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respiration > breathing > Flashcards

breathing Flashcards

1
Q

boyle’s law

A

states that the pressure exerted by a gas is inversely proportional to to its volume (P a 1/V).
Note that gases (singly or in mixtures) move from areas of high pressure to areas of low pressure.

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2
Q

Dalton’s law

A

states that the total pressure of a gas mixture is the sum of the pressures of the individual gases.

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3
Q

Charles law

A

states that the volume occupied by a gas is directly related to the absolute temperature (v a T)

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4
Q

henry’s law

A

states that the amount of gas dissolved in a liquid is determined by the pressure of the gas and it’s solubility in the liquid.

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5
Q

expiratory reserve volume

A

1100 mL

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6
Q

what is the vital capacity volume

A

4600 mL

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7
Q

inspiratory reserve volume

A

3000 mL

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8
Q

dead space volume

A

150 mL

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9
Q

what is the alveolar ventilation pressure for o2

A

13.3 kPa - 100mm hg

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10
Q

what is the alveolar ventilation pressure for Co2

A

5.3 kPa - 40 mm hg

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11
Q

during inspiration diaphragm does

A

contract and the volume increases

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12
Q

during expiration the diaphragm does

A

relax and the volume decreases

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13
Q

intra thoracic alveolar pressure is

A

negative or positive in comparison to atmospheric pressure

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14
Q

intra pleural pressure

A

always negative

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15
Q

trans pulmonary pressure

A

always positive

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16
Q

the pulmonary circulation is an example of what system?

A

high flow, low pressure system

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17
Q

tissue values partial pressure of oxygen and carbon dioxide

A

02 - 40 mmHg (5.3kPa)

C02- 46 mmHg (6.2kPa)

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18
Q

factors that affect gas exchange are

A

partial pressure gradient
gas solubility
surface area
thickness of membrane

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19
Q

what is the perfect ventilation: perfusion ratio

A

1

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20
Q

alveolar dead space causes

A

pulmonary vasodilation in response in increase oygen and bronchial constriction in response to alveolar decreases carbon dioxide levels

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21
Q

anatomical dead space refers to

A

air in the conducting zone of the respiratory tract

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22
Q

Type 2 alveolar cells produce what which does what?

A 
surfactant
increases lung compliance
reduces recoil
makes breathing easier
effective in small alveoli 
relaxes water tension
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23
Q

equation of LaPlace

A

P=2T/r

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24
Q

high compliance refers to

A

large increase in lung volume in response to a small decrease in ip pressure

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25
Q

compliance represents

A

stretch ability

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26
Q

examples of obstructive lung disorders

A

asthma

COPD (bronchitis or emphysema (loss of elasticity) - very low FEV1, slightly low FVC (low ratio)

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27
Q

examples of restrictive lung disorders

A

fibrosis
infant respiratory distress syndrome (no surfactant)
oedema
Pneumothorax
normal or elevated FEV1/FVC ratio, but severely decreased lung capacity. use FEF.

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28
Q

what is the test for breathing?

A

spirometry

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29
Q

haemoglobin increases oxygen carrying in RBC to how much?

A

200ml

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30
Q

02 solubility in water is

A

0.03ml/L/mmHg

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31
Q

what is the oxygen demand of resting tissues?

A

250ml/min

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32
Q

Haemoglobin A consists of

A

2 alpha and two beta strands with each having a heme group with an iron centre

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33
Q

each gram of haemoglobin can bind to

A

1.34ml of oxygen

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34
Q

how long does oxygen saturation with haemoglobin take?

A

0.25 seconds

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35
Q

at resting cell partial pressure of 40mm Hg o2 what is the saturation of haemoglobin

A

75%

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36
Q

what factors effect haemoglobin saturation

A

2,3-DPG, pH, PCO2, and temperature

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37
Q

how many more times stronger is carbon monoxide’s affinity for haemoglobin

A

250x

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38
Q

a PCO of what is sufficient for causing carboxyl haemoglobin formation

A

0.4mmHg

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39
Q

how is carbon dioxide transported?

A

7% directly in plasma
23% as deoxyhaemoglobin
70% as bicarbonate ions

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40
Q

hypoventilation will result in respiratory..

