Respiratory

Question 1

CYP450 Inducers

Answer 1

Alcohol (chronic use)
Barbiturates
Carbamazepine
Griseofulvin
Modafinil
Phenytoin
Rifampin
St. Johns wort

Question 2

CYP450 Inhibitors

Answer 2

Alcohol (acute use)
Amiodarone
Azoles(fluconazole)
Cimetidine
Diltiazem, verapamil
grapefruit juice
Isoniazin, macrolides, quinolones
protease inhibitors (ritonavir)
SSRI’s (fluoxetine)

Question 3

What drugs are commonly effected by CYP450

Answer 3

Antiepileptics
theophylline
warfarin

Question 4

What senses hypercapnia

Answer 4

Central Chemoreceptors

Question 5

What senses hypoxemia

Answer 5

Carotid and aortic bodies

Question 6

Respiratory drive in COPD patient

Answer 6

Normally resp drive is d/t CO2, but COPD patients become sensitized to elevated CO2, so hypoxia serves to stimulate respiratory drive

Question 7

Causes of acute COPD exacerbation

Answer 7

Infectious (70%)
Viral: rhinovirus, influenza, RSV
Bacterial: H. Influenza, Moraxella catarrhlis, step pneumoniae
Noninfectious (30%)

Question 8

Abnormal oxygen metabolism in sepsis

Answer 8

Decreased global o2 delivery
Decreased microcirculatory o2 extraction
Decreased mitochondrial o2 use

Question 9

Decreased global o2 delivery

Answer 9

Hypovolemia: Decreased ECBV (capillary leak)
Hypoxemia: Decreased PaO2 (ARDS)

Question 10

Decreased microcirculatory o2 extraction

Answer 10

Shunt blood through organs
Edema: Decrease o2 diffusion
Microthrombosis: capillary obstruction

Question 11

Decreased mitochondrial o2 use

Answer 11

ROS->mitochondrial damage and decreased ETC function
->
Decreased oxidative phosporylation and decreased ATP production

Question 12

What are the causes of pleural effusion

Answer 12

↑Hydrostatic pressure Gradient (Heart failure)
↑vascular permeability (infection)
Lymphatic obstruction (pleural malignancy)
↓oncotic pressure (nephrotic)

Question 13

What is silicosis

Answer 13

nodular densities on x-ray
calcified hilar lymph nodes
birefringent particles on biopsy
whorled collagenous nodules

Question 14

What is asbestosis

Answer 14

ferruginous bodies with fusiform rods

Question 15

What is Varenicline

Answer 15

Partial agnoist of nicotinic ach receptor
Reduces symptoms of nicotine withdrawal

Question 16

Strep pneumo virulence

Answer 16

polysaccharide capsule
encases organism and prevents phagocytosis and complement binding

Question 17

Cryptococcus neoformans

Answer 17

budding yeast, thick capsules, stain with mucicarmine
immunocompromised pts.
Soil and pigeon droppings

Question 18

Cryptococcus causes

Answer 18

meningoencephalitis
after disseminating from lungs

Question 19

What is bosentan

Answer 19

endothelin receptor antagonist
(endothelin->vasoconstrictor)
↓pulmonary arterial pressure
use in pulmonary HTN