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Misc. Notes Year 1 > RESP RECAP > Flashcards

RESP RECAP Flashcards

1
Q

Can a LABA (e.g. salmeterol) be used as mono-therapy

A

No

Has to be in a combination inhaler with ICS

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2
Q

Which enzyme does theophylline allegedly activate

A

histone deacetylase

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3
Q

What 2 classes of substances does the adrenal cortex produce

A

Glucocorticoids

Mineralocorticoids

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4
Q

What part of the adrenal cortex are Mineralocorticoids released from

A

Zona Glomerulosa

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5
Q

What part of the adrenal cortex are Glucocorticoids released from

A

Zona Fasciculata

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6
Q

Which genes do glucocorticoids affect and how

A

Increase transcription of genes encoding anti-inflammatory proteins
Decrease transcription of genes encoding inflammatory proteins

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7
Q

What are the major muscles of inspiration

A

External intercostal

Diaphragm

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8
Q

What are the muscles of active expiration

A

Internal intercostal

Abdominal muscles

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9
Q

What are the accessory muscles of inspiration

A

Sternocleidomastoid

Scalenus

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10
Q

What is the asthma triad

A

Airway Hyper-responsiveness
Airway inflammation
Reversible airflow obstruction

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11
Q

What is the pneumonic for causes of pulmonary fibrosis

A 
BREAST I 
Bleomycin 
Radiation 
Extrinsic Allergic Alveolitis (EAA)
Asbestosis/ Ankylosing Spondylitis 
Sarcoidosis
TB 
Idiopathic
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12
Q

What are the 2 fibrogenic DPLD’s (diffuse parenchymal lung disease)

A

Asbestosis

Silicosis

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13
Q

What are the 3 non-fibrogenic DPLD’s (diffuse parenchymal lung disease)

A

Baritosis (barium)
Siderosis (Iron)
Stanosis (Tin)

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14
Q

What are the treatments for DPLD

A

PO Prednisolone
PO azathioprine
Anti-fibrotic (Pirfenidone)
Anti-oxidant (Acetylcysteine)

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15
Q

What is the neural sequence for normal breathing

A

Pre-Botzinger complex excites dorsal neurones
Dorsal neurones fire in bursts
Firing = Contraction of diaphragm + External intercostal
Firing stops = Passive expiration

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16
Q

What is the neural sequence for active expiration

A

Increased firing of Dorsal neurones excites Ventral neurones
Ventral firing = contraction of internal intercostal and abdominal muscles

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17
Q

What part of the brain is respiratory rhythm established in

A

Medulla

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18
Q

Where can the rhythm established in the medulla be modified from

A

Pons

More specifically the pneumotaxic centre

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19
Q

What does stimulation of the Pneumotaxic Centre (PC) cause

A

Termination of inspiration

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20
Q

When is the Pneumotaxic Centre (PC) stimulated to fire

A

When dorsal neurones fire

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21
Q

What is breathing like when the Pneumotaxic Centre (PC) is not active

A

Prolonged inspiration with brief expiration

Apneusis

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22
Q

Name 5 adaptations the body makes in response to chronic altitude hypoxia

A

Increased RBC production (polycythaemia)
Increased 2,3 DPG (easier to offload O2)
Increased number of capillaries
Increased number of mitochondria
Kidneys conserve acid -> decreased arterial pH

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23
Q

Which muscarinic receptor causes inhibition of Ach release

A

M2

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24
Q

Which muscarinic receptors does Ipratropium block

A

M1, M2, M3 (non-selective)