A

acidosis

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41
Q

hyperventilation will result in respiratory..

A

alkalosis

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42
Q

the DRG controls

A

the dorsal respiratory group controls the inspiratory muscles

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43
Q

the VRG controls

A

the ventral respiratory group controls expiratory muscles and inspiratory pharynx, larynx and tongue muscles

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44
Q

the central chemoreceptor in the medulla is driven by

A

hypercapnea - raised partial pressure of carbon dioxide

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45
Q

during acidosis ventilation is

A

stimulated

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46
Q

during alkalosis ventilation is

A

inhibited and vomiting

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47
Q

FEV1/FVC <70%

A

obstructive lung disease

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48
Q

FEV1 > 80%

A

normal

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49
Q

FEV1 < 80%

A

restrictive lung disease

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50
Q

what are the possible complications of CODP

A 
Pneumonia
macro nutrient deficiency
muscle wasting 
polycythaemia
pulmonary hypertension
Cor pulmonale 
depression 
pneumothorax
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51
Q

examples of short acting bronchodilators

A

SABA (salbutomal) or SAMA (ipratropium)

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52
Q

examples of long acting bronchodilators for worsening FEV1

A

LAMA ( long acting anti-muscarinic agents) or LABA (long acting beta 2 agonist)

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53
Q

high dose inhaled corticosteroids for even worse FEV1 examples

A

Relvar, fostair MDI, LABA

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54
Q

list the COPD management value pyramid from top to bottom

A

telehealth for chronic disease, triple therapy, LABA, tiotropium, pulmonary rehabilitation, stop smoking wit pharmacotherapy, flu vaccinations

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55
Q

oxygen treatment of 7.3 to 8 kPa should be given for COPD if

A

polycythaemia
nocturnal hypoxia
peripheral oedema
pulmonary hypertension

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56
Q

asthma definition

A

Episodic wheeze and/or cough in a clinical setting where asthma is likely and other rarer conditions have been excluded”

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57
Q

what percentage of kids in the uk are on inhaled steroids

A

5%

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58
Q

is a cough predominant or cough variant asthma possible?

A

must have a wheeze, cough predominant common no such thing as cough variant asthma

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59
Q

what are the mechanisms for a wheeze in asthma

A

bronchoconstriction
airwall thickening
luminal secretions

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60
Q

what is the treatment for responsiveness’ in asthma

A

ics for two months

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61
Q

ideally for asthma there should be

A

response to treatment
shortness of breath at rest
wheeze
parental asthma

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62
Q

Acute epiglottitis is caused by

A

group A beta haemolytic streptococci

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63
Q

what are the three main components of the respiratory tract defence mechanism

A

alveolar macrophages
mucociliary escalator
cough reflex

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64
Q

bronchopneumonia appears on a x ray as

A

bilateral patchy opacification due to the consolidation of pus in the alveoli

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65
Q

what percentage of bronchiectasis starts in childhood

A

75%

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66
Q

what are the clinical features of bronchiectasis

A

cough, abundant foul sputum, chronic infection, coarse crackles, haemoptysis

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67
Q

what are some of the potential causes of aspiration pneumonia

A 
vomiting
oesophageal lesion
obstetric anaesthesia 
neuromuscular disorders
sedation
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68
Q

what is type 1 respiratory failure characterized by

A

PaO2 <8kPa

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69
Q

how is type 2 respiratory failure characterized by

A

PaCO2 >6.5kPa

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70
Q

what are the four abnormal states associated with hypoxaemia

A

ventilation/perfusion imbalance
diffusion impairment
alveolar hypoventilation
shunt

