clinical stuff Flashcards
1-complement cascade creates MAC
-causes cell lysis
2-complement binds to FC receptor
- chemotaxic chemicals released
- attracts neutrophils
- neutrophils destroy the cells
3-opsonisation and phagocytosis
-happens in the spleen
4-antibody mediated
- natural killer cells
- binds to antibodies in the AD-AB complex
- causes cell death
5-causes antibody antigen complex to interrupt normal cell processes -not cell death
-AB bound to the antigen causes changed receptor response
Alzheimer’s disease
caused by a build up of aberrant protein in the brain
- cells cannot communicate effectively-treated with acetylcholinesterase inhibitors
- causes of acetylcholinesterase to be unable to break down acetylcholine in the brain-increased communication between cells-alleviating symptoms
mad cow disease
- build up of prions in the brain that fold up into an almost indestructible aggregate
- also causes other prion proteins to fold up swell
cystic fibrosis -6 different classifications
class 1-MRNA is not produced correctly or at all so no protein channels are created class 2-the proteins are made but do not fold correctly class 3-the proteins are made and put into the membrane, but the channels are blocked class 4-the channel is made but isn't as effective so only some ions can diffuse out class 5-there is not enough of the proteins made so they cannot allow a big enough total volume of ions to diffuse out of the cells class 6-the half life of the proteins is too short so there isn't enough in the cell membrane at one time
Asthma
can be allergic(extrinsic)
or non-allergic(intrinsic)
asthma -first exposure
-on first exposure to the allergen=sensitisation occurs
asthma-second exposure
-mast cells release histamines and spasmogens which cause the bronchioles to go into spasm and restrict the airways
asthma-late phase attack
t helper 2 cells are recruited and activate inflammatory cells.this can cause excessive mucous production and bronchoconstriction hours after exposure
asthma-peak flow meter
-will show a LOW FEV1 due to its nature as an obstructive disease
asthma-spirometer
vitalograph with a shallower curve, but reaching the same max volume-an obstructive pattern
COPD
- collapse of the alveolar walls and build up of fluid in the lungs means that air can be retained in the alveoli and no extra air can be taken in
- this causes hyperinflation of the lungs
- spirometry shows a higher volume and reduced expiration rate
- x-ray shows longer lungs -more than 10 ribs can be counted on each side
- if infection suspected-co-amoxiclav
COPD-acute exacerbation
- increase in dyspnoea, cough, wheeze, increase in sputum
- hypoxic-oral prednisolone 30mg for 5 days
end stage COPD treatment
opioid or benzodiazepine medications for symptomatic relief of breathlessness
emphysema
break down of alveoli walls decreasing surface area
chronic bronchitis
swelling of bronchioles causing obstructive disease
acute bronchitis
usually self limiting
odemous large airways and sputum due to inflammation of trachea and bronchi
disease usually resolves in 3 weeks
management-analgesia,fluids consider antibiotics if systemically very unwell or co-morbidities
doxycycline first line
severe pulmonary fibrosis
visible on an X-ray as much more coarse or fine white streaks
every type of volume is reduced due to restrictive disease
sarcoidosis
- inflammatory deposits in various parts of the body
- creates a restrictive issue in the lungs
- presents similar to fibrosis
- enlarged lymph nodes
erythema nodosum
- red patches on the skin
- associated with many types of autoimmune disease
wheeze
- lower airways, heard during expiration
- airway obstruction at the level of bronchioles,increasing airway resistance
- polyphonic wheeze-each bronchiole is restricted a different amount
stridor
- occurs at the level of the larynx
- infection and swelling or vocal cord palsies
- airway obstruction outside the thoracic cavity
- heard during inspiration
pharyngeal pouch
- outpouching of the hypo pharynx just superior to upper oesophageal sphincter
- between 2 parts of inferior constrictor
- can trap food and cause bad breath, cough,aspiration or infection
tension pneumothorax
- trauma causing the pleural membranes to rupture
- air gets into the pleural cavity and allows the lungs to deflate
- trachea is palpably shifted to the opposite side
- chest drain is needed to be placed into second intercostal space on the side of the trauma
Virchow’s node
- supraclavicular cervical lymph node in the left subclavian triangle
- close proximity to the thoracic duct
- enlargement suggests abdominal malignancy
- especially gastric
haemoptysis
blood in sputum
rhino sinusitis
-upper respiratory
usually viral and clears in a week
if longer than 10 days there could be a secondary bacterial infection
periorbital oedema creates visual changes, cranial nerve palsies are possible
-papillodema=swelling of the brain pressing on the optic disk
common cold
upper ri
50% rhinovirus
25% coronavirus
15% influenza
acute pharyngitis
upper ri
- viral tonsilitis will resolve by self
- bacterial needs antibiotics, usually streptococcus
bronchiolitis
-lower ri leading cause of admission for under 5 year olds -respiratory syncytial virus -swelling of the bronchioles -90% will resolve within 3 weeks
pneumonia
- lower ri
- pleuritic chest pain -also common with pulmonary embolism
- high temperature, breathing rate, heart rate
- CURB65 score is used to assess the severity -confusion,urea ,heart rate ,breathing rate
complications of pneumonia
pleural effusion-build up of pleural fluid in the pleural space
empyema-pus in the pleura
ARDS-acute respiratory distress syndrome
abscesses
cavitating disease
