Mode Stress Flashcards by Emily Brown

Emphysema is the increase in size of the airspaces in alveoli (resp bronchioles too but NIT terminal bronchioles) due to what

Dilatation and destruction of their walls

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How does emphysema cause obstruction

Through air trappung

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Is it restrictive or obstructive that’s characterised by difficulty getting air in

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Inter is o or r

R
Stiffness of lung tissue

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Shortness of breath could lead to difficulty in exhaling air

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Air will remain inside the lung after full expiration for o

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Long term oxygen therapy when?

PaO2 of <7.3
Doesn’t matter if they have additional features it not

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If chronic hypoxia, pulmonary hypertension, peripheral oedema, nocturnal worsening of hypoxia, at what time is long term oxygen therapy offered?

PAO2 <8

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How many people develop COPD

Less than half of long term smokers

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What likely causes the development of childhood asthma?

Underlying abnormality in the epithelium

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Peripheral eosinophilia is not diagnostic of asthma, but it is suggestive atopy

Yes

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What’s related to atopy

Asthma
Eczema
Hay fever
Allergic rhinitis

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Important t to take history and full examination before diagnosing with asthma

No
Examination findings are probs normal
Diagnosis is from the history!!

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A child under 5 hasn’t got the usual lose dose unglazed corticosteroid, instead they have:

Leukotriene receptor agonist

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What’s ipratropium bromide?

Muscarinic antagonist
(saba?)
Works by relaxing the smooth muscle of the airways

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Bronchial asthma hasn’t got reduced resp drive

Yah

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What’s pneumonia

Inflammation of the lungs, caused by infection

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Diarrhoea and vomiting is a feature of atypical pneumonia

Yes
Also headache
Myalgia (muscle ache)
Dry cough

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Wheeze is uncommon in bacterial lower resp tract infection

True

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Signs for bacterial lower resp. Tract infections are:

Dullness to percussion
Crepitations
Bronchial breath sounds
Fever
Cough

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Pseudomonas aeruginosa pneumonia is associated with what

Cystic fibrosis and other bronchiectatic disease

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Pfizer/BioNTech and Moderna covid vaccine uses what virus

mRNA

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AstraZeneca uses what vaccine

Attenuated SARS-COV2

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The resp. tract is protected by free moving what

Macrophages

Macrophage-mucociliary escalator

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Pulmonary TB is at the Alice’s

True

During normal tidal breathing, where does air go

More air go to the apex than the base of the kings

Pulmonary TB will often give a positive Acid Alcohol Fast Bacilli smear

True dat But not all positive AAFC tests are TB, and a negative AAFV smear does not rule out TB

Is the hyper inflammatory phase of COVID-19 a norma physiological host response to infection

No It’s a severe response

What happens in the hyper inflammatory phase of covid ?

A cascade of pro-inflammatory molecules (cytokine storm) leads to uncontrolled inflammation

Bronchitis is a recurrent illness

Recurrent cycles yah

Lung consolidation results in increase in vocal resonance

Yah

Epiglottis is what infection

Haemophilia influenzae

What’s the differential diagnosis for sore throat??? With purulent exudate and tonsillitis????

Epstein-Barr virus/ glandular fever

What happens if you give some one with Epstein Barr (EBV) / glandular fever amoxicillin

You give them a rash

What do you give to someone with streptococcal throat infection instead of amoxicillin

Penicillin if antibiotics are required

Pneumonia is an infected where

Within the alveolar air spaces

Why is there consolidation in pneumonia

Because of bacteria and inflammatory cellular debris

People with neuromuscular disorders are at higher risk of opportunistic infections

True dat

PET/CT shows metabolic activity of a lesion

True

Smoking increases risk of bladder cancer

Following pneumonectomy, the patient will have an air filled cavity for the rest of thei life

False- resected king will fill with fkuid

Hornets syndrome = compression of the sympathetic trunk

When do effusions require drainage?

When the pH is low (suggesting empyema)

Can many pleural effusions be resorbed?