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71
Q

embryonic phase of lung morphogenesis lasts for

A

3-8 weeks

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72
Q

the pseudo glandular phase of lung morphogenesis lasts for

A

5-17 weeks

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73
Q

canalicular phase of lung morphogenesis lasts for

A

16-26 weeks, at this point extra uterine life is possible at end of this stage

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74
Q

saccular phase of lung morphogenesis lasts for

A

24-38 weeks

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75
Q

alveolar phase of lung morphogenesis lasts for

A

36 weeks ~ 2-3 years

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76
Q

what are some common lung developmental diseases

A 
airway stenosis
airway malacia 
pulmonary agenesis 
trachea-oesophageal fistula 
bronchogenic cyst
congenital pulmonary anomalies
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77
Q

when is a patient most likely to present features

A

fetus - ultrasound - 75%
newborn - 10%
childhood 15%

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78
Q

what are the characteristics of trachea bronchomalacia

A

seal like cough
early onset
breathlessness
stridor/wheeze

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79
Q

what treatment do you avoid with bronchomalacia

A

asthma treatments such as bronchodilators

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80
Q

how long does diaphragm development take

A

18 weeks

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81
Q

what are the fetal origins of COPD

A 
utero nicotine exposure
fetal infection
malnutrition
premature birth
genetic
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82
Q

what are the paediatric origins of COPD

A 
infection
ETS (A1 AT deficiency) 
environmental 
lack off nutrients
genetic
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83
Q

COPD is the

A

3rd leading cause of death in the world

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84
Q

normal FEV1 is about

A

4 litres

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85
Q

normal FVC is about

A

5 litres

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86
Q

COPD can also be measured by

A

PEFR: Peak expiratory flow rate

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87
Q

normal PERF rate

A

400-600L/min, 80-100% pass rate

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88
Q

chronic bronchitis is clinically defined as

A

productive cough for 3 consecutive months, or 2 or more consecutive years.

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89
Q

the definition of emphysema is

A

Increase beyond the normal in the size of airspaces distal to the terminal bronchiole arising either from dilatation or from destruction of their walls and without obvious fibrosis

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90
Q

centri-acinar

A 
begins with bronchiolar definition
measured by number
related to inflammation
not everywhere 
still alveolar damage 
closer to the bronchioles
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91
Q

pan-acinar

A 
stems from alpha 1 antitrypsin deficiency
found everywhere
measured by area
towards the ends of the bronchioles 
more alveolar damage
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92
Q

peri-acinar

A

airpsaces are larger than 1 cm in space, can cause the lung to collapse and pulmonary distress. singularly a bulla if >1cm. bleb describes a bulla just underneath the pleura

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93
Q

what part of COPD can be targeted pharmacologically

A

small airway inflammation and muscle tone

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94
Q

what is an important aspect of emphysema

A

loss of alveolar attachments

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95
Q

how many patients present with late stage lung cancer

A

2/3rd’s

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96
Q

order of systematic review of a chest x-ray

A 
name
lines/metal
heart
mediastinum
lungs zones 
bones
diaphragm
soft tissue
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97
Q

how long before you should be concerned for a lobar lung collapse

A

2 to 3 weeks

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98
Q

a pulmonary mass is

A

an opacity over 3cm

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99
Q

a pulmonary nodule is

A

a mass up to 3cm

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100
Q

tests to determine T in a TNM

A

CT PET or bronchoscopy

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101
Q

tests to determine N in TNM

A

PET CT mediastinoscopy

EBUS/ECHO

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102
Q

tests to determine M in TNM

A

PET CT, bone scan

103
Q

what is the analogue used in a PET CT scan

A

18F-FDG glucose

104
Q

T1

A

<3cm

105
Q

T 2

A

3-5cm or involves main bronchus, visceral pleura or obstruction

106
Q

T5

A

5-7cm invading chest wall, phrenic nerve or parietal pericardium

107
Q

T4

A

larger than 7cm and invading vertebral body, trachea, heart, laryngeal nerve, diaphragm etc, or tumours in separate lobe

108
Q

N1

A

ipsilateral nodes or intrapulmonary nodes

109
Q

N2

A

ipsilateral mediastinal and sub carinal

110
Q

N3

A

contralateral mediastinal, hilar or supraclavicular.

