Respiratory Flashcards
Alpha-1 Antitrypsin does what?
reduces tissue damage caused by inflammation through the inhibition of neutrophil elastase.
What is seen histologically in a1antitrypsin deficiency?
red/[ink PAS positive granules in periportal hepatocytes.
What 2 organ systems are affected by a1 antitrypsin deficiency? and how are they affected.
Liver- FIRST. accumulation of A1AT molecules => cirrohsis, hepatocellular carcinoma
LUNGS- destruction of alveolar walls, large amounts of elastin, by tissue damaging enzyemes. => panacinar emphysema
What occurs in the lung when hypoxemia occurs in an underventilated area?
Why is this?
vasoconstriction occurs in the small muscular pulmonary arteries
diverts blood flow from underventilated area toward more well-ventilated areas
Where is the lowest pulmonary vascular resistance located on Lung volumes graph?
functional residual capacity (FRC) because here the
lung is maximally compliant,
intrathoracic and atmosphere pressures equal,
allveoli do not eert pressure on vasculature
2-4 weeks after initial TB infection what pathenogenesis occurs?
interferon secrtion by activated Tcells leads to M0 activation =>
M0 form epithelioid cells and improves their ability to kill intracellular TB
Characteristic of VIRULENT mycobacterial strains?
growth of thick ropelike cords of MB in serpentine = presence of cord factor (virulence factor):
inactivates neutrophils, magages mitochondria, induce rls of TNF
In the pathogenesis of Center acinar emphysema proteases such as elastase early strong which to type of cells?
Infiltrating neutrophils
alveoli macrophages
DOC theophylline induced cardiac tachycardias?
Morbid SE of Theophyline?
B-blockers
Siezures
What physiologic change in alveolar ventilation causes hypocapnia?
What directly indicates this change?
hyperventlation
arterial PaCO2
Cheyne-Strokes Respiration description:
When are they seen?
cyclic breathing-> increasing tidal vol, then decr. tidal volume. with intermittent apnea
CHF
Kussmal breathing is associated with what disease and what metabolic state?
DKA
Metabolic Acidosis
3 main descriptions of Cluster headaches +3 others
unilateral, severe episodic, temporal
ptosis, lacrimation, nasal congestion
HIV DRUGS: Fusion Inhibitors Protease Inhibitors Reverse transcriptase inhibitors Integrase Inhibitors CCR5 Receptor Inhibitors
F-Enfuviritide P-saquinivir, ritonavir RTi-tenofivir, lamovudine, efavirinez I-Raltegravir CCR5-maraviroc
defective enzymes in orotic aciduria
Presentation (4)
Treatment
Oroate phosphoribyl transferase, OMP decarboxylase
Megaloblastic anemia, neuro abnormalities, growth retardation, orotic acid in urine
Uridine
Proto Oncogenes 6
ras N-myc ERB-B1/2 TGF sis abl
Tumor Suppressors 7
BRCA1/2 NF1 APC DCC p53 RB WT1
RESPITORY INFXN:Virus nasopharyngitis/commoncold: Larygeotracheitis/croup: Epiglottitis: Bronchiolitis:
N-Rhino/Inflluenza/Corona
L-Parainfluenza virus
E-Haemophilus Influenza
B-RSV-respiratory syncitial virus
Virion protein: host cell receptor
HIVgp120:
EBV gp350:
Parvovirus B19
CD4
CD21
Erythrocyte P antigen
Pulmonary lungs chart: what does COPD increase?
RV
NonNucleoside Reverse Transcriptase inhibitors-name3
Nevirapine
efavirenz
delavirdine
What enzyme is necessary for NRTI’s to fxn? name 2
zidovudine
Zalcitabine
thymidine kinase
Common problems associated with left ventricular infarct (4)
Left ventricular failure
Cardiogenic acute pulmonary edema
Pulmonary venous hypertension
Transudate of Plasma into lung intersitium/alveoli
Where should you perform thoracocentesis?
Midclavicular
Midaxillary
Posterior scapular line
MC- Above 7th Rib
MA- Above 9th Rib
PS- Above 11th Rib
