Notes in Week 6

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Published	10/29/2023	{{c1::B2 agonists}} work by activating {{c2::adenylyl cyclase}}, increase {{c3::cAMP}} production and causing smooth muscle {{c4::relaxation}}. It can…
Published	10/29/2023	Albuterol, metaproteronol, and tertbutaline are examples of {{c1::short acting B2 agonists (SABA)}}
Published	10/29/2023	Salmeterol and formoterol are examples of {{c1::long acting B2 agonists (LABA)}}
Published	11/07/2023	{{c2::Muscarinic antagonists::Medication}} for the lungs work by blocking {{c1::acetylcholine}}, resulting in {{c3::decreased}} smooth muscle contract…
Published	10/29/2023	Montelukast and zafirlukast are examples of {{c1::leukotriene receptor antagonists}}, which are mainly used for asthma {{c2::prophylaxis}}
Published	10/29/2023	Zileuton is an example of a {{c1::leukotriene synthesis inhibitor}}, which works by inhibiting {{c2::5-lipoxygenase}}. It is effective for asthma {{c3…
Published	10/29/2023	Theophylline is a {{c1::methylxanthine}}, which inhibits {{c2::phosphodiesterase (PDE)}}, increasing {{c3::cAMP}} within the cell, leading to smooth m…
Published	10/29/2023	Corticosteroids effect in mast cells:Increase {{c1::annexin-1}} proteins, which inhibits synthesis of {{c2::arachidonic acid}} (and therefore leukotri…
Published	10/31/2023	Corticosteroids effect in Th2 cells:Decrease {{c1::IL-4}} and {{c1::IL-5}} production, decreasing activity of {{c2::mast cells}} and {{c2::eosinophils…
Published	10/29/2023	Common suffix for corticosteroids is {{c1::-sone}} or {{c1::-lone}}
Published	10/29/2023	Nedocromil and cromolyn are examples of {{c1::mast cell stabilizers}}, which inhibit release of {{c2::prostaglandins}} and {{c2::leukotrienes}} by sta…
Published	10/29/2023	Omalizumab is an example of an {{c1::Anti-IgE antibody}}, which decreases activation of {{c2::mast cells}}
Published	10/31/2023	{{c1::Pulmonary fibrosis}} occurs with interstitial {{c2::thickening}} that increases diffusion {{c3::distance}}. O2 exchange is impacted {{c4::more}}…
Published	10/31/2023	Medications that indicate {{c1::interstitial lung disease}}:Methotrexate, amiodarone, nitrofurantoin
Published	10/31/2023	Physical exam findings of {{c3::ILD}}:{{c1::Tachy}}pnea{{c2::Clubbing}} of fingers{{c4::Exercise}} desaturation{{c5::Rales::Lung sounds}}{{c6::Right}}…
Published	10/31/2023	Spirometric values of ILD:FEV1 and FVC are {{c1::low}}{{c3::FEV1/FVC}} ratio is {{c2::normal}}TLC is {{c4::low}}DLCO is {{c5::low}}
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Published	10/31/2023	Idiopathic Pulmonary Fibrosis:Age of onset: {{c1::6/7th}} decade{{c2::Velcro rales::Lung sounds}} and clubbingImage shows {{c3::reticular infiltrates}…
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Published	10/31/2023	This is a sign of {{c1::honeycombing}}, indicative of {{c2::idiopathic pulmonary fibrosis (IPF)}}
Published	10/31/2023	IPF treatment includes {{c1::antifibrotics}} like nintedanib and pirfenidone
Published	10/31/2023	{{c2::Nintedanib}}: {{c1::tyrosine kinase}} inhibitor that targets various TK, including VEGF, Fibroblast growth factor, and PDGF receptors
Published	10/31/2023	{{c1::Pirfenidone}}: {{c2::Pleiotropic}} effects: regulate important profibrotic and proinflammatory {{c3::cytokine}} cascades and reduces {{c4::…