111
Q

what percentage of lung cancer is attributable to smoking

A

> 85%

112
Q

in the lung periphery a tumour is likely to be

A

an adenocarcinoma, due to bronchi alveolar stem cell transformation

113
Q

in central airways a tumour is likely to be

A

squamous cell carcinoma as bronchial epithelial stem cells transform - strongly associated with smoking

114
Q

what oncogene is most smoking induced in adenocarcinogensis

A

KRAS then EGFR

115
Q

what are the local effects of lung cancer

A

bronchial collapse, lipid pneumonia, infection/abcess or bronchiectasis
pleural inflammation
chest wall invasion
invasion of the phrenic, laryngeal nerve, brachial plexus, cervical sympathetic, and mediastinum.
lymph node metastasis

116
Q

bronchiectasis refers to

A

permanent enlargement of the airways

117
Q

distant effects of lung cancer

A

metastases of liver, adrenal, bone, brain and skin, neural and vascular problems
paraneoplastic syndromes
finger clubbing
hypertrophic pulmonary osteoarthropathy

118
Q

increase in ACTH and siADH indicates what type of carcinoma

A

small cell

119
Q

increase in PTH indicates

A

squamous cell

120
Q

what is the 5yr prognosis for lung cancer

A

9.8%

4% for small cell carcinoma

121
Q

what are the predictive biomarkers for adenocarcinoma

A

EGFR, KRAS, HER 2 BRAF

ALK translocations and ROS 1 translocations

122
Q

in non-small cell carcinoma what is the immune checkpoint target and biomarker

A

PD1/PDL1, CTLA4

123
Q

what is the 5 year prognosis for a T1 stage

A

70%

124
Q

what is a 5 year prognosis for a N2 stage

A

16%

125
Q

what is the medication for a pulmonary embolism

A 
Low molecular weight heparin e.g. dalteparin
Warfarin
Direct Oral Anticoagulants (DOAC)
rivaroxaban, apixaban
Thrombolysis
Alteplase (rt-PA)
126
Q

pulmonary hypertension is defined as

A

pulmonary artery pressure above 25mm Hg

127
Q

what is the specific treatments for pulmonary hypertension

A 
Calcium channel antagonist e.g. amlodipine
Prostacyclin
Endothelin receptor antagonists
bosentan
ambrisentan
Phosphodiesterase inhibitors
sildenafil
tadalafil
128
Q

what are the infective agents that are viral for upper respiratory tract infections

A 
Viral
Adenovirus
Influenza A, B
Para’flu I, III
RSV
Rhinovirus
129
Q

bacterial agents for upper respiratory infections

A 
Bacterial
H influenzae
M catarrhalis
(Mycoplasma)
(S aureus)
Streptococci
B haemolytic, S pyogenes
Non haemolytic, S pneumoniae
130
Q

how long should a runny nose go for?

A

16 days

131
Q

average duration of an earache

A

9 days

132
Q

should you offer antibiotics to treat otitis media

A

not really, doesn’t offer immediate relief and by the time action is effective there is no point.

133
Q

what should you give for tonsillitis

A

not amoxycillin

10 days penicillin.

134
Q

how long should a sore throat last for

A

7 days

135
Q

croup signs

A

stridor, barking cough, hoarse throat

136
Q

croup treatment

A

oral dexamethasone

137
Q

epiglottis signs

A

stridor, drooling

138
Q

epiglottis treatment

A

intubation and antibiotics

139
Q

croup duration

A

3 days

140
Q

what are the antenatal causes of COPD predisposition

A 
nicotine exposure
infection 
maternal nutrition
premature
micronutrients
141
Q

what are the post natal causes of COPD disposition

A 
infection
growth
alpha tyrosin deficiency 
environmental pollution
micro nutrients
142
Q

human development pre-embryonic phase

A

0-3 weeks

143
Q

embryonic phase of foetal development

A

4-8 weeks

144
Q

foetal phase lasts for

A

9-40 weeks

145
Q

after several replications the zygote forms

A

a morula

146
Q

a fetus inherits mitochondrial diseases form

A

the mother

147
Q

a morula develops into

A

a blastocyst, containing a blastocystic cavity, inner cell mass and trophoblast

148
Q

how long does it take the blastocyst to reach the uterus?

A

5 days

149
Q

abnormal uterine ciliary function could result in

A

an ectopic pregnancy

150
Q

implantation occurs

A

day 7

151
Q

the trophoblast forms what, and what is its function?

