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hd & t sg > Lung Pathology and Pharmacology > Flashcards

Lung Pathology and Pharmacology Flashcards

1
Q

What is atelectasis?

A

Inadequate expansion of airspaces

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2
Q

Acute Respiratory Distress Syndrome (ARDS)

A

Caused by trauma to the lung resulting in inflammation resulting in generalized fluid accumulation (progression of acute injury and damage from activated NEUTROPHILS)-high rate of fatalities

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3
Q

COPD

A

(congestive obstructive pulmonary disease: emphysema, asthma, bronchietasis)

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4
Q

Emphysema

A

destruction of alveolar walls and permanent enlargement of airspaces

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5
Q

Chronic bronchitis

A

(persistent cough > 3 months in 2 consecutive years): smoking, air pollution

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6
Q

Bronchiectasis

A

(obstruction of bronchi and persistent necrotizing infections): destruction of elastin and muscles in bronchial walls

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7
Q

Three characteristics of Asthma

A

(reactive airway disease and narrowing of airways-hyperreactivity):

  1. Hyperinflated lungs,
  2. Thick mucus plugs in airways
  3. Smooth muscle hypertrophy
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8
Q

Fibrosing lung diseases is associated with…

A

Collagen vascular diseases such as rheumatoid arthritis

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9
Q

Occupational lung diseases

A

(restrictive, e.g., mineral dust-induced, silicosis, asbestosis [mesothelioma])

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10
Q

Sarcoidosis

A

Abnormal connective tissue and reduced elastic propertis; multi-organ involvement)

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11
Q

Pulmonary embolus originate from what location in the body?

A

Deep veins in legs

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12
Q

Two causes of pulmonary hypertension

A
  1. Heart disease

2. Recurrent thromboemboli

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13
Q

Restrictive lung disease

A

Caused by fibrosis or chest wall abnormalities; gas exchange impaired; difficulty inhaling and expanding lungs

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14
Q

Vascular lung disease

A

Gas exchange impaired by obstruction or hemorrhage; may be abrupt or insidious

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15
Q

Obstruction lung disease

A

Blocked airways; gas exchange through septal walls NOT impaired; unable to exhale

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16
Q

What causes tuberculosis?

A

Mycobacterium tuberculosis

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17
Q

5 Characteristics of Tuberculosis

A
  1. Usually lungs but can affect other organs
  2. Flourishes in crowded, impoverished areas
  3. Non-contagious during long periods of dormancy
  4. Problems with multidrug antibiotic resistance
  5. Forms necrotizing granulomas
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18
Q

How much more likely is a smoker to develop a lung tumor?

A

55X more than the general population

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19
Q

What percent of primary lung cancers are carcinomas?

A

95%

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20
Q

What cell types are most common in lung cancer?

A

Adeno and squamous

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21
Q

What 2 groups of people have a higher prevalence of asthma?

A

Females and children

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22
Q

What are typical relievers for asthma?

A

Beta2 agonist at minimum dose and frequency

23
Q

What is the mechanism of action for asthma relievers?

A

Directly relax airway & smooth muscle

24
Q

What is the speed of onset and time of effect for albuterol and salmeterol

A
  • Albuterol (rapid onset and 4-6 hrs)

- Salmeterol (slower onset, 12 hrs)

25
Q

(T/F) Asthma relievers are most effective for severe cases.

A

False

26
Q

(T/F) Asthma relievers are short-acting

A

True

27
Q

What are the dental side effects of asthma controllers?

A

Nose bleeds, sores in nose, mouth, tongue that doesn’t heal

28
Q

(T/F) Asthma controllers are best for long-term stability

A

True

29
Q

(T/F) Asthma controllers often have few side effects.

A

False

30
Q

What is the most common asthma controller?

A
  • Inhaled corticosteroids (Fluticasone)

- chronic management, not for rescue

31
Q

What is a common add-on controller for asthma?

A

Methylxanthine drugs; theophylline (tablet or inhaler)

32
Q

What is the mechanism of add-on asthma controllers?

A

Phosphodiesterase inhibitor and increases cAMP and relaxes airway smooth muscle

33
Q

Add-on asthma controllers can be used by themselves for:

A

Mild asthma

34
Q

What is the advantage to combining an add-on asthma controller to a corticosteroid?

A

Reduce steroid doses and side effects

35
Q

Example and function of antimuscarinics

A
  • Ipratropium

- Reverses contraction of smooth muscle from vagal activity-usually backup for beta 2 agonists

36
Q

Example and mechanism of Leukotriene modifiers

A
  • Montelukast (Singulair)

- block leukotriene-binding to receptor

37
Q

Who is the ideal patient for a leukotriene modifier?

A

Patients who have trouble with inhaled therapies (e.g., nasal bleeding) because it can be taken orally. Also use for prophylaxis

38
Q

Cromolyn

A

inhibits release of inflammatory mediators such as histamine

39
Q

Omalizumab

A

inhibits IgE binding to mast cells-very expensive, only for severe non-responsive asthma

40
Q

What are 3 struggles a dentist might have with an asthma patient?

A
  • Asthmatics tend to be mouth breathers—dry mouth
  • Asthma inhalers irritate muscosa of mouth, especially back of roof of mouth
  • Make sure asthmatics bring inhalers to appoint: avoid asthma attacks
41
Q

2 causes of COPD?

A
  • Long smoking hx, or exposure to environmental irritants

- Airflow limitations-due to progressive, irreversible airway remodeling

42
Q

3 typical treatments of COPD?

A
  1. Longer acting bronchodilators such as tiotropium bromide (Spireva)
  2. Longer acting beta 2 agonists such as salmeterol
  3. Theophylline with glucocorticoids
43
Q

(T/F) Responses to treatment in COPD are typically better than those responses in asthma patients.

A

False

44
Q

Typical influenza treatment, and how it works?

A

Oseltamivir (Tamiflu)-prevents separation of virus particle from cell receptors, stopping viral spread—earlier treatment essential

45
Q

What are 3 forms of Nicotine replacement therapy (NRTs)?

A
  1. Gum
  2. Transdermal patch
  3. Nasal spray
46
Q

What are the 3 options for antismoking pharmacology?

A
  1. Nicotine replacement therapy (NRTs)
  2. Bupropion-Wellbutrin or Zyban: antidepressant
  3. Varenicline (Chantix)- partial nicotine agonist-relieves craving of smoking.
47
Q

What are 3 causes for Atalectasis

A
  1. Aspiration
  2. Pneumothorax
  3. Pleural fibrosis
48
Q

Are glucocorticoids alone an effective treatment for COPD?

A

No

49
Q

Inhaled corticosteroids are sometimes used with what type of drug to be an effective asthma controller?

A

Beta 2 agonists

50
Q

Cor pulmonale

A

Right ventricle failure

51
Q

Three causes for pulmonary embolis

A
  1. Prolonged bed rest
  2. Surgery
  3. Congestive heart failure
52
Q

Is sarcoidosis restrictive, obstructive or vascular?

A

Restrictive

53
Q

Emphysema has a deficiency of what?

A

alpha-1 antitrypsin deficiency

hd & t sg (12 decks)

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