjusted in patients with COPD?{{c1::Decreased (slow)}}
Published	12/13/2023	What causes this?{{c1::Auto-PEEP (dynamic hyperinflation)}}
Published	12/13/2023	Auto-PEEP is treated by {{c2::increasing the expiratory time}} or {{c1::disconnecting the breathing circuit}}.
Published	12/13/2023	A high minute ventilation, especially in patients with COPD, may cause {{c1::auto-PEEP}}.
Published	12/13/2023	{{c1::Decreases}} in expiratory flow may cause auto-PEEP.
Published	12/13/2023	{{c1::Increased}} in airway resistance may cause auto-PEEP.
Published	12/13/2023	Auto-PEEP increases the {{c1::intrathoracic}} pressure, leading to {{c2::hypo}}tension.
Published	12/13/2023	What type of lung disease does pulmonary edema cause?{{c1::Restrictive}}
Published	12/13/2023	How should the I:E ratio be adjusted in patients with restrictive lung disease?{{c1::Prolong inspiratory time (1:1)}}
Published	12/13/2023	In patients with restrictive lung disease, peak pressures should be kept below {{c1::30}} cm H2O in order to prevent {{c2::barotrauma}}.
Published	12/13/2023	What class of drugs are omeprazole, lansoprazole, and pantoprazole?{{c1::Proton pump inhibitors}}
Published	12/13/2023	After aspiration, CXR may show infiltrates in the {{c1::perihilar}} and {{c2::dependent}} lung regions.
Published	12/13/2023	Limiting the use of {{c1::sedation}} reduces the incidence of ventilator-associated pneumonia.
Published	12/13/2023	{{c1::Subglottic}} suctioning reduces the incidence of ventilator-associated pneumonia.
Published	12/13/2023	Performing a daily {{c1::spontaneous breathing trial}} reduces the incidence of ventilator-associated pneumonia.
Published	12/13/2023	What medication can be administered to prevent GI bleed in patients at risk for ventilator associated pneumonia?{{c1::Sucralfate}}
Published	12/13/2023	What bacteria is the #2 cause of nosocomial pneumonia?{{c1::Staphylococcus aureus}}
Published	12/13/2023	What type of pneumothorax has no communication between the pleural cavity and the atmosphere?{{c1::Closed pneumothorax}}
Published	12/13/2023	What type of pneumothorax has is characterized by partial re-expansion during expiration?{{c1::Communicating (open) pneumothorax}}
Published	12/13/2023	Does a closed pneumothorax present with a mediastinal shift?{{c1::No}}
Published	12/13/2023	How does a pneumothorax affect the CVP?{{c1::Increased}}
Published	12/13/2023	What two ultrasound findings are suggestive of pneumothorax?{{c2::Lack of lung sliding}}{{c1::Absence of comet tails (reverberation artifact)}}
Published	12/13/2023	A  pleural effusion of {{c2::blood}} is also known as {{c1::hemothorax}}
Published	12/13/2023	The presence of blood clots in the chest is also known as {{c1::fibrothorax}}
Published	12/13/2023	The presence of pus in the chest is also known as {{c1::pyothorax (empyema)}}
Published	12/13/2023	The presence of serous fluid in the chest is also known as {{c1::pleural effusion}}
Published	12/13/2023	What vessel rupture is the most common cause of hemothorax?{{c1::Intercostal vessels}}
Published	12/13/2023	What is the treatment for patients with hemodynamically stable hemothorax (e.g. bleeding < 150 mL/hr)?{{c1::VATS}}
Published	12/13/2023	How does the flail chest segment move with expiration?{{c1::Moves outward (paradoxical chest wall motion)}}
Published	12/13/2023	Pulmonary hypertension causes dilation of the {{c1::right ventricle}}.
Published	12/13/2023	Does late-stage pulmonary hypertension present with systolic or diastolic dysfunction?{{c1::Systolic dysfunction}}
Published	12/13/2023	In patients with late-stage pulmonary hypertension, the cardiac output is dependent on {{c1::preload}}.
Published	12/13/2023	How does hypothermia affect pulmonary vascular resistance (PVR)?{{c1::Increased}}
Published	12/13/2023	What induction agent can increase the pulmonary vascular resistance (PVR)?{{c1::Ketamine}}
Published	12/13/2023	How does atelectasis affect pulmonary vascular resistance (PVR)?{{c1::Increased}}
Published	12/13/2023	How does nitroglycerin affect pulmonary vascular resistance (PVR)?{{c1::Decreased}}
Published	12/13/2023	What inhaled prostaglandins are used in the treatment of pulmonary hypertension?{{c1::PGE1 and PGI2::2}}
Published	12/13/2023	{{c1::Portal}} hypertension can cause pulmonary hypertension.
Published	12/13/2023	The preferred neuraxial anesthetic technique in patients with pulmonary hypertension is {{c1::epidural}}.