A

the chorion, and it implants, forming a part of the placenta and secretes chorionic gonadotropin

152
Q

the chorion fuses with

A

the decidua basalis

153
Q

the inner mass of cells in the blastocyst forms

A

a bilaminar disc the epiblast with the amniotic sac above, and the hypoblast with the yolk sac below.

154
Q

the function of the placenta?

A

foetal nutrition, transport of waste and gases, immunity

155
Q

what is the order of events for the trilaminar disc formation

A

primitive steak in the epiblast, axis formation, cell proliferation, displacement of hypoblast and formation of ectoderm, mesoderm, endoderm. cells now specialised.

156
Q

the ectoderm forms

A

the notochord which lies between the mesoderm/endoderm, neural plate, which then forms the neural tube through invagination between the ectoderm/mesoderm

157
Q

the mesoderm splits into

A

paraxial plate, intermediate plate, and the lateral plate

158
Q

the lateral plate forms the

A

somatic and splanchnic mesoderm space in between the intraembryonic coelom
to form the body cavity and coverings

159
Q

the intermediate plate forms the

A

urogenital system

160
Q

the paraxial mesoderm forms

A

somites

161
Q

the heart starts to beat on the

A

24th day

162
Q

how any pairs of somites form

A

43

163
Q

the endoderm folds to form

A

the gut

164
Q

somites divide to form

A

dermatome, myotome and sclerotomes

165
Q

what weeks is the greatest sensitivity to teratogens?

A

weeks 3-8

166
Q

the tracheal budding begins at what week?

A

4rth week

167
Q

the protruding foregut is coated in what?

A

splanchnic mesoderm

168
Q

a fistula is

A

an abnormal passage between two organs

169
Q

an atresia is

A

orifice being abnormally sealed

170
Q

the parietal pleura develops from

A

the somatic mesoderm

171
Q

what are some embryonic congenital conditions

A

accessory lobe
lobe of azygos vein
agenesis of lung

172
Q

the septum transversum forms the

A

central tendon of the diaphragm

173
Q

the pleuroperitoneal membranes form the

A

primitive diaphragm

174
Q

the dorsal mesentery of the oesophagus forms the

A

median portion and crura of the diaphragm.

175
Q

muscular ingrowth from the lateral walls from what aspect of the diaphragm

A

the peripheral parts.

176
Q

the septum transversum migrating brings what nerves

A

C3,4,5,

177
Q

three defects of diaphragmatic hernia

A

posterolateral, anterior and central

178
Q

what are the two types of hiatus hernia

A

parasophageal hernia (rolling) and sliding hiatus hernia

179
Q

what causes acute epiglottis?

A

group A beta haemolytic streptococci or haemophilus influenza type B

180
Q

what are the aetiological types of pneumonia

A 
Community Acquired Pneumonia
Hospital Acquired (Nosocomial) Pneumonia
Pneumonia in the Immunocompromised
Atypical Pneumonia
Aspiration Pneumonia
Recurrent Pneumonia
181
Q

what are the patterns of pneumonia

A

Bronchopneumonia
Segmental
Lobar

Hypostatic
Aspiration
Obstructive, Retention, Endogenous Lipid

182
Q

what are the complications of pneumonia

A 
Pleurisy, Pleural Effusion and Empyema
Organisation 
mass lesion
COP(cryptogenic organising pneumonia (BOOP))
Constrictive bronchiolitis
Lung Abscess
Bronchiectasis
183
Q

why does pneumonia cause hypoxemia

A

Ventilation / Perfusion abnormality (mismatch)
Bronchitis / Bronchopneumonia
Shunt
Severe bronchopneumonia
Lobar pattern with large areas of consolidation

184
Q

what are the symptoms of lung cancer

A 
chronic coughing
difficulty swallowing 
wheezing
chest/bone pain 
chest infection 
haemoptysis 
weight loss
SOB
raspy voice
185
Q

what are the clinical signs of lung cancer

A
  • Chest signs
  • Clubbing
  • Lymphadenopathy
  • Horner’s syndrome
  • Pancoast tumour
  • Superior vena cava obstruction
  • Lymphadenopathy
  • Hepatomegaly
  • Skin nodules (metastases)
186
Q

what is the dynamic turnover of pleural fluid in an hour

A

30-75%

187
Q

what is the negative pressure of the pleura

A

-0.66kPa

188
Q

a transudate is characterized by and caused by??

