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My Respiratory > Other > Flashcards

Other Flashcards

1
Q

Is carbon dioxide more or less soluble in the blood than oxygen?

A

carbon dioxide is more soluble than oxygen

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2
Q

Why is there never co2 retention in pulmonary fibrosis?

A

pulmonary fibrosis is not an airway disease but the problem is in the gas exchange so there is never Co2 retention

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3
Q

What is the first line treatment for COPD?

A
  • oxygen if their levels are low (remember that the target is lowered for patients with type 2 failure)
  • salbutamol
  • steroids
  • ipratropium
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4
Q

What is the second line treatment for COPD?

A

second line is IV aminophylline but this doesn’t always work

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5
Q

How do you treat acute asthma?

A

oxygen if needed, salbutamol, ipratropium and oral steroids

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6
Q

What ventilation treatment do you never use with asthma?

A

NIV

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7
Q

Which way does a tension pneumothorax shift?

A

away from the pneumothorax

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8
Q

What is the first diagnostic test for pneumonia?

A

sputum culture

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9
Q

What is the first line treatment for legionella?

A

levofloxacin

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10
Q

What disease is most commonly associated with honeycombing?

A

idiopathic pulmonary fibrosis

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11
Q

What does type 1 respiratory failure mean?

A

short of oxygen

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12
Q

What does type 2 respiratory failure mean?

A

short of oxygen and too much carbon dioxide

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13
Q

What is perfusion without ventilation?

A

shunting

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14
Q

What is ventilation without perfusion?

A

dead space

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15
Q

What is the difference between effort dependent and effort independent tests?

A
  • effort dependent tests include FEVs and flow rates with spirometry
  • effort independent tests include relaxed vital capacity with spirometry, whole body plesmography etc
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16
Q

What are the changes to FEV1 and FVC in asthma?

A
  • decrease FEV1

- FVC will be normal

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17
Q

What are the changes to FEV1 and FVC in COPD?

A
  • decrease FEV1

- FVC reduced

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18
Q

What are the measurable changes in obstructive lung disease?

A
  • decreased PEFR
  • decreased FEV1
  • normal FVC (asthma), reduced in COPD
  • less than 75% ratio
  • greater than 15% FEV1 response to beta 2 agonist in asthma
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19
Q

What are the measurable changes in restrictive lung disease?

A
  • normal PEFR
  • decreased FEV1 and FVC
  • greater than 75% for the ratio
  • no FEV1 response to beta 2 agonist
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20
Q

Which of the white cells are granulocytes?

A

neutrophils, eosinophils and basophils

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21
Q

Which of the white cells are agranulocytes?

A

lymphocytes and monocytes

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22
Q

What is the word for low levels of platelets?

A

thrombocytopenia

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23
Q

How is plasma assessed?

A

secondary haemostats and viscosity

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24
Q

What is MCV in haematology?

A

the average volume of red cells

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25
Q

What are the three types of MCV classifications of red cells?

A
  • microcytic (smaller cells) due to iron deficiency
  • macrocytic cells (larger cells) due to B12/folate deficiency or alcohol excess
  • normocytic cells due to acute blood loss or anaemia of chronic disease
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26
Q

What are the reasons for anaemia of chronic disease?

A

changes in

  • iron supply to developing red cells
  • proliferation of erythroid cells
  • production of erythropoietin
  • life span of red cells
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27
Q

What is the add on ‘cytosis’ used for?

A

high numbers of total and agranulocytes

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28
Q

What is the add on ‘philia’ used for?

A

high numbers of granulocytes

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29
Q

How are coagulation times measured?

A
  • prothrombin time

- activated partial thromboplastin time

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30
Q

What can plasma viscosity reflect?

A

changes in plasma proteins and increased can be found in inflammation

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31
Q

What is palliative care?

A

palliative care is the active total care of patients whose disease is not responsive to curative treatment both for cancer and not

32
Q

What are common symptoms experienced by palliative care patients?

A
  • pain
  • nausea and vomiting
  • fatigue
  • anorexia
  • breathlessness
  • itch
  • drowsiness
33
Q

What is Advance Care Planning?

A

a sensitive but realistic conversation with a patient to find out and try to meet the patients needs

34
Q

How long is a normal pregnancy term?

A

37-42 weeks

35
Q

When is surfactant released in babies?

A

30-32 weeks

36
Q

What is the management of a baby with surfactant deficiency?

A

keep the baby warm and administer surfactant

37
Q

What is there increased risk of in preterm babies?

A

risk of pneumothorax with IPPV (bag) and CPAP

38
Q

What classifies as chronic lung disease in neonates?

