NBME CBSE STUDY GUIDE SOLUTION EXAM
Type II pneumocytes - >>>surfactant (*lecithin*)
Proliferate after injury
Type I progenitors
*Neonatal Respiratory Distress Syndrome*
Polio live v killed vaccine - >>>Killed = Salk = IgG Live = Sabin = IgG + IgA
- can be shed in feces
Neonatal Respiratory Distress: Etiology + Tx - >>>Maternal DM (*high insulin*) or C-section (*low cortisol*)
TX: *dexamethasone* before birth
Lung maturity determined with - >>>Amniocentesis of Phospholipids (*type II pneumocytes)
L >> S
Type I pneumocytes - >>>Squamous gas diffusion
Elastase in lungs - >>>macrophage: *lysosomes*
PMN: *azuronphilic granules* Elastin stretches and recoils due to - >>>Lysine interchain crosslinks
air pressure and intrapleural pressure at FRC - >>>Air pressure = 0
Intrapleural pressure = -5
Pulm Vasc Resistance is lowest during - >>>Exhale of Tidal Volume
Lung Compliance is decreased by - >>>LHF, pulmonary edema, pulmonary fibrosis
Lung Compliance is increased by - >>>emphysema, age
Obesity affects ERV and FRC - >>>DECREASE ERV & FRC
Blood flow/min (pulmonary v systemic) - >>>pulmonary = systemic
Anatomic pulmonary shunting - >>>Bronchial circulation causes *decreased PO2 in LA/LV*
than in pulmonary capillaries
More ventilation is at the - >>>BASE
O2-Hgb dissociation LEFT shift - >>>basic, cold, low 2,3 BPG low pO2 (compensatory erythrocytosis)
O2-Hgb dissociation RIGHT shift - >>>low pH, high 2,3BPG, high T
HOT, ACIDIC
CO2 transport to lungs - >>>*carbonic anhydrase*
Cl shift
*Haldane*: CO2 released to lung
(*Bohr*: O2 release to tissue)
CO poisoning causes - >>>carboxyhemoglobin no affect on PaO2
Cyanide poisoning causes - >>>lactic acidosis
How to treat cyanide poisoning - >>>*Amyl nitrite* --> Methemoglobin
THEN *Thiosulfate* (hydroxycobalamin)
Normal A-a gradient - >>>5-15
Hypoventilation: Heroin OD or high altitude
Increased A-a gradient - >>>*Diffusion impairment* (fibrosis)
*R-L shunt* (aspiration, ARDS)
*V/Q mismatch* (pulmonary edema AT --> AT II where and how - >>>ACE (- high in sarcoidosis)
In small pulmonary bV
C5a induces what - >>>PMN influx (ie: in lungs)
Korotkoff sound - >>>BP cuff - appear and disappear in inflation/deflation
Pulsus Paradoxus - >>>10mmHg difference in Korotkoff sound
Pulsus Paradoxus occurs in - >>>Cardiac Tamponade
Kussmaul sign - >>>JVP rises *during inspiration*
Constrictive Pericardiditis
Restrictive/Interstitial Lung Disease: A-a, FVC, FEV1, EFR - >>>Airway widening due to *radial traction* from fibrosis
*increase Aa*
decreased FVC & FEV1
*Increased EFR*
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller ProfessorMillan. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $14.49. You're not tied to anything after your purchase.