physio + pharma

Question 1

mechanism salbutamol

Answer 1

beta receptor agonist // relaxes broncial smooth muscle

Question 2

mechanism ipratropium

Answer 2

blocks muscarinic ACh receptors –> bronchial relaxation

Question 3

mechanism theophylline

Answer 3

increase camp

Question 4

oxygen therapy in acutely ill patients

Answer 4

reservoir 15 l/min

Question 5

mx to COPD

Answer 5

if type II resp failure 88-92%

Question 6

what causes an O2 shift to the left (lower O2 delivery)

Answer 6

HbF, carboxyHb // Low H+ // low pCO2 // low 23DPG // low temp

Question 7

what causes an O2 shift to the right (higher O2 delivery)

Answer 7

raised H // raised pCO2 // raised 23DPG // raised temp

Question 8

tidal volume

Answer 8

volume inspired each breath (M: 500ml, F:350ml)

Question 9

what is insp reserve volume

Answer 9

max air that can be inspired at end of tidal volume (2-3L)

Question 10

what is insp capacity

Answer 10

tidal volume + insp reserve volume

Question 11

what is residual volume

Answer 11

volume of air remaining after max epiration // increases with age // residual volume = functional residual volume - expiratory reserve volume

Question 12

what is the vital capacity

Answer 12

max volume of air expired after maximal inspiration (5L) // inspiratory capacity + expiratory reserve volume

Question 13

what is total lung capacity

Answer 13

vital capacity + residual volume

Question 14

what is transfer factor

Answer 14

rate at which air diffuses from lungs to blood

Question 15

what is used to test transfer factor

Answer 15

carbon monoxide

Question 16

what is the transfer coefficient

Answer 16

KCO -transfer factor corrected for lung volume

Question 17

what causes raised transfer factor

Answer 17

asthma // pulm haemorrhage // left to right cardiac shunts // polycythaemia // hyperkinetic // male, exercise

Question 18

what causes low transfer factor

Answer 18

fibrosis // pneumonia // PE // pulm oedema // emphysema (COPD) // anaemia // low CO

Question 19

PFTs in obstructive lung disease

Answer 19

FEV1 reduced

Question 20

restrictive lung diease PFTs

Answer 20

reduced FEV1, FVC, FEV1%

Question 21

examples restrictive lung disease

Answer 21

pulmonary fibrosis // asbestosis // sarcoidosis // ARDS // ankylosing spondylitis // neuromuscular disorders // severe obesity

Question 22

what can trigger theophylline toxicity

Answer 22

illness, cipro + erythromycin

Question 23

features theophylline toxicity

Answer 23

vomiting, agitation, dilated pupils, tachycardia, raised glucose, hypoK

Question 24

mx theophylline toxicity

Answer 24

activate charcoal // ondasetron // IV crystalloid // HAEMODIALYSIS