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PPE > Resp > Flashcards

Resp Flashcards

1
Q

What is pulmonary ventilation rate?

A

resp rate x tidal volume

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2
Q

what is vapour pressure? What is saturated vapour pressure dependent on?

A

vapour pressure - pp of water above a surface of water

dependent on temp

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3
Q

what is tension

A

gases tendency to escape a liquid

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4
Q

Which ribs are typical and which are true ribs?

A

3-9 typical

1-7 true

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5
Q

describe the appearance of ribs 1 and 2

A

1 - shorter and wider with groove for subclavian artery. oonly 1 articular facet
2 - rough area for attachment of serratus anterior

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6
Q

What is the costal margin?

A

upside down V formed by cartilage of ribs 7 - 10

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7
Q

What is the direction of fibres of the external and internal intercostals?

A

external - anterior and inferior (hands in pocket)

internal - anterior and superior

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8
Q

What do the intercostal veins drain into?

A

azygous vein

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9
Q

what can be found in the superior mediastinum? What is its superior and inferior boundary

A

arch of aorta, trachea, oesophagus, SVC, phrenic nerve

Boundary - thoracic inlet to T4

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10
Q

What can be found in the anterior mediastinum?

A

thymus in kids, long thoracic artery and vein

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11
Q

Posterior mediastinum?

A

oesophagus, thoracic aorta, azygous vein, vagus nerve

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12
Q

What is the nitrogen washout used for and how does it owrk?

A

used to measure serial dead space.

forced expiration then inspire 100% o2 and measure n2 released in expiration

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13
Q

Is asthma obstructive or restrictive?

A

obstructive

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14
Q

what does helium dilution measure and how does it work?

A

measures residual volume. Helium doesnt enter blood, measure difference in conc.

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15
Q

What gas molecule is used to measure transfer conductance/

A

CO

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16
Q

How does haem buffering prevent fluctuations in pH?

A

increase in co2 results in addition of H+ to form HCO3

Decrease in co2 results in addition of water to form H+

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17
Q

what are the effects of acidosis and alkalosis?

A

acidosis - seizures, arrhythmia, vomiting

alkalosis - fainting, tetany

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18
Q

Where are the central chemoceptors found? How does blood pH affect the central chemoceptors?

A

medulla

co2 can enter but hco3 cant

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19
Q

what does chronic hypoxia result in?

A

pulmonary hypertension

20
Q

what are the symptoms of asthma?

A

polyphonic wheeze, SOB, dry cough, chest tightness

21
Q

how would you investigate asthma?

A

flow volume loop (obstructive) with a 12% increase in FEV with salbutamol, FENO (NO exhaled in inflammation)

22
Q

What are the symptoms of COPD?

A

hypercapnia (flapping), tachypnoea, accessory muscle usage

23
Q

what are the resp defences?

A

mucociliary escalator, cough and sneeze, macrophages, IgA and IgG

24
Q

how do you treat hospital and community acquired pneumonia?

A

hosp - co-amoxiclav

community - penicillin

25
Q

What are the common MOs that cause hosp and community pneumonia

A

hosp - MRSA, staph aureus, pseudomonas aeruginosia

community - strep pneumoniae, klebsiella pneumoniae, H.influenzae

26
Q

What are the symptoms of pneumonia?

A

productive cough, dyspnoea, inspiratory chest pain, vomiting, fever, dull percussion, wheezes crackles and bronchial breathing on auscultation

27
Q

How do you assess the severity of pneumonia?

A 
CURB 65
U - >7 mmol
R - >30
BP - less than 90/60
over 65
28
Q

How can bronchial breath sounds be pathological?

A

if heard outside of trachea, indicates consolidation.

29
Q

How does clavulinic acid work?

A

suicide inhibitor of beta lacatamase

30
Q

Outline the pathophysiology of TB

A

primary - subpleural granuloma with granulomatous hilar lymph node infection

31
Q

What is the host reponse to TB?

A

macrophase ingestion. TB escapes and multiplies in cytoplasm. granuloma forms.

32
Q

What are the symptoms of TB?

A

sputum, haemoptysis, fever, weight loss

33
Q

How do you treat TB?

A 
RIPE - RIPE for 2 months and then RI for another 4 months
Rifampicin
Isoniazide
Pirazinimide
Ethambutol
34
Q

What symptom suggests regional metastases of a lung cancer?

A

hoarsenss of voice

35
Q

What are the common lung cancer types/

A

squamous cell, adenocarcinoma, large cell, small cell

36
Q

what does pleural effusion look like on a CXR?

A

loss of costophrenic angles, meniscus

37
Q

What are the symptoms of ILS?

A

SOB, dry cough, tachypnoea, tachycardia, coarse crackles, cyanosis, RHF, restrictive

38
Q

What factors result in an increase in pleural fluid?

A

increased BP, increased permeability (infection or malignancy), decreased oncotic

39
Q

What factors results in decreaed reabsorption?

A

increased BP, lymph blockage

40
Q

define transudate

A

30g protein per litre or less

41
Q

What are the symptoms of PE?

A

SOB, chest pain on inspiration, cyanosis, tachycardia, haemoptysis

42
Q

How do you diagnose PE

A

d-dimer to exclude in those with low probability, CT pulmonary angiogram

43
Q

how do you treat PE?

A

heparin/warfarin

44
Q

What are the symptoms of pleurisy?

A

pleural rub, pain on inspiration, cough, sneeze, shoulder pain (referred)

45
Q

What is pleurisy caused by?

A

RA, SLE, infection, cancer, PE

PPE (18 decks)

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