A

imbalance of hydrostatic forces, normally bilateral <30g/L proteins. range of conditions such as liver cirrhosis, peritoneal dialysis and left ventricular failure.

189
Q

an exudate is characterized by and caused by?

A

increased permeability and unilateral. >30g/L proteins. caused by inflammation in response to malignancy, embolism or autoimmune disease.

190
Q

how large a volume for the effusion before it is visible on a cxr

A

200ml

191
Q

what needle is used for a pleural biopsy and how many samples?

A

Abram’s needle.

at least 4

192
Q

a non-iatrogenic pneumothorax means

A

penetrating chest injury or blunt chest injury

193
Q

a iatrogenic pneumothorax examples are

A

biopsy acupuncture, cannulation.

194
Q

what’s a large pneumothorax defined as

A

rim of air >2cm

195
Q

what’s the management for a pneumothorax?

A

cannula inserted in the 2nd intercostal space along the mid clavicular line then insert intercostal chest drain.

196
Q

what is asbestos?

A

highly fibrous naturally occurring mineral

197
Q

what is the most dangerous form of asbestos

A

crocidolite

198
Q

how does CF effect fertility in men

A

blocked/absent vas deferens

199
Q

when is a patient considered for lung transplant

A

once FEV1 <30%/predicted to be soon

200
Q

what is the genetic prevalence of CF

A

1:25

201
Q

that is the function of the CFTR

A

active transport of chloride regulating liquid volume, its compromise results in cilia dysfunction

202
Q

what is the accepted sweat chloride values

A

> 60 is CF

<30 normal if over the age of 6 months

203
Q

what is the treatment for pancreatic insufficiency

A

fat soluble vitamins, Proton pump inhibitors, high energy diet and enteric enzyme pellets

204
Q

common pathogens for CF

A

Staphylococcus aureus and Haemophilus influenzae in early years
Pseudomonas aeruginosa later
uncommonly there is atypical mycobacteria e.g. m abscessus

205
Q

restrictive lung disease is associated with

A

reduced compliance
low FEV 1 and low FCV but normal ratio
reduced gas transfer
V/Q imbalance.

206
Q

restrictive lung disease often results in

A

type 1 respiratory failure.

207
Q

diffuse alveolar damage results from

A

type 2 cell necrosis, has an exudative phase, hyaline membrane formation phase. can be fatal or progress to fibrosis.

208
Q

sarcoidosis is

A

multisystem granulomatous disorder

209
Q

sarcoidosis presents with

A

arthralgia, erythema nodosum and bilateral hilar lymphadenopathy, shortness of breath and cough with abnormal x ray.

210
Q

hypersensitivity pneumonia is an example of

A

type 3 and type 4 hypersensitivity reactions.

211
Q

usual interstitial pneumonia demonstrates

A

temporal and spatial heterogeneity - patches of recent and old trauma.

212
Q

how many people are infected with tuberculosis world wide?

A

2 billion

213
Q

what bacteria is responsible for tuberculosis?

A

mycobacterium

214
Q

mycobacteria are

A 
non-motile bacillus
slow growing 
aerobic
thick cell wall
resistant to acid, alkalis, detergents, neutrophils and macrophages
215
Q

name of the stain for mycobacterium

A

zhiel neilson stain

216
Q

what is the immunopathology of tuberculosis

A

activated macrophages then epithelioid cells then langhans cells. accumulation, the granuloma formation. it then forms a central caseating necrosis which may calcify.

217
Q

primary infection of tuberculosis may present with

A

erythema nodosum

cough, fever, but often asymptomatic

218
Q

post primary infection often involves the

A

skeletal system, the meninges, pleural effusion and most the tissues.

219
Q

what is the Tb regime

A 
4 drugs for two months 
Rifampicin 
Isoniazid 
Ethambutol
Pyrazinamide

then two drugs for 4 months
rifampicin
isoniazid

220
Q

side effects of the Tb multi drug therapy?