Published	10/31/2023	{{c2::Non-specific interstitial pneumonia (NSIP)}}:Imaging: diffuse {{c3::ground-glass infiltrates}}Commonly seen in patients with {{c1::connective ti…
Published	11/07/2023	This is an example of {{c1::ground-glass opacities}}
Published	10/31/2023	This is an example of {{c1::rheumatoid arthritis}}
Published	10/31/2023	Rheumatoid arthritis pulmonary manifestation:Rheumatoid {{c1::nodules}}{{c2::Bronchiolitis}} obliteransDrug-related {{c3::pneumonitis}}Pleural {{c4::e…
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Published	10/31/2023	Best treatment of sarcoidosis is {{c1::immunosuppression}}
Published	10/31/2023	Sarcoidosis is {{c1::multi-}}system disease
Published	10/31/2023	{{c2::Cryptogenic organizing pneumonia (COP)}}:Associated with viral and bacterial {{c1::pneumonias}}, inhaled {{c3::toxins}}, connective tissue disea…
Published	10/31/2023	{{c2::Cryptogenic organizing pneumonia}} pathology: {{c1::polypoid}} plugs of loose organizing connective tissue within the lungs
Published	10/31/2023	This is an example of {{c1::cryptogenic organizing pneumonia}}
Published	10/31/2023	{{c2::Hypersensitivity pneumonitis}}:From inhalation/sensitivity to dustsMost common is after exposure to {{c1::actinomyces}} in moldy hay ({{c3::Farm…
Published	10/31/2023	{{c2::Hypersensitivity pneumonitis}}:Radiology: {{c3::upper}} lung field, small nodules, ground glassPathology: peri-bronchial lymphocytic infiltrates…
Published	10/31/2023	{{c1::Bronchiectasis}}: clinical syndrome of chronic {{c2::cough}} with abnormal {{c3::thickening/dilation}} of bronchial wall
Published	10/31/2023	{{c3::Bronchiectasis}} can present with a history of recurrent {{c1::lower respiratory tract}} infections and unexplained {{c2::hemoptysis}}
Published	10/31/2023	Main predisposing conditions for bronchiectasis:Infection: {{c1::tuberculosis}}Genetics: {{c2::cystic fibrosis}}
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Published	10/31/2023	{{c1::High resolution CT}} is the imaging of choice for bronchiectasis
Published	10/31/2023	This is an example of a "{{c1::signet ring}} sign" which indicates {{c2::bronchiectasis}}
Published	10/31/2023	Treatment for bronchiectasis:{{c1::Antibiotics::Main one}}Treating underlying issue (CFTR, immunodeficiency, removal of foreign body, etc.)Bronchodila…
Published	10/31/2023	Bronchiectasis is a form of {{c1::obstructive}} lung disease
Published	10/31/2023	A hallmark symptom of cystic fibrosis is {{c1::steato}}rrhea
Published	10/31/2023	{{c5::Cystic fibrosis}}:{{c1::F508del}} gene variantMultisystem diseaseChronic sinopulmonary disease{{c2::Pancreatic}} insufficiency: malabsorptionEle…
Published	10/31/2023	Cystic fibrosis is caused by a mutation in the {{c1::CFTR}} gene on chromosome {{c2::7}}, which codes for a cAMP regulated {{c3::chloride}} channel. T…
Published	10/31/2023	The pulmonary circulation is a {{c1::high}} flow, {{c2::low}} pressure, {{c3::low}} resistance circuit
Published	10/31/2023	Pulmonary hypertension is considered a pulmonary pressure of >{{c1::20}}mmHg
Published	10/31/2023	Pulmonary hypertension groups:Group 1: {{c1::pulmonary arterial hypertension}}Group 2: PH due to {{c2::left heart disease}}Group 3: PH due to {{c3::lu…
Published	10/31/2023	Key sign of {{c2::pulmonary arterial hypertension}} is {{c1::plexiform lesions}}, which arise from anastomoses involving bronchial arteries or va…