Published	12/13/2023	What is the normal inspiratory force?{{c1::75-100 cm/H2O}}
Published	12/13/2023	What is a normal PaO2 at room air (21%)?{{c1::> 80 mmHg}}
Published	12/13/2023	What is a normal PaO2 at 100% O2 ?{{c1::> 400 mmHg}}
Published	12/13/2023	What is a normal A-a gradient at 100% O2 ?{{c1::< 100 mmHg}}
Published	12/13/2023	A inspiratory force of < {{c1::25}} cm/H2O is a strong indication for mechanical ventilation.
Published	12/13/2023	A PaO2  of < {{c1::55}} mmHg is a strong indication for mechanical ventilation.
Published	12/13/2023	A A-a gradient of {{c1::>55}} mmHg is a strong indication for mechanical ventilation.
Published	12/13/2023	A PaCO2 of {{c1::> 60}} mmHg is a strong indication for mechanical ventilation.
Published	12/13/2023	A respiratory rate of {{c1::> 40}} or {{c1::< 6}} is a strong indication for mechanical ventilation.
Published	12/13/2023	A patient with a {{c1::DLCO::gas exchange measure}} < 40% of predicted values is at high risk for postoperative pulmonary complications.
Published	12/13/2023	The normal VO2 max in a male is {{c1::35}} mL/kg/min.
Published	12/13/2023	The normal VO2 max in a female is {{c1::30}} mL/kg/min.
Published	12/13/2023	A {{c1::VO2 max}} < 15 mL/kg/min is a strong predictor of postoperative pulmonary complications.
Published	12/13/2023	One-lung ventilation is indicated in patients with lung {{c1::infections}} to avoid contamination.
Published	12/13/2023	One-lung ventilation is indicated in patients with massive {{c1::hemorrhage}} to avoid contamination.
Published	12/13/2023	One-lung ventilation is indicated in patients with a {{c1::bronchopleural}} fistula to control distribution of ventilation.
Published	12/13/2023	One-lung ventilation is indicated in patients with a large/unilateral {{c1::cyst/bulla}} to control distribution of ventilation.
Published	12/13/2023	What is the typical double lumen endotracheal tube size for males?{{c1::39-41 French}}
Published	12/13/2023	What is the typical double lumen endotracheal tube size for females?{{c1::37-39 French}}
Published	12/13/2023	What is the typical double lumen endotracheal tube insertion depth for females?{{c1::27 cm}}
Published	12/13/2023	What is the typical double lumen endotracheal tube insertion depth for females?{{c1::29 cm}}
Published	12/13/2023	Bronchial cuffs are {{c1::low}}-volume {{c1::high}}-pressure cuffs.
Published	12/13/2023	What is the typical double lumen endotracheal tube size for children 8-9 years old?{{c1::26 French}}
Published	12/13/2023	What is the typical double lumen endotracheal tube size for children 10+ years old?{{c1::28-32 French}}
Published	12/13/2023	What are the alternatives to double-lumen endotracheal tubes in children?Single lumen advanced into {{c1::mainstem bronchus}}Single lumen + {{c2::bron…
Published	12/13/2023	In the lateral decubitus position, which lung is better ventilated?{{c1::Non-dependent lung}}
Published	12/13/2023	In the lateral decubitus position, which lung is more prone to atelectasis?{{c1::Dependent lung}}
Published	12/13/2023	What is the recommended respiratory rate in patients undergoing one-lung ventilation?{{c1::12-15 (target PaCO2 of 35-45 mmHg)}}
Published	12/13/2023	An {{c1::alveolar recruitment}} maneuver should be performed before starting one-lung ventilation.
Published	12/13/2023	Which lung is more prone to hypoxemia during one-lung ventilation?{{c1::Left}}
Published	12/13/2023	How many lung lobes are on the right side?{{c1::3 }}
Published	12/13/2023	How many lung lobes are on the left side?{{c1::2 }}
Published	12/13/2023	What complication of one-lung ventilation is signaled by absent breaths sounds in the upper lobe? {{c1::double-lumen tube too deep}}
Published	12/13/2023	What complication of one-lung ventilation is signaled by bilateral breath sounds? {{c1::double-lumen tube too shallow}}
Published	12/13/2023	What are the two most common serious complications of mediastinoscopy?1. {{c2::Hemorrhage}}2. {{c1::Pneumothorax (usually right)}}
Published	12/13/2023	{{c1::Mediastinoscopy}} is performed to diagnose and stage lung cancer.
Published	12/13/2023	In a mediastinoscopy, the scope is passed anterior to the {{c1::trachea}}.
Published	12/13/2023	In a mediastinoscopy, the scope is passed posterior to the {{c1::aorta}}.
Published	12/13/2023	Mediastinoscopies are absolutely contraindicated in patients with a {{c1::previous mediastinoscopy}}.
Published	12/13/2023	Mediastinoscopies are relatively contraindicated in patients with {{c1::tracheal}} deviation.
Published	12/13/2023	Mediastinoscopies are relatively contraindicated in patients with {{c1::thoracic aortic}} aneurysm.
Published	12/13/2023	Mediastinoscopies are relatively contraindicated in patients with {{c1::superior vena cava}} obstruction.
Published	12/13/2023	Compression of the innominate artery disrupts circulation to the {{c1::right}} side of the circle of Willis.
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