A

Rifampicin Orange ‘Irn Bru’ urine, tears
Induces liver enzymes, prednisolone, anticonvulsants
Oral contraceptive pill ineffective
Hepatitis

Isoniazid		Hepatitis
			Peripheral neuropathy (pyridoxine B6)

Ethambutol Optic neuropathy (check visual acuity)

Pyrazinamide Gout

221
Q

screening test for an under 16 year old for tb

A

no immunity to tuberculinprotein so the mantoux or heaf test

222
Q

older then 16 screening test for tb

A

chest x-ray

223
Q

what does a right heart catheter measure?

A

wedge pressure, cardiac output and the blood pressure of the artery.

224
Q

what hormone secretion is associated with small cell cancer lung

A

ACTH siADH

225
Q

what hormone secretion is associated with large cell carcinoma lung

A

PTH

226
Q

asthma is the result of IgE antibodies inappropriately reacting to inert antigens, causing mast cells to release.

A

microthrombins , prostaglandins, histamine and lysosomal enzymes in a exaggerated inflammatory response. Spasmogens such as histamine also trigger an immediate response

227
Q 
you perform aspiration and perform a look and sniff, what do this signs indicate 
foul smelling 
pus 
food particles 
milky 
blood stained 
blood
A 
foul smelling - anaerobic empyema 
pus - empyema
food particles – oesophageal rupture
milky – chylothorax (usually lymphoma)
blood stained - ?malignancy
blood – haemothorax, trauma
228
Q

name some chemotactic released in asthma

A

NCF
LTB4
PAF
ECF-A

229
Q

name some spasmogens released in asthma

A

histamine
SRS
PG
PAF

230
Q

CURB 1 pneumonia treatment

A

amoxicillin or clarithromycin

231
Q

CURB 2 pneumonia treatment

A

amoxicillin and clarithromycin

232
Q

CURB 3-5 pneumonia treatment

A

co-amoxiclav and clarithromycin

233
Q

how quickly does small cell lung carcinoma double

A

every 29 days

234
Q

what is the response rate of small cell lung cancer to therapy

A

90%

235
Q

how many cycles of chemotherapy for lung cancer are undertaken

A

4 cycles

236
Q

what Is the dosage of radiation for stage 3 lung cancer

A

55Gy+

237
Q

what drugs are used for stage 1-2 adjuvant therapy for lung cancer

A

cisplatin and vinorelbine

238
Q

how long does non small cell lung cancer take to double

A

129 days

239
Q

what are the drugs of choice for small cell lung carcinoma

A

cisplatin and etoposide with early thoracic radiotherapy and prophylactic cranial radiation

240
Q

how prevalent is asthma in the population

A

10%

241
Q

what drugs to avoid with asthma managing

A

beta blockers
NSAIDS
asparin
sedative/opiates

242
Q

what drugs to give during an acute asthma attack

A

beta 2 agonists, steroids, leukotriene receptor antagonist, monoclonal antibodies
theophyllines
magnesium
oxygen

243
Q

adverse effects of beta 2 stimulants

A

tremor, cramp, headache, flushing, palpitations, angina

244
Q

side effects of long term inhaled steroidal use

A

oropharyngeal candidiasis

dysphonia

245
Q

acute asthma signs

A

PEF 33%-50%
respiratory rate of more than 25/min
heart rate above 110 min
inability to complete a sentence in a breath

246
Q

life threatening asthma signs

A 
altered consciousness
exhaustion
hypotension
cyanosis
silent chest
poor respiratory rate
raised PCO2
247
Q

what is the duration of a cough associated with bronchiolitis

A

25 days

248
Q

duration of bronchiolitis

A

16 days

249
Q

would you treat tracheitis with antibiotics?

A

yes, Augmentin

250
Q

bronchitis antibiotics?

A

no

251
Q

LRTI/pneumonia antibiotics?

A

oral amoxicillin

252
Q

bronchiolitis, antibiotics?

A

no

253
Q

empyema, antibiotics?

A

yes, IV

respiration (4 decks)

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