Respiratory

Question 1

Hypoxemia is

Answer 1

Decreased o2 content in the areterial blood normal values 80-100mmhg

Question 2

Hypercapnia is

Answer 2

Increased co2 (paCO2) in the blood 35-45mmHg

Question 3

Hypoxia is

Answer 3

Decreased cellular and tissue oxygenation affecting pH - normal pH is 7.35-7.45

Question 4

Sa02 is

Answer 4

Bound by Hb apparent on ABG values

Question 5

Sp02 is

Answer 5

Pulse oximetry, Hb bound oxygen

Question 6

Pa02 is

Answer 6

Amount of oxygen in the blood

Question 7

Factors affecting gas exchange

Answer 7

Decreased surface area, thickened resp membrane, solubility of gas, rate of diffusion, pressure gradient between the membranes

Question 8

Smooth muscle regulates

Answer 8

Diameter of the airways and is lined with ciliated epithelium, cilia beat continuously to move mucus out of the lungs.

Question 9

Epithelium is

Answer 9

Lined with goblet cells and traps inhaled particles

Question 10

Shunting of the alveoli is

Answer 10

Obstructed alveolus, no ventilation e.g mucus plug

Question 11

Dead space of the alveolus

Answer 11

Blood flow obstruction, adequate ventilation often with pulmonary embolism

Question 12

Protective hypoxic vasoconstriction

Answer 12

Under ventilated lung leads to local vasoconstriction to limit blood flow to affected lung tissue and divert blood to a well ventilated area to continue removal of C02. O2 therapy can cause constricted capillaries to dilate increasing C02 content rapidly and cause pulmonary HTN

Question 13

Hakdane effect

Answer 13

More desaturated the Hb, the more c02 it carries

Question 14

Pulmonary oedema is

Answer 14

Hydrostatic fluid is greater than the oncotic pressure = excess lung fluid. Obstructed lymph drainage, blood circulation not moving correctly (LV failure/HTN/AMI/ drugs/ noxious gas inhalation.

Question 15

Treatment of PO

Answer 15

Diuretics to increase fluid excretion,
Vasodilators (GTN) donates nitric oxide increases smooth muscle cGMP
Inotropic agonist - increase HR to improve contractions
02 therapy
Mechanical ventilation - CPAP

Question 16

Atelectasis is

Answer 16

Collapse lung due to compression in pleural space or Tumor or absorption (inhaled conc 02 or noxious gas)

Question 17

Acute resp distress syndrome

Answer 17

Huge inflammatory response causing damage to the capillary membrane allowing fluid to leak into the alveoli. Common cause is sepsis

Question 18

Asthma

Answer 18

Chronic inflammation causing narrowing of the airways

Question 19

Asthma is

Answer 19

Often initiated by environmental triggers (extrinsic atopic) leading to dendritic cells presenting the invading toxin to type 2 helper cells (TH2 immune cell subtype) which proliferate against specific allergens by producing cytokines like IL4 = IgE = mast cells leukotrines, prostaglandins and histamines. IL5 = eosinophils = more cytokines and leukotrienes = type 1 hypersensitivity because of IgE

Question 20

Emphysema can be triggered by

Answer 20

alpha 1 anti-trypsin deficiency which can be caused by smoking

Question 21

O2 diffusion from alveolus to capillaries occurs because

Answer 21

the PaO2 is less in the capillary than the alveolus - diffusion occurs from a high concentration to a low concentration

Question 22

Bronchospasm

Answer 22

spreads along an airway, indicates chronic disease

Question 23

Chronic athsma is identified by

Answer 23

chronic airway remodelling, mucus plugs (hypertrophy of mucus glands) leading to a build up of scar tissue

Question 24

parasympathetic division of the ANS causes

Answer 24

bronchoconstriction

Question 25

Classic signs of pneumonia are

Answer 25

Crackles, dullness to percussion due to lung consolidation (fluid), tactile fremitus (vibration of chest when breathing), sharp lung pain, dyspnoea, fatigue, fever, productive cough with yellow sputum (dead neutrophils as pus)

Question 26

Prednisolone MOA

Answer 26

Corticosteroid that has anti-inflammatory and immunosuppressive mechanisms by decreasing vasodilation and capillary permeability in addition to decreasing leukocyte migration to the area of inflammation

Question 27

Salmeterol is and MOA

Answer 27

LABA - bronchodilator that stimulates beta 2 actions and therefore cause bronchodilator and increased airflow.