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MED200 > Resp - Lecture > Flashcards

Resp - Lecture Flashcards

1
Q

What vaccines useful in preventing CAP

A

Influenza and Pneumococcal Vaccine

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2
Q

List some risk factors for CAP

A 
Age >50
Alcoholism
Asthma
COPD
Dementia
CHF
Immunosuppression 
Indigenous
Smoking 
Stroke
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3
Q

What do peripheral chemoreceptors respond to

A
  1. Oxygen (critical response PaO2 <60mmHg)
  2. Carbon Dioxide
  3. H+
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4
Q

What do central chemoreceptors respond to

A
  1. CO2

2. H+

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5
Q

Where are peripheral chemoreceptors located

A

Type 1 Glomus Cell In Carotid Bodies (CN9) and Aortic Bodies (CN10)

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6
Q

Where are central chemoreceptors located

A

Ventral Medulla

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7
Q

Give an example of a Schedule 2 (Pharmacy Medicine)

A

Aspirin, Paracetamol, Ibuprofen

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8
Q

Give an example of a Schedule 3 (Pharmacist Only)

A

Ventolin, Pseudoephedrine

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9
Q

Give an example of a Schedule 4 (Prescription Only)

A

BZD, SSRI, Retenoids

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10
Q

Give an example of a Schedule 5 (Caution)

A

Phenergan, Lomotil

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11
Q

Give an example of a Schedule 8 (Controlled Drug)

A

Morphine

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12
Q

List some key features of mucosal immunity

A 
Mucus
IgA
MALT
Microbiota
Tolerance
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13
Q

What is the difference in Ig between Mucosal vs Systemic Immunoglobulins

A 
Mucosal = 80% IgA
Systemic = 52 % IgG, 30% IgA
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14
Q

Where is IgA1 Predominantly

A
  1. Nasal Mucosa
  2. Respiratory Tract
  3. Lacrimal Gland
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15
Q

What Interleukins are important for differentiating B cells to Plasma Cells

A

IL-5 and IL-6 (From Th2)

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16
Q

What are important mediators of immune regulation

A

IL-10 and TGF-beta

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17
Q

The mucosal immune system is made up of EPITHELIUM and LAMINA PROPRIA, give examples of the cell types of each

A 
E = M cells, Goblet Cells
LP = IgA, CD4/8, Macrophage, Mast, Plasma Cells
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18
Q

What components are important in an occupational history

A
  1. Age
  2. Occupation - title and role
  3. Exposure - FUMES/DUST/CHEMICALS
  4. Years
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19
Q

List 3 complications of Asbestosis

A
  1. Pleural Plaque
  2. Lung Cancer
  3. Mesothelioma
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20
Q

List come complications of Crystalline Silica (SiO2) Inhalation

A
  1. Acute/Chronic Silicosis
  2. Lung Cancer
  3. Industrial Bronchitis
  4. TB
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21
Q

List complications of Coal Inhalation

A
  1. Coal Worker Pneumoconiosis
  2. Bronchitis
  3. Airflow Obstruction
22
Q

List some bacterial causes of CAP

A 
Streptococcus pneumoniae
Haemophilus influenzae 
Staphylococcus aureus (post influenza)
Moraxella catarrhalis 
Anaerobes (aspiration)
Mycoplasma pneumoniae 
Legionella
23
Q

List some viral causes of CAP

A

Influenza A and B
RSV
Rhinovirus
Adenovirus Type 4 and 7

24
Q

List some fungal causes of CAP

A

Aspergillus

Pneumocystis jirovecii

25
Q

How can you differentiate bronchitis vs pneumonia on a CXR

A

Pneumonia = consolidation on CXR (not in bronchitis)

26
Q

What contextual features are important in a ?pneumonia history

A
  1. CAP vs Nosocomial
  2. Immunocompromised vs competent
  3. Travel +/- Endemics
27
Q

Patient query CAP has recently travelled to the tropics. What microbiology are of interest

A

Meliodosis

Acinetobacter

28
Q

Patient query CAP who owns an aviary (birds). What microbiology are of interest

A

Chlamydia psittaci

29
Q

Patient query CAP works in an abbatoir. What microbiology are of interest

A

Coxiella burnetti

30
Q

Patient query CAP works as a gardner. What microbiology are of interest

A

Legionella

31
Q

Patient query CAP is an alcoholic. What microbiology are of interest

A

S.pneumoniae
Klebsiella
Anaerobes
Acinetobacter

32
Q

What is the antibiotic treatment for pneumococcus pneumonia

A

Beta-Lactam (AMOXYCILLIN)

33
Q

What is the antibiotic treatment for atypical pneumonia (legionella, mycoplasma, chlamydia)

A

Macrolide (ROXITHROMYCIN)

34
Q

What is the antiobiotic treatment for nosocomial pneumonia

A

Extended Spectrum Beta-Lactamase

3rd Gen Cephalosporin

35
Q

What are some DDx for pneumonia that has poor treatment response

A 
Obstruction
Abscess
Parapneumonic Effusion
Empyema 
Drug Fever
Not Pneumonia
36
Q

What are important investigations in Pneumonia

A 
Sputum Culture and PCR
Oropharyngeal Swab
Blood Culture Sets
Serology 
CXR
37
Q

What microbiology are of interest in immunocompromised CAP

A

S.pneumoniae
Mycoplasma
Legionella

38
Q

What microbiology are of interest in decreased lymphocyte CAP

A

Pneumocystis jirovecci
TB
CMV

39
Q

What does a failure of oxygenation cause

A

Hypoxia

40
Q

What does a failure of ventilation cause

A

Hypercapnia

41
Q

What level of PaO2 defines respiratory failure

A

<55

<60 in organ failure/damage

42
Q

What defines Type 2 Respiratory Failure

A

PaO2 <55 mmHg

PaCO2 >45 mmHg

43
Q

What pH and bi-carb would suggest ACUTE T2RF

A

pH <7.35 (acidosis)

Normal HCO3- (no compensation)

44
Q

What bi-carb would suggest ACUTE on CHRONIC T2RF

A

HCO3- >28 (renal alkalosis compensation - with acidosis)

45
Q

What pH and bi-carb would suggest CHRONIC T2RF

A

Normal pH

Bi-Carb >28 (fully compensated)

46
Q

What is oxygenation

A

Uptake of oxygen by Hb

47
Q

What is ventilation

A

Removal of CO2 from blood

48
Q

What are 5 mechanisms of HYPOXAEMIA

A
  1. Impair diffusion (ILD, Pulm edema)
  2. V/Q Mismatch
  3. Hypoventilation
  4. R to L Shunt
  5. Reduced FiO2 (High Altitude)
49
Q

What are 2 mechanisms of HYPERCAPNIA

A
  1. Hypoventilation

2. V/Q Mismatch

50
Q

What is a DDx for the ACUTE SOB patient

A

RESP (PE, pneumothorax, obstruction, effusion)
CARDIO (AMI, Tamponade, ACPO, CHF, Arrhythmia)
INF (Sepsis/Bacteraemia)
SHOCK (haemorrhage, anaphylaxis, obstructive)

51
Q

What are important acute investigations in the SOB patient

A

CXR
ABG
ECG
BLOOD (FBP. Glucose)

MED200 (9 decks)

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