Published	10/31/2023	This is an example of {{c1::plexiform lesions}}
Published	11/14/2023	Drugs associated with {{c4::group 1 PAH}}: {{c1::methamphetamine}}, {{c2::fenfluramine}}, {{c3::dasatinib}}
Published	10/31/2023	Chemical mediators that can cause PAH:Reduced {{c1::nitric oxide}}Reduced {{c2::prostacyclin}}Increased {{c3::endothelin-1}}
Published	10/31/2023	Main gene mutation for group 1 PAH: {{c1::BMPR2}} gene
Published	10/31/2023	Gold standard test for pulmonary arterial hypertension: {{c1::right heart catheterization}}
Published	10/31/2023	Most common DVTs are {{c1::popliteal}} but most common DVTs causing PE occur {{c2::above}} the knee
Published	10/31/2023	Example of {{c1::Hampton's Hump}}
Published	10/31/2023	Example of {{c1::Westermark's Sign}}
Published	10/31/2023	D-dimer tests have good {{c1::sensitivity::sensitivity/specificity}} but poor {{c1::specificity::sensitivity/specificity}} for PE
Published	11/02/2023	Initial diagnostic testing for acute respiratory failure is {{c1::pulse oximetry}}
Published	11/02/2023	{{c1::Hypoxemic}} (Type {{c2::1}}) Acute Respiratory Failure:PaO2 {{c3::<60}} or SpO2 {{c3::<90}}Problem is {{c4::oxygenation}}
Published	11/02/2023	{{c1::Hypercapneic}} (Type {{c2::2}}) Acute Respiratory Failure:PaO2 {{c3::>45}} and pH {{c3::<7.35}}Problem is {{c4::ventilation}}
Published	11/02/2023	Hypoxemia vs Hypoxia:Hypoxemia: {{c1::low oxygen in blood}} (low PaO2, low SaO2)Hypoxia: {{c2::insufficient oxygen delivered to tissues}}
Published	11/02/2023	In a normal O2 dissociation curve, the {{c1::mixed venous}} blood PaO2 is {{c2::40}}mmHg and has a %O2 sat of {{c3::75}}%
Published	11/02/2023	Exercising muscle is {{c1::acidic::pH}}, {{c2::hyper}}carbic, and {{c3::hot::temperature}}
Published	11/02/2023	Normal V/Q ratio averaged over the lung is {{c1::0.8}}Both ventilation and perfusion increase from {{c2::top}} to {{c2::bottom}}, but {{c3::perfusion}…
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Published	11/02/2023	Main causes of V/Q mismatch: {{c1::airway obstruction}} and {{c2::pulmonary embolism}}
Published	11/02/2023	V/Q mismatch {{c1::increases}} A-a gradient
Published	11/02/2023	A-a gradient = {{c1::PAO2}} - {{c1::PaO2}}
Published	11/02/2023	Main cause of reduced inspired O2 (low oxygen supply) is {{c1::high altitude}}
Published	11/02/2023	{{c1::Hyper}}ventilation is most important/immediate adaptation to high altitude
Published	11/02/2023	In hypoxia related to high altitude, A-a oxygen gradient is {{c1::normal}}
Published	11/02/2023	What type of hypoxemia does not respond well to oxygen?{{c1::Shunts}}
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Published	11/02/2023	There is an {{c1::inverse}} relationship between alveolar ventilation and PaCO2
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Published	11/02/2023	In airway obstruction:V/Q is {{c1::low}}, PAO2 is {{c2::low}}, PaO2 is {{c2::low}}, PACO2 is {{c2::high}}
Published	11/02/2023	The adaptive mechanism for low V/Q is {{c1::hypoxic vasoconstriction}}
Published	11/02/2023	In a PE:V/Q is {{c2::high}}, ventilation is {{c3::normal}}, and perfusion is {{c3::reduced}}Significantly higher {{c1::dead space}}
