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Weaker + unknown topics from qs > Respiratory > Flashcards

Respiratory Flashcards

1
Q

What does it mean if am entire bronchopulmonary segment or lobe becomes ‘consolidated’?

A

The tissue is filled with inflammatory cells and oedema

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2
Q

What are the components of the CURB-65 score and what is it used for?

A
  • The CURB-65 score aids in deciding the severity of pneumonia and further management based on this

Components (1 point for each if present):
- Confusion +/-
- Urea >7
- Respiratory Rate >30
- Blood pressure: systolic < 90 or diastolic <60
- More than 65 years old

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3
Q

How is a CURB-65 score of 0/1 managed?

A
  • Home-based care
  • Oral amoxicillin for 5 days (macrolide e.g. clarithromycin, doxycycline or tetracycline if penicillin allergic)
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4
Q

How is a CURB-65 score of 2 managed?

A
  • Hospital-based care
  • 7-10 day course of dual antibiotic therapy with amoxicillin (IV or oral) and a macrolide
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5
Q

How is a CURB-65 score of 3 managed?

A
  • Hospital / ITU-based care
  • 7-10 day course of dual antibiotic therapy with IV co-amoxiclav / ceftriaxone / tazocin and a macrolide
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6
Q

What is the definition of hospital acquired pneumonia (HAP)?

A

Lower respiratory tract infection that develops more than 48 hours after admission to hospital

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7
Q

What is the definition of pneumonia?

A
  • Lower Respiratory Tract Infection / Pneumonia is caused by infection and subsequent inflammation of the alveoli and terminal bronchioles.
  • This leads to an entire bronchopulmonary segment or lobe becoming consolidated, which means that tissue is filled with inflammatory cells and oedema.
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8
Q

In obstructive lung disease, FEV1 would be less than what percentage?

A

Less than 80%

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9
Q

What kind of molecule is surfactant?

A

Phospholipid

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10
Q

What are the effects of surfactant?

A
  • Minimises alveolar surface tension
  • Improves compliance
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11
Q

Lung compliance is _____ during inspiration as the rate of expansion of alveolar surface area is _____ than the rate of secretion of surfactant during inspiration, hence the alveolar surface tension remains _____ and the compliance _____.

A

smaller, higher, high, low

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12
Q

During expiration, the _____ volume of surfactant relative to the shrinking of alveoli _____ the surface tension and _____ compliance.

A

higher, reduces, improves

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13
Q

What is the effect of tension pneumothorax on lung compliance and why?

A

Lung compliance decreases as the intrapleural pressure becomes greater than the atmospheric pressure

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14
Q

What is the effect of parasympathetic innervation on muscarinic receptors on the airways?

A

Bronchoconstriction

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15
Q

The lungs mainly contain what kind of beta adrenoceptor to dilate the bronchioles?

A

Beta 2 adrenoceptors

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16
Q

Cough in ACE inhibitors occurs by what mechanism?

A

Bradykinin accumulation

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17
Q

What is Poiseuille’s law?

A

Poiseuille’s law states that as the radius of an airway decreases, the resistance of the airway increases exponentially by its power of 4.

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18
Q

What feature of respiratory bronchioles and alveolar ducts allows for dispersion of total airway resistance?

A

Parallel arrangement

19
Q

In chronic hypercapnia, chemoreceptors in the _____ bodies detect _____ oxygen in the blood and send signals via _____ nerves to the _____ respiratory group. Motor output is sent via the _____ nerve to stimulate contraction of the _____ and _____ respiratory rate.

A

carotid, low, cranial, dorsal, phrenic, diaphragm, increase

20
Q

What is the cardiac synctium?

A

The cardiac syncytium is defined as individual cardiomyocytes that are connected by intercalated discs (groups of cell junctions) to work together as a single functional organ. This allows for synchronised cardiac tissue contraction as the electrical signal is propagated.

21
Q

What is the equation for alveolar ventilation?