Yes They could be managed by treating underlying cause

15 years after stopping smoking, heart attack risk returns to that of a never smoker

Yes

What’s radical treatment

Given with the intent to cure the xancer

Radiotherapy can be used to treat the symptoms of lung cancer

True

Adenocarcinoma = bronchioalveolar epithelial stem cells, transform and undergo what

Atypical adenomatous hyperplasia, developing into adenocarcinoma in situ

Bronchiectasis isn’t a side effect of radiotherapy for lung cancer

True

Side effects of radiotherapy for lung cancer include what

Pulmonary fibrosis Oesophagitis Ulceration Burning to skin Pericarditis

10% of smokers will develop lung cancer

True

Lights criteria: exudate Pleural fluid protein/serum protein > 0.5 Pleural fluid LDH/serum LDH > 0.6 Pleural fluid LDH > 2/3 the upper limit of the lab reference range for serum LDH

Yah

Pleural effusion secondary to cancer or pneumonia is what most likely

It’s exudative

What’s tracheomalacia

It’s collapse of airway while breathing Baby

A pneumothorax (air in the pleural cavity) leads to a slight outward shift in the chest wall

Yes- remember, parietal pleura is attached to chest wall Equilibrium between elastic lung recoil, and elastic chest wall expansion is lost- lungs recoil and chest wall expands

What happens in an increase in action potentials from phrenic?

Inspiration

Lung compliance is what

Magnitude of change in lung volume produced by a given change in trans pulmonary pressure

Both peripheral and central chemoreceptors are stimulated by an increase in blood acidity (⬆️ H+) What’s the only difference then?

Peripheral chemoreceptors are less picky. They’ll react to any increase in H+. Whereas central chemoreceptors are only stimulated by increase in H+ as a result of CO2.

Do central chemoreceptors respond to an increase in CO2?

Yes ARTERIAL CO2, and arterial pH too. They respond to decrease in pH = increase jn acidity.

Would gas exchange ever occur in the distal parts of the bronchioles?

Yes And alveoli mainly tbo

Oxygen d curve shift to right =? (2)

Decrease in haemoglobin affinity Decrease in oxygen content in blood

Vital capacity =

Total max exhaled after total max inhaled

Hyperventilation = curve left or right?

Left = decrease in CO2 And up H+

Low affinity for O2 is where on the graph

Left

Where in the dissociation curve is the lungs?

Right- high affinity So low affinity on left, high affinity on the right

Presence of CO = shift where?

To the left

Left shift results from what: Temp CO2 H+ /ph CO

Decrease in temp Decrease in CO2 Decrease in H+ ions/ increase in pH (cuz decrease in CO2)

Right shift results from what changes to these: Temp CO2 H+

Increase in temp Increase in CO2 Decrease in pH, increase in H+

Right/left = increase or decrease in oxygen affinity?

Right = decreased oxygen affinity therefore more oxygen available Left = increased oxygen affinity therefore less oxygen available

The pleural cavity is a space that lies where

Between the lungs and the chest wall

What’s anaemia really , and affects haemoglobin vs plasma

Fall in total blood oxygen content RBC’s can’t carry as much oxygen, but they are still saturated. (Most oxygen carried by haemoglobin in blood cells, like 95%). Plasma content unaffected, cuz the lack of oxygen is due to haemoglobin being able to carry less, plasma is still there though.

Hyperventilation wouldn’t compensate for metabolic alkalosis, why?

Hyper = blow off more CO2, = more alkaline, as less CO2 = reduction in H+ formation

Why if you blow off extra CO2, = H+ formation reduced?

Because of how CO2 is carried in the body we

True or false Peripheral chemoreceptors respond to changes in levels of O2 in solution

True Whereas anaemia is a problem is a decrease in oxygen binding capacity. Plasma is unaffected, haemoglobin still saturated

Alkalosis/increase in pH = what affinity, therefore, what happens to saturation

Alkalosis = increase in pH Increase affinity = increase in saturation People on acid don’t think right, and therefore give up there haemoglobin, less affinity, so decrease saturation

Spirometry is what

Volume of air that can be exhaled