Published	11/02/2023	Neonatal respiratory distress syndrome:Deficiency of {{c4::surfactant}}Risk factors are {{c1::prematurity}}, maternal {{c2::diabetes}}, and {{c3::c-se…
Published	11/02/2023	Neonatal respiratory distress syndrome:Clinical features: Asymptomatic at birth, later {{c1::dys}}pnea, {{c1::tachy}}pnea, {{c1::tachy}}cardia, and {{…
Published	11/02/2023	Treatment of NRDS: supplemental oxygen, nasal {{c1::CPAP}}In severe cases, might need mechanical ventilation and intratracheal {{c2::surfactant}} ther…
Published	11/02/2023	Adult respiratory distress syndrome:{{c1::Acute}} onset{{c2::Bilateral}} opacities{{c3::P/F}} ratio {{c4::<300}} mmHgNot due to {{c5::heart failure…
Published	11/02/2023	ARDS causes:S{{c2::epsis}}P{{c3::neumonia}}P{{c4::ancreatitis}}A{{c5::spiration}}uR{{c1::emia}}T{{c6::rauma}}A{{c7::mniotic fluid embolism}}S{{c8::hoc…
Published	11/02/2023	Main difference between CHF and ARDS is that ARDS does not have {{c1::cardiomegaly}}
Published	11/02/2023	{{c1::Cardiogenic}} pulmonary edema has a high {{c2::left atrial}} pressure and an edema fluid/plasma protein ratio of {{c3::<}}0.5 ({{c3::transuda…
Published	11/02/2023	{{c1::Non-cardiogenic}} pulmonary edema has excess vascular {{c2::permeability}} and an edema fluid/plasma protein ratio of {{c3::>}}0.5 ({{c3::exu…
Published	11/02/2023	Classic histopathological finding in ARDS:Diffuse {{c1::alveolar}} damage and {{c1::hyaline}} membrane
Published	11/07/2023	This is an example of {{c1::ARDS::disease}}
Published	11/02/2023	Pathophysiology of ARDS:Sloughing of {{c1::alveolar epithelium}}{{c2::Endothelial}} cell injuryFlooding of alveoli with {{c3::protein}} rich fluid, ce…
Published	11/02/2023	Phases of ARDS:{{c1::Exudative}}{{c2::Proliferative}}{{c3::Fibrotic}}
Published	11/02/2023	Classic finding of ARDS on CXR:{{c1::Bilateral infiltrates}}
Published	11/02/2023	Heterogeneous lung units in ARDS:{{c1::Aerated}}, {{c2::ventral}} regions have highest compliance{{c2::Dorsal}} region has increased {{c3::density}} c…
Published	11/02/2023	Most important ventilator strategy with ARDS is {{c1::postive end expiratory pressure (PEEP)}}
Published	11/02/2023	Do steroids help with ARDS?{{c1::YES}}
Published	11/02/2023	For refractory hypoxemic ARDS patients on ventilators, {{c1::prone}} positioning can ease symptoms
Published	11/07/2023	{{c1::Sleep drive}} increases throughout the day, countered by the {{c2::circadian drive}} to remain alert. These processes determine the timing of sl…
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Published	11/07/2023	{{c1::Apnea}} is complete cessation of airflow lasting at least {{c2::10}} seconds
Published	11/07/2023	{{c1::Obstructive sleep apnea}} is diagnosed if a patient has more than {{c2::5}} obstructed breathing events per hour of sleep
Published	11/14/2023	Therapies for obstructive sleep apnea (OSA):General: avoidance of {{c1::alcohol/sedatives}}, {{c2::weight}} loss, change in {{c3::sleeping position}}{…
Published	11/07/2023	Central sleep apnea:Flat line on {{c3::expiratory}} flowUsually seen in {{c1::CHF}} or {{c2::CNS}} disease
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Published	11/07/2023	This is an example of {{c1::Cheyne Stokes}} breathing
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Published	11/07/2023	Restless leg syndrome is connected to low {{c1::iron}} levels
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