A

oxygen required beyond 36 weeks, evidence of pulmonary parenchymal disease on CXR and wheeze

39
Q

How does diaphragmatic hernia present in neonates?

A

severe breathing difficulty

40
Q

How is neonatal diaphragmatic hernia treated?

A

tube not a bag-mask and surgery

41
Q

What is transient tachypnoea in neonates and what does it cause?

A

fluid in the lungs and causes shortness of breath

42
Q

What is the carrier incidence of cystic fibrosis?

A

1 in 25 people

43
Q

What type of disease is cystic fibrosis?

A

multi-system genetic disorder that is autosomal recessive

44
Q

What does asthma present as in children?

A

wheeze, cough, chest tightness and difficulty breathing

45
Q

What will be seen on a flow volume graph in an asthma patient?

A

scallop shape

46
Q

How do you treat paediatric asthma?

A

inhaled beta-agonist, inhaled steroids then add a long acting beta agonist or leukotriene antagonist

47
Q

What is commonly used to administer inhaled asthma drugs in children?

A

a spacer

48
Q

How is acute asthma attack treated in children?

A

oxygen and nebuliser bronchodilator

49
Q

What caused bronchiolitis?

A

viral infection by RSV

50
Q

How does paediatric pneumonia present?

A

cough and high temperature and dullness of chest on percussion and bronchial breathing

51
Q

What are the common bugs for pneumonia in neonates?

A

GBS, E.coli, Klebsiella and staph aureus

52
Q

What are the common bugs for pneumonia in infants?

A

strep pneumonia and chlamydia

53
Q

What is the presentation of croup in children?

A

stridor and barking cough

54
Q

What is the treatment of paediatric croup?

A

oral steroid to reduce inflammation

55
Q

What are some causes of breathlessness?

A
  • heart failure
  • asthma and lung disease
  • PE
  • angina
  • hyperventilation syndrome
  • anaemia
56
Q

What causes instant breathlessness?

A

PE or pneumothorax

57
Q

What causes acute breathlessness?

A

asthma, pneumonia, acute MI and cardiac tamponade

58
Q

What causes subacute breathlessness?

A

pleural effusion, pulmonary vasculitis and SVCO

59
Q

What causes chronic breathlessness?

A

COPD, ILD, pulmonary hypertension or anaemia

60
Q

What are the assessments for breathlessness?

A
  • oxygen transport
  • mechanical disadvantage
  • respiratory drive
  • perception of breathing
61
Q

What are the tests for breathlessness?

A

spirometry, peak flow, CT, CXR, VQ scan

62
Q

Where does the respiratory system develop from?

A

mid section of the foregut just anterior to the pharynx in the fourth week of gestation

63
Q

What are the first few steps of embryological development of the lungs?

A

laryngeotracheal groove forms on the ventral side
this deepens to become the diverticulum which then separates from the oesophagus and splits into a left and right bronchial bud

64
Q

What has happened by weeks 5 and 6 of embryological development?

A

by week 5 there is asymmetrical branching and by week 6 the main divisions are in place

65
Q

What does the distal end of the diverticulum development into?

A

the tracheal bud

66
Q

What is the diverticulum lined by?

A

endoderm so all the respiratory epithelium and glands are endodermal in origin

67
Q

What comes from the mesoderm layer?

A

supporting structures such as cartilage, blood vessels, muscles and connective tissue

68
Q

What does the mesoderm regulate?

A

branching so inhibit around the trachea and stimulates around the bronchi

69
Q

What are two common congenital defects of the respiratory system?

A
  • oesophageal atresia (blind-ending)

- tracheoesophageal fistula (communication)

70
Q

What are the three periods of respiratory embryological development?

A
  • glandular period
  • canalicular period
  • terminal saccular period
71
Q

What happens in the glandular period?

A

(weeks 7-16)
All major lung elements develop
Bronchial tree develops to level of terminal bronchioles

72
Q

What happens in the canalicular period?

A

(weeks 16-26)
The bronchioles, alveolar ducts and the primitive alveoli develop
The lung tissue becomes very vascular and capillaries develop

73
Q

What happens in the terminal saccular period?

A

(weeks 26-40)
More alveoli develop and mature
Alveolar cells differentiate into type 1 and 2 pneumocytes
Epithelium thins and surfactant secretion begins
Capillaries develop around the alveoli

74
Q

What do the type 1 pneumocytes do?

A

these predominate and are the specialised cells for gas exchange

75
Q

What do the type 2 pneumocytes do?

A

secrete surfactant that decreases surface tension of the mucoid lining the alveoli (prevents respiratory distress syndrome)

My Respiratory (15 decks)

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