Respiratory

Question 1

MOA Sildenafil

Answer 1

PDE 5 inhibitor cGmp

Question 2

MOA Milrinone

Answer 2

PDE 3 inhibitor cAmp

Question 3

MOA INO

Answer 3

L-arginine and nitric oxide synthase cGmp

Question 4

What embryological tissue is the respiratory tract derived from?

Answer 4

Endoderm

Question 5

What does branching depend on for respiratory tract?

Answer 5

Mesodermal Mesenchyme

Question 6

What aortic branch is the pulmonary vasculature derived from?

Answer 6

6th aortic arch

Question 7

What is airway development under control?

Answer 7

Retinoic signaling

Question 8

What defects associated with embryonic stage?

Answer 8

TE fistula,
CHAOS
Tracheostenosis/atresia
larygneostenosis/atresia
Bronchogenic cysts

Question 9

What cells produce amniotic fluid from lungs?

Answer 9

Goblet columnar

Question 10

What defects associated with pseudoglandular stage?

Answer 10

CDH
Congenital lobar emphysema
Cystic pulmonary airway malformation
Pulmonary lymphangiectasia

Question 11

What stage is lungs viable?

Answer 11

Canalicular

Question 12

What gene is defective in alveolar capillary dysplasia?

Answer 12

FOX F1

Question 13

Fried egg, thin flat, few #, gas exchange

Answer 13

Type 1 pneumocytes

Question 14

Cuboidal, many #, surfactant, develop 1st

Answer 14

Type 2 pneumocytes

Question 15

What electrolyte induces flow of liquid into the fetal lung?

Answer 15

Chloride

Question 16

What inhibits the production of fetal lung fluid?

Answer 16

Epinephrine and beta adrenergic agonist

Question 17

What electrolyte leads to the absorption of fetal lung fluid?

Answer 17

Sodium

Question 18

How is fetal lung fluid cleared?

Answer 18

Decreased formation of lung fluid
Switch from chloride secreting to sodium absorption
Increased oncotic pressure
Compression chest at delivery
Catecholamine surge
High cortisol and thyroxine
Lung distention at birth

Question 19

What is the major lipid for surfactant?

Answer 19

Dipalmitoyl phosphatidylcholine

Question 20

What component in amniotic fluid indicates lung maturity?

Answer 20

Lecithin and phosphatidylglcerol

Question 21

How to optimize surfactant use?

Answer 21

Early use, gravity, high volume, adequate peep and pressure to distribute

Question 22

How is pulmonary vascular resistance decreased?

Answer 22

Lung inflation
Gas exchange
Vasoactive mediators

Question 23

MOA Caffeine

Answer 23

Methylxanthine blocks adenosine receptor, phosphodiesterase inhibitor activating cAmp allowing for bronchial smooth muscle relaxation and vasodilation/bronchodilation

Question 24

How does caffeine help with apnea

Answer 24

Decreases hypoxic depression of breathing
Decreases periodic breathing
Improves CO2 sensitivity
Increase diaphragmatic activity
Increases minute ventilation

Question 25

What is FRC?

Answer 25

Functional residual capacity: expiratory reserve volume (air blown out) + residual volume (air left in lungs); prevent lung collapse allows for alveoli to easily expand with next inhalation

Question 25

List the lung capacities and volumes of neonates with RDS

Answer 25

Decreased: TLC, RV, IC, IRV, TV, ERV Low lung volume at end of expiration Increased dead space

Question 26

What will shift the dissociation curve to the left?

Answer 26

Low acid (alkalosis) Low oxygen Low 2,3 DPG Low temp Loves O2 = greater affinity and won’t let go

Question 27

Formula to calculate effect of altitude on paO2

Answer 27

(Barometric pressure - 47) x FiO2 for each place

Question 28

How does CPAP reduce apnea?

Answer 28

Activation of stretch receptors (addresses central apnea) Reduces airway collapse (associated with obstructive apnea)