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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
Q

Which muscarinic receptors does Tiotropium block

A

M3 selective

26
Q

Why is Tiotropium favourable to Ipratropium

asides from the fact that it is longer acting

A

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
Q

What are the 3 types of Rhinitis

A

Allergic
Non-Allergic
Mixed

28
Q

What are the 3 types of Allergic Rhinitis

A

Episodic, Seasonal (SAR) and Perennial (PAR)

29
Q

What can cause onset of Non-Allergic Rhinitis

A 
Infection 
Hormonal imbalance 
Vasomotor disturbance 
NARES (Non-Allergic Rhinitis with Eosinophilia Syndrome)
Drug induced
30
Q

What type of Rhinitis is linked to occupation

A

Mixed (Allergic & Non-Allergic)

31
Q

What are the 4 aspects of rhinitis treatment

A

Anti-inflammatory
Mediator receptor blockers
Decreasing Nasal Blood flow
Anti-Allergic

32
Q

Name the class of drug given as anti-inflammatory, method of administration and types of rhinitis used in

A

Glucocorticoids
Nasal Spray or Oral (Prednisolone)
Useful in SAR and PAR

33
Q

Name the class of drugs given as mediator receptor blockers, method of administration and types of rhinitis used in

A

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
Q

What is the aim of giving vasoconstrictors in rhinitis

A

To decrease nasal blood flow

35
Q

Give an example of a vasoconstrictor given in rhinitis and its method of administration

A

Oxymetazoline (a-1 selective agonist)

Given intranasally for allergic rhinitis)

36
Q

Why should vasoconstrictors not be given for long periods of time in rhinitis

A

When stopped can lead to rebound congestion

known as Rhinitis Medicamentosa

37
Q

What is the anti-allergic drug given in allergic rhinitis and how does it work

A

Sodium Cromoglicate (cromone)
Mast cell stabiliser
Given nasally

38
Q

Which Muscarinic receptor antagonist can be given in SAR and PAR to prevent Rhinorrhoea

A

Ipratropium

Given nasally

39
Q

What is the treatment for atypical community-acquired pneumonia (E.g. Mycoplasma, Coxiella and Chlamydia)

A

Tetracycline + Macrolides

40
Q

What is the causative organism of Q fever

A

Coxiella Burnetti

41
Q

What is the location of the lesion in primary TB

A

BUZZWORD - Ghon focus

Mid zone of lung

42
Q

Where is the lesion found in secondary TB

A

BUZZWORD - Assmann focus

Apical cavitating lesion

43
Q

What are the 3 possible treatments for empyema

A

Drainage
IV broad spectrum antibiotics
Oral culture specific antibiotics (Takes 14days)

44
Q

What is the treatment for croup (viral laryngotracheobronchitis )

A

Oral steroid (Prednisolone)

45
Q

What is the investigation for a DVT

A

Ultrasound Doppler leg scan

46
Q

What is the name of the ECG phenomenon rarely seen in a patient with a P.E

A

S1Q3T3

47
Q

What is Virchow’s triad

A

Hypercoagulability (Post-MI, Cancer)
Endothelial Damage
Circulatory Stasis

48
Q

What are the possible causes of a transudate effusion

A

Cardiac failure

Hypoproteinemia

49
Q

What are the possible causes of an exudate effusion

A

Cancer, Pneumonia, TB, Connective tissue disease

50
Q

What is stridor and what causes it

A

A predominantly inspiratory wheeze usually due to a large airway obstruction

51
Q

What is the treatment for anaphylaxis

A 
IM Adrenaline 
IV Corticosteroid 
IV Anti-histamine 
Nebulized bronchodilators 
High flow O2
52
Q

What is the maximum score on the Epworth sleepiness scale and what is a normal score

A

Max score is 24

Normal score is <10

53
Q

What are the consequences of Obstructive Sleep Apnoea

A

Excessive daytime sleepiness
Personality change
Cognitive impairment
Daytime function decreased

54
Q

How is Obstructive Sleep Apnoea diagnosed

A

Epworth Sleepiness scale (score >10)

Polysomnography

55
Q

What is the treatment of Obstructive Sleep Apnoea

A

CPAP

Continuous Positive Airway Pressure

56
Q

What does MLCK stand for

A

Myosin Light Chain Kinase

57
Q

What happens to MLC to cause muscle contraction and what must be present

A

MLC is phosphorylated in the presence of elevated intracellular Ca and ATP

58
Q

How is muscle relaxation brought about

A

Dephosphorylation of MLC by myosin phosphatase

59
Q

In the presence of elevated intracellular Ca will phosphorylation exceed dephosphorylation or vice versa

A

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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