extras Flashcards
FRV is where
outward recoil of chest is balanced by outward recoil of lung
What is a shunt
perfusion of a non ventilated lung
will be REFRACTORY TO SUPPLEMENTAL OXYGEN
VQ mismatch corrects with oxygen
What does a PE achieve
ventilation of lung that is not perfused distal to the blockage
FRC in obesity
falls
-inward recoil of lung overbalances the outward recoil of chest
Resp centre where
ventral medulla oblongata
most potent resp stimulus
low CSF pH
cao2 and oxygen moving between tissues and capillaries
internal respiration
nasal ep is
pseudostratified ciliated columnar epithelium with goblet cells
BiPAP in COPD
reduced risk intubation
reduces mortality
hypoxia- EPAP and oxygen
hypercapnoea- IPAP
BIPAP contraindications
PaCO2 over 60 severe hypoxia unstable not cooperative not conscious excess resp secretions past facial surgery
If normal FEV1/FVC and FVC reduced, what are the options
restrictive defect
or
trapped gas +++
Normal TLC but increased RV
gas trapping neuromuscular disease (but typically TLC also down)
Increase alveolar PCO2 on DLCO
increase as reduce PaO2 so less competition for binding sites
ground glass and fleichner guidelines?
doesnt apply- need longer follow u
eye disease in sarcoid
sicca
granulomatous uveitis bilateral- can go blind
sarcoid and hep c- avoid…?
IFN alpha- worsens disease
if not using steroids in sarcoid, using what for symptoms
NSAIDS
delta F 508 problem
defective folding, processing, trafficking
is antibiotic susceptibility testing useful in CF
does not predict clinical outcome
give one abx for each organism on culture, 2 if possible for each gram neg
why are males infertile in CF
absent vas deferens
IMprove survival in IPF
lung transplant
Improve exercise tolerance in IPF
supplemental oxygen
improve QOL in IPF
pulm rehab
ground glass opacity in IPF?
minimal
compare NSIP with ground glass predominance- without evidence honeycombing, temporally uniform histology
Where is COP in the chest
peripheral predominant
subpleural sparing in
hypersens pneumonitis
AIP histological hallmark
prominence and uniformity of fibroblastic/myofibroblastic proliferation
acute hypersensiticity pneumonitis what type reaction?
chronic?
Type III
Type IV
see GRANULOMAS on histology which distinuguishes from IPF
ILD in CTD which patterns
RA- UIP
NSIP- others
methotrexate and amiodarone pneumonitis
stop drug give CS
remember nitrofurantoin can do acute or chronic too
upper and lower lobe fibrosis
SCHART RASCO
upper
Sarcoid Coal workers pneumoconiosis Histiocytosis Ank spond Radiation TB
lower
RA Asbestosis Scleroderma Cryptogenic fibrosing alvelolitis - IPF Others: mtx, amiod, bleomycin, hydralazine
