Introduction to Physiology and Pharmacology Flashcards
What is Asthma?
- Common lung condition
- Heterogenous disease
- Chronic airway inflammation
- Makes bronchioles narrow and more difficult to breath
- History of respiratory problems
- Obstructive pulmonary disease
What causes Asthma?
- TH2 cells release cytokines and activate B cells which produce IgE
- Allegens interact with IgE antibodies, this causes mast cell degranulation and release of mediators such as histamine which causes bronchial constriction
- Inflammatory cells such as eosinophils, neutrophils and mast cells release mediators and cytokines which cause inflammation
- Family hitry and reduced exposure to bacteria can increase risk
What are the signs and symptoms of Asthma?
- Coughing, wheezing, chest tightness
- Dyspnea- shortness of breath
- Sputum with mucus plugs or casts from small bronchi which block air exchange and medication
- Charlot-leyden crystals in sputum which are needle shaped from breakdown of eosinophils
- Usually worse at night and early morning
- On examination- wheezing on auscultation in forced expiration, may be absent in severe asthma-silent chest
How is Asthma diagnosed?
- Frequency of medication and symptoms- if inhalers work then probably asthma
- FEV1 or FVC- FEV1 should be reduced
- Variation in lung function greater than in healthy individuals- if changes a lot then likely to be asthma
- PERF- peak expiratory rate flow- low
- Eosinophlia inflammation- measured by peripheral blood eosinophil count, sputim ad exhaled nitric oxide
What is the treatment for Asthma?
- S- Smoking cessation
- I- Inhaler technique
- M- Monitoring
- P- Pharmacology
- L- Lifestyle
- E- Education
- Also Medications
- Low dose inhaled corticosteroids
- Regular low dose ICS
- a) LABA and low dose ICS 3b) LABA and increased dose ICS
- LABA and high ICS and LTRA/aminophylline
- Daily oral corical steroid and high dose ICS
- SABA as required at all steps, if more than 2x a week then step up
What is an Asthma attack?
- Worsening symptoms which can be sudden or gradual
- Triggered by viral infections or allergens
How is an Asthma attack treated?
- O- Oxygen
- S- Salbutamol (nebulised beta agonist)
- H- Hydrocortisone
- I- Ipratropium (M3 antagonist)
- T- Theophylline (phosphodiesterase inhibitor)
- M- Magnesium (decrease vagal tone)
- E- Escalate (send to ICU)
What is Familial hypercholesterolemia?
- High cholesterol that runs in the family
What causes Familial hypercholesterolemia?
- Defect on chromosome 19
- Body is unable to remove LDL cholesterol from the body
- Autosomal dominant
What are the signs and symptoms of Familial hypercholesterolemia?
- High cholesterol
- Development of heart problems
- Athersclerosis
What is the treatment for Familial hypercholesterolemia?
- Statin which lower LDL
- Improve diet and lifestyle
What is Familial male precocious puberty?
- Condition that cuases early sexual development in male
What causes Familial male precocious puberty?
- LHCGR gene mutation
- This releases LH which causes androgen release
- Autosomal dominant
What are the signs and symptoms of Familial male preocious puberty?
- Puberty begins in early childhood between 2-5 years
- Increased boyd hair, growth of penis and testis, underarm odor
- Stop growing earlier so shorter when an adult
What is the treatment for Familial male precocious puberty?
- Spironolactor and testolactone
- Blocks androgens and oestrogen synthesis
What is Hereditary spherocytosis?
- Condition that affects red blood cells
What causes Hereditary sphercytosis?
- Mutation in genes- at least 5
- Misshapen cells and rigidity
- Usually autosomal dominant but can be recessive
What are the signs and symptoms of Hereditary sphercytosis?
- Anemia
- Splenomegaly
- Jaundice
- Gallstones
What is the treatment for Hereditary spherocytosis?
- No cure
- Vitamins and transfusions help symptoms
- Surgery to remove spleen
What is Hypertension?
- High blood pressure
- Systolic- arterial pressure when heart is contracting
- 120-139 is pre hypertension
- 140 or more is hypertension
- Diastolic- Arterial pressure when the heart is relaxing
- 80-89 is pre hypertension
- 90 or more is hypertenion
What causes Hypertension?
- No clear cause
- Primary
- over time, old age, obesity, salt heavy diet, lack of exercise
- Secondary- 10%
- low renal blood flow, atherscleosis, vasculature or aortic dissection
- This causes more renin release, water is retained, more fluid volume, and so hypertension
- Increased aldosterone due to a tumour does the same thing
What are the signs and symptoms of Hypertension?
- Primary
- none usually- silent killer
- may cause headaches
- Secondary
- Underlying cause symptoms
- May cause wear and tear of endothelial arteries
- causes MI, stroe, aneurysm
- 180/110 or higher will cause hypertensive crisis
- damages end organs
- confusion, drowsiness, chest pain breathlessness
- damages end organs
What is the treatment for Hypertension?
- Lifestyle changes
- Medications
- ACE inhibitors, ARBs, Calcium channel blocers, Diuretics, Beta blockers
What is Nephrogenic diabetes insipidus?
- Rare condition where you produce large amount of urine and feel thirsty
What causes Nephrogenic diabetes insipidus?
- Kidney does not respond to ADH and so too much water is passed from the body
- Due to kidney damage or could be inherited
- May be caused by lithium
What are the signs and symptoms of Nephrogenic Diabetes Insipidus?
- Polydipsia- extreme thirst
- Polyuria- passing large amounts of urine
What is the treatment for Nephrogenic Diabetes Insipidus?
- Medications like thiazide diuretics which reduce amounts of urine the kidney makes
What is Pheomochromocytoma?
- Rare tumour of the adrenal gland which sits just above the kidney
What causes Pheomochromocytoma?
- Usually no reason
- May be genetic, MEN, VHL syndrome or NF1
What are the signs and symptoms of Pheomochromocytoma?
- Severe headaches
- Sweating
- Heart palpitations
What is the treatment for Pheomochromocytoma?
- Laproscopic surgery or open surgery to remove it
What is Retinitis Pigmentosa?
- Group of rare genetic disorders that involve the breakdown and loss of cells in the retina
What causes Retinitis Pigmentosa?
- Inherited disorder that causes mutation in 1 of 50 genes- may produce toxic proteins or not make proteins
- Autosomal recessive, dominant or X linked
What are the signs and symptoms of Retinitis Pigmentosa?
- Long time to adjust to light
- Difficulty finding way in the dark
- Photophobia
- Vision loss
What is the treatment for Retinitis pigmentosa?
- No cure
- Vitamin A can slow progression
- Searching for a treatment