25
Which muscarinic receptors does Tiotropium block
M3 selective
26
Why is Tiotropium favourable to Ipratropium | asides from the fact that it is longer acting
It is M3 selective whereas Ipratropium blocks M1 and M2 also Blocking of M2 is not desirable since it actually inhibits Ach transmission i.e decreased muscle contraction
27
What are the 3 types of Rhinitis
Allergic Non-Allergic Mixed
28
What are the 3 types of Allergic Rhinitis
Episodic, Seasonal (SAR) and Perennial (PAR)
29
What can cause onset of Non-Allergic Rhinitis
``` Infection Hormonal imbalance Vasomotor disturbance NARES (Non-Allergic Rhinitis with Eosinophilia Syndrome) Drug induced ```
30
What type of Rhinitis is linked to occupation
Mixed (Allergic & Non-Allergic)
31
What are the 4 aspects of rhinitis treatment
Anti-inflammatory Mediator receptor blockers Decreasing Nasal Blood flow Anti-Allergic
32
Name the class of drug given as anti-inflammatory, method of administration and types of rhinitis used in
Glucocorticoids Nasal Spray or Oral (Prednisolone) Useful in SAR and PAR
33
Name the class of drugs given as mediator receptor blockers, method of administration and types of rhinitis used in
H1 receptor antagonists (block mast cell histamine) SAR, PAR and episodic Can be oral (Fexofenadine) or nasal (Azelastine) CysLT1 receptor antagonists PAR and SAR Oral only - Montelukast
34
What is the aim of giving vasoconstrictors in rhinitis
To decrease nasal blood flow
35
Give an example of a vasoconstrictor given in rhinitis and its method of administration
Oxymetazoline (a-1 selective agonist) | Given intranasally for allergic rhinitis)
36
Why should vasoconstrictors not be given for long periods of time in rhinitis
When stopped can lead to rebound congestion | known as Rhinitis Medicamentosa
37
What is the anti-allergic drug given in allergic rhinitis and how does it work
Sodium Cromoglicate (cromone) Mast cell stabiliser Given nasally
38
Which Muscarinic receptor antagonist can be given in SAR and PAR to prevent Rhinorrhoea
Ipratropium | Given nasally
39
What is the treatment for atypical community-acquired pneumonia (E.g. Mycoplasma, Coxiella and Chlamydia)
Tetracycline + Macrolides
40
What is the causative organism of Q fever
Coxiella Burnetti
41
What is the location of the lesion in primary TB
BUZZWORD - Ghon focus | Mid zone of lung
42
Where is the lesion found in secondary TB
BUZZWORD - Assmann focus | Apical cavitating lesion
43
What are the 3 possible treatments for empyema
Drainage IV broad spectrum antibiotics Oral culture specific antibiotics (Takes 14days)
44
What is the treatment for croup (viral laryngotracheobronchitis )
Oral steroid (Prednisolone)
45
What is the investigation for a DVT
Ultrasound Doppler leg scan
46
What is the name of the ECG phenomenon rarely seen in a patient with a P.E
S1Q3T3
47
What is Virchow's triad
Hypercoagulability (Post-MI, Cancer) Endothelial Damage Circulatory Stasis
48
What are the possible causes of a transudate effusion
Cardiac failure | Hypoproteinemia
49
What are the possible causes of an exudate effusion
Cancer, Pneumonia, TB, Connective tissue disease
50
What is stridor and what causes it
A predominantly inspiratory wheeze usually due to a large airway obstruction
51
What is the treatment for anaphylaxis
``` IM Adrenaline IV Corticosteroid IV Anti-histamine Nebulized bronchodilators High flow O2 ```
52
What is the maximum score on the Epworth sleepiness scale and what is a normal score
Max score is 24 | Normal score is <10
53
What are the consequences of Obstructive Sleep Apnoea
Excessive daytime sleepiness Personality change Cognitive impairment Daytime function decreased
54
How is Obstructive Sleep Apnoea diagnosed
Epworth Sleepiness scale (score >10) | Polysomnography
55
What is the treatment of Obstructive Sleep Apnoea
CPAP | Continuous Positive Airway Pressure
56
What does MLCK stand for
Myosin Light Chain Kinase
57
What happens to MLC to cause muscle contraction and what must be present
MLC is phosphorylated in the presence of elevated intracellular Ca and ATP
58
How is muscle relaxation brought about
Dephosphorylation of MLC by myosin phosphatase
59
In the presence of elevated intracellular Ca will phosphorylation exceed dephosphorylation or vice versa
In the presence of intracellular Ca, the rate of MLC phosphorylation will exceed the rate of MLC dephosphorylation

Misc. Notes Year 1 (13 decks)

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