A

This is calculated as VA = (Vt –Vd) x RR where:

VA = Alveolar ventilation (L/min)
Vt = Tidal volume (L)
Vd = Dead space (L)
RR = Respiratory rate (/min)

22
Q

What is bird fanciers’ lung caused by?

A

Avian proteins

23
Q

What are side effects of b2 adrenoceptor agonists?

A
  • Lactic acidosis - b2-adrenoceptor agonists such as salbutamol cause glycogen to break down into lactic acid in muscle, causing lactic acidosis
  • Tremor
24
Q

Oropharyngeal candidiasis can occur as an unwanted effect of what drug class?

A

Inhaled glucocorticoids due to immunosuppressive actions of this group of agents - A proportion of the inhaled dose of glucocorticoids often can inadvertently come into contact with the oral mucosa, leading to inhibition of the action of T lymphocytes which are important in protection against fungal infections such as candidiasis.

25
Q

What is the mechanism of action of montelukast?

A

Leukotriene receptor antagonist (LTRA) - Montelukast blocks the action of leukotriene D4 in the lungs causing a decrease in inflammation and relaxation of airway smooth muscle

26
Q

Omalizumab is a humanised monoclonal antibody directed towards another antibody involved in the pathophysiology of asthma. Which antibody is it directed toward?

A

IgE

27
Q

What is the mechanism of action of theophylline?

A

Inhibits phosphodiesterase and blocks adenosine receptors which ultimately leads to smooth muscle relaxation

28
Q

What is an example of a b2-adrenoceptor agonist?

A

Salbutamol

29
Q

What type of drug is ipratropium bromide?

A

Short-acting muscarinic antagonist (SAMA) - blocks parasympathetic activity in the lungs, resulting in bronchodilation

30
Q

What are side effects of ipratropium bromide?

A

Brain: drowsiness, dizziness, confusion, hallucinations
Eyes: blurred vision, dry eyes
Mouth: dry mouth
Heart: tachycardia
Bowel: constipation
Bladder: urinary retention
Skin: inability to sweat, overheating

31
Q

What can be given to treat theophylline toxicity?

A

Activated charcoal

32
Q

Surfactant production begins around which week of development?

A

Week 22

33
Q

Lung cancer can present with ipsilateral elevation of the hemidiaphragm due to compression of what nerve?

A

Phrenic nerve

34
Q

What anatomical defect is associated with male infertility in cystic fibrosis?

A

Absent vas deferens (sperm duct)

35
Q

How is cystic fibrosis diagnosed?

A

Chloride sweat test

36
Q

Where are peripheral chemoreceptors located and what is their function?

A
  • Located in the bifurcation of carotid arteries and arch of the aorta
  • They respond to changes in reduced pO2, increased H+ and increased pCO2 in arterial blood
37
Q

Where are central chemoreceptors located and what is their function?

A
  • Located in the medulla
  • Respond to increased H+ in brain interstitial fluid to increase ventilation
  • NB the central receptors are NOT influenced by O2 levels
38
Q

What are some features of sarcoidosis?

A
  • Erythematous lesions
  • Bilateral hilar lymphadenopathy on chest x-ray
  • Raised serum ACE
39
Q

What is a normal tidal volume for males and females?

A
  • Males - 500ml
  • Females - 350ml
40
Q

Which area of the brain stem coordinates the basic rhythm of breathing?

A

Medulla oblongata

41
Q

What are features of lung collapse?

A
  • Trachea deviates to the affected side
  • Dull percussion
  • Reduced breath sounds
42
Q

What is the definition of expiratory reserve volume?

A

The maximum volume of air that can be expired at the end of a normal tidal expiration

43
Q

Foetal haemoglobin’s oxygen dissociation curve lies to the _____ of adult haemoglobin, haemoglobin A. This allows maternal haemoglobin to preferentially offload oxygen to the foetus across the placenta, as foetal haemoglobin has a _____ _____.

A

left, higher affinity

44
Q

What are features of a pneumothorax?

A
  • Diminished breath sounds
  • Hyper-resonant chest, ipsilateral to the pain

Weaker + unknown topics from qs (3 decks)

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