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General Respiratory Medicine Flashcards

To learn about respiratory medicine

1
Q

Which area of the brain coordinates basic rhythm of breathing?

A
  1. Medullary rhythmicity area of the medulla oblongata
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2
Q

How is ventilation controlled and coordinated?

A
  1. Control of ventilation coordinated by respiratory centres, chemoreceptors, lung receptors and muscles
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3
Q

Where does automatic and involuntary control of respiration occur?

A

Medulla

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4
Q

What does the respiratory centres control?

A

Rate and depth of respiration

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5
Q

What are the respiratory centres of the brain?

A
  1. Medullary respiratory centre
  2. Apneustic centre
  3. Pneumotaxic centre
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6
Q

What is the Medullary Respiratory centre responsible for?

A
  1. Inspiratory and expiratory neurones

2. Controls forced voluntary expiration/expiration

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7
Q

What is the apneustic centre responsible for?

A
  1. In the lower pond
  2. Stimulates inspiration
  3. Activates and prolongs inhalation
  4. Overridden by pneumotaxic control to end inspiration
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8
Q

What is the pneumotaxic centre responsible for?

A
  1. In the upper pond

2. Inhibits inspiration at a certain point. Fine tunes respiratory rate

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9
Q

What are the peripheral chemoreceptors responsible for?

A
  1. Located at the bifurcation of if carotid arteries

2. Respond to reduced P02, inc PC02, inc H+ in ARTERIAL blood

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10
Q

What are central chemoreceptors responsible for?

A
  1. Located in medulla, respond to inc H+ on brain
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11
Q

Where does the phrenic nerve originate?

A
  1. C3,C4, C5

2. Supplies the Diaphragm and pericardium

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12
Q

Which of the thoracic vertebrae lies posterior to where the left main bronchus divides?

A
  1. T6
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13
Q

What are the inferior borders of the Lungs?

A
  1. 6th rib in the mid clavicular line
  2. 8th rib in mid axillary line
  3. 10th rib posteriorly
  4. The pleura tuns two ribs lower than lung level
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14
Q

If a PICC line is inserted into the basilica vein at elbow, where is it likely to pass from here?

A
  1. Basilica vein drains into axillary vein
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15
Q

Which of the paranasal sinuses is located on the roof of the posterior nasal cavity, inferior to the pituitary gland?

A

Sphenoid sinus

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16
Q
  1. A lady has bilateral inguinal hernias, chest pain and collapses. X ray shows mediastinal widening. What is diagnosis?
A

Aortic dissection

17
Q

Marfan’s syndrome can present with?

A
  1. Variety of connective tissue disorders
  2. Bilateral inguinal hernias
  3. High risk of aortic dissection
18
Q

A man undergoes coronary artery bypass. During the median sternotomy which structures would require division?

A
  1. The interclavicular lies at the upper end of a median sternotomy and is routinely divided to provide access.
19
Q

What TB drug causes orange urine?

A

Rifampicin

20
Q

What TB drug causes numbness, tingling or burning in hands and feet and can cause unsteadiness?

21
Q

What TB drug causes visual changes: ie colour changes and visual acuity?

A

Ethambutol

22
Q

Which TB drug causes arthralgia, fatigue and GI disturbance?

A

Pyrazinamide

23
Q

Which TB drug causes vestibular toxicity?

A

Streptomycin

24
Q

What organism most likely causes empyema?

A

Streptococcus. pneumoniae

25
Q

The management of patients with community acquired pneumonia is usually determined according to a risk stratification process using a scoring system called CURB65?

A 
C confusion ( abb mental test score<8/10)
U urea >7mmol/L
R respiration rate of >30/min
B bp: systolic<=90mmHg and or dia <=60
65 Aged >65
26
Q

How are patients treated once CURB65. determined?

A
  1. Score of 0: treated in community
  2. Score of 1: if Sa02 > 92%, then treated in com
  3. Score of 2: managed in hospital
27
Q

Pedestrian in RTA. Multiple injuries. Develops adult respiratory distress. Reason for hypoxaemia?

A

Reduced diffusion

28
Q

What is Adult respiratory distress syndrome?

A

Characterised by bilateral pulmonary infiltrates and severe hypoxemia. Two stages:

  1. Early stage: Exudative stage and oedema
  2. Repair: fibro proliferative changes can get scarring
29
Q

What causes ARDS? (Acute respiratory distress syndrome)

A
  1. Sepsis
  2. Direct lung injury
  3. Trauma
  4. Trauma
  5. Acute pancreatitis
  6. Long bone/multiple fractures
  7. Head injury (causes sympathetic nervous stimulation leading to pulmonary hypertension)
30
Q

Which vertebrae is consistent with origin if trachea?

A

C6

Trachea runs from C6 - T5 (bifurcates)

31
Q

A baby born via caesarian. Appears normal at birth. Soon after delivery baby’s respiratory rate elevated (other obs normal). What is most likely diagnosis?

A

Transient tachypnoea of the new born (TTN)

32
Q

What is TTN caused by?

A

Delay in the clearance of lung fluid. Mor common in babies born via ceasarian. soon settles.

33
Q

How does respiratory distress syndrome present in the new born?

A
  1. Gets progressively worse
  2. Due to surfactant deficiency
  3. Seen in new born/prems

Respiratory Medicine (28 decks)

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