Physiology Flashcards
effects of high altitude
low bicarbonate as kidneys excrete BC03 to combat metabolic alkalosis
increased erythropoeitin
increased ventillation –> resp alkalosis
symptoms of AMS an HACE
acute mountain sickness - nausea, fatigue, dyspnoea
high altitude cerebral oedema - ataxia, decrease mental status, coma
pathophysiology of carbon monoxide poisoning
decreases oxygen delivery to the tissues
pathophysiology of type 1 hypersensitivity reaction
reversible bronchoconstriction of vasoactive amines
what type of cells do adenocarcinomas of the lung derive from
mucous producing glandular cells
what is responsible for the changes in influenza that make it highly infective
viral point mutations as it undergoes genetic drift and shift
acid fast rods in sputum
TB
Activates macrophages and induces the release of tumor necrosis factor-α
TB
what is the main mechanism behind cardiogenic pulmonary oedema
increased capillary hydrostatic pressure
what is the main mechanism behind oedema due to nephrotic syndrome and cirrhosis
decreased capillary oncotic pressure
what is the main mechanism behind sepsis induced ARDS
neutrophil release of proteases
does total lung capacity increase or decrease in obstructive lung disease
TLC increases
mechanism of ebstein barr virus
infects b cells from CD 21
what is the mechanism of the monospot test
heterophil antibodies detected by agglutination
culture media used for H.influenza
chocolate agar
culture media used for N. gonorrhea and n. meningitidis
thayer-martin
culture media for bordetella pertusis
bordet gengou
(bordet for bordetella)
culture media for diptheria
loffler
culture media for mycoplasma pneumonia
eaton agar
culture media for m.tuberculosis
lowenstein-jensen medium, middlebrook medium
culture media for fungi
sabouraud agar
(sab’s a fun guy)
culture media for bordetella, legionella, fransciella
charcoal yeast extract buffered with cystine and iron
gram stain for legionella
silver stain
gram stain for pneumocystitis jiroveci pneumonia
flourescent antibody stain
arteries within the kisselbach plexus
kisselbach drives his pLEXUS with his LEGS
Labial artery
anterior/posterio ethmoidal arteries
greater palatine artery
sphenopalatine artery
most common location of epistaxis
anterior segment
kisselbach plexus (labial artery, anterior/posterior ethmoidal arteries, greater palatine artery, sphenopalatine artery)
location of life threatening epistaxis
posterior segment
sphenopalatine artery (branch of maxillary artery)
virchows triad
stasis (post op, long haul flight)
hypercoaguability (COCP, pregnancy, cancer, factor V leiden)
endothelial damage (exposed collagen triggers clotting cascade)
how does PE affect V/Q
V/Q mismatch as the alveoli are ventillated but not perfused
what type of shock would a large PE cause
obstructive shock
(thrombus causes large RV, prevents filling of LV)
what are lines of Zahn on histology
interdigiting areas of pink (fibrin/platelets) and red (RBC) found in thrombi formed before death
(PE)
FEV1 and FVC in obstructive vs restrictive lung disease
obstructive - FEV1 decreased more then FVC
restrictive - FEV1 and FVC proportionately decreased
Respiratory volume (RV) change in restrictive and obstructive lung disease
obstructive - RV increased
restrictive - RV decreased
flow volume loop change in obstructive and restrictive lung disease
obstructive - shifts to the left
restrictive - shifts to the right
metasplasia associated with COPD
COPD leads to metaplasia of pseudostratified ciliated columnar epithelium into stratified squamous epithelium
centriacinar and pancacinar emphysema - difference in aetiologies ?
centriacinar (spares distal alveoli) –> smoking
panacinar (affects respiratory bronchioles and alveoli) –> alpha 1 antitrypsin deficiency
histological feature found in asthma
curschmann spirals
(shed epithelium form whorled mucous plugs)
charcot-leyden crystals (eosinophillic, hexagonal, double pointed crystals formed from breakdown of eosinophilsin sputum)
histological feature found in mesothelioma
psammoma bodies
what part of the lung does asbestos affect
base (lower lobes)
what part of the lung does silica, coal and berillium affect
apex (upper lobes)
what stain is used to visualise asbetos
Prussian blue stain
describe how asbestos looks on histology
asbestos bodies are golden-brown fusiform rods resembling dumbbells
lights criteria for exudate pleural effusion
pleural fluid/serum protein > 0.5
pleural fluid/serum LDH > 0.6
pleural fluid LDH > 2/3 upper limit normal serum LDH
exudate vs transudate
exudate - cloudy fluid due to infection/malignancy
transfudate - clear fluid due to increased hydrostatic pressure (Na retension, HF) or decreased oncotic pressure (nephrotic syndrome, cirrhosis)
air fluid levels in right lung - what does this indicate
lung abscess
