Respiratory Flashcards
At what vertebral level does the trachea begin?
C6
What is a typical tidal volume?
500 ml
What is a typical residual volume?
1200ml
If the lung is full of fluid, how will vocal resonance sound?
Louder
What is the majority of acute epiglottitis caused by?
Haemohpilus influenzae Type B
What do we call pus in the pleural space?
Empyema
HIgh pH and normal PaCO2 = what?
Metabolic alkalosis
Give a 2 word definition of asthma
Reversible bronchoconstriction
There is chemotaxis of which cell type in the delayed phase of asthma?
Mast cells
Lymphocytes
Eosinophils
Macrophages
Basophils
What is a Ghon’s complex comprised of?
Gohn focus + lymphadenopathy
Which lobe does secondary TB typically affect?
Upper lobe
What is Potts disease?
Single organ TB of the spine
What level must PaO2 drop below before it has an effect on ventilation?
~50mmHg
What information about cough must be obtained during history taking?
Site: throat vs deep chest
Quality: Dry vs wet; colour; thickness; pus; blood
Severity: volume of sputum (teaspoon vs cup)
Time course: duration
Context: Exertion; time of dayl time of year; smoking
Aggravating:
Relieving: medications
Associated features: pain while coughing
Vaccination Hx
Smoking Hx
What is haematemesis?
Vomited up blood
In which species is Type A influenza virus found?
Humans and other species
Which muscles may be contracted for forceful exhalation
Abdominal and internal intercostal muscles
Where does rotavirus replicate?
Rotavirus replicates in epithelial muscosa of GIT
What are the most common causes of otitis media?
Pneumococci,
H. influenzae
Moraxella catarrhalis
Hiow much oxygen is consumed at rest?
250ml/min
Define breathlessness
Pt’s recognition of an inappropriate relationship between respiratory work and total body work
What is corryza?
Runny nose
Name 4 features of airway remodelling in asthma that cause obstruction of the airways
Goblet cell hyperplasia with increased mucous production
Subepithelial collagen thickening
Increased airway smooth muscle volume
Increased mucosal vascularity
Define Gohn focus
Gohn focus = peripheral area of granulomatous inflammation and caseation
Which 3 factors determine fluid movement across pulmonary capillaries?
1 Hydrostatic pressure
2 Oncotic pressure
3 Capillary permeability
Define phlegm
Mucous + cell debris/bacteria/DNA etc
That is in the body
What is a medical way of saying “coughing up blood”
Haemoptysis
What is the most common cause of the common cold?
Rhinovirus
What influences the peripheral chemoreceptors involved in respiratory regulation?
PaO2, PaCO2, pH
What is the double fold of pleura inferior to the hilum called?
Pulmonary ligament
What is a normal PaCO2?
38-42 mmHg
On a CXR, what causes Kerley b lines?
Dilated lymphatics
What are 3 complications of emphysema?
1 hypoxia
2 pulmonary hypertension –> cor pulmonale
3 PTx
Define mucous
Physiological substance that is in the body
HIgh pH and low PaCO2 = what?
Respiratory alkalosis
What is on your list of differentials for haemoptysis?
Bronchitis
Pneumonia
Bronchiectasis
Pulmonary embolis
Tuberculosis
Lung cancer
Trauma
Inhaled foreign bodies tend to travel where?
Right main bronchus to right lung
What is a normal PaO2?
90-98 mmHg
What is the most viral common causes of croup?
Parainfluenza
What is the pressure of O2 at sea level?
160 mmHg
How does cigarette smoking lead to emphysema?
Cigarette smoke -> ROS -> alveolar damage
Smoke -> ROS –> neutrophil recruitment –> elastase -> alveolar septal degradation
Smoke -> inactivation of anti-proteases -> increased elastase -> alveolar septal degradation
What do people with chronic hypercapnoea have an increased dependence on for ventilatory regulation?
Respiratory drive
What does work of breathing include?
Elastic and resistive work
Which cell makes up most of the surface area of the alveolus?
Type 1 pneumocyte
What is stridor?
An audible breathing sound from the throat (often on inspiration)
What are the 4 most common viral causes of pneumonia?
Parainfluenza 3
Respiratory syncytial virus
Influenza virus
Adenovirus
What is a normal mixed venous PO2?
40mmHg
What causes excess mucus in chronic bronchitis?
Hypertrophy of mucus secreting glands
Increased goblet cells
What are the side effects of inhaled GCSs?
Oral candidiasis
Dysphonia
Decreased serum cortisol
What clinical feature particularly distinguishes influenza from other respiratory tract infections?
Muscle aches
What are 3 important DDx for peripheral oedema?
1 Left heart failure
2 Low serum protein
3 Fluid volume overload
What does Fick’s law determine?
Rate of diffusion of a gas
What are 2 unique features of the Mycobacterium tuberculosis cell wall?
Contains mucolic acid in the cell wall, giving it a waxy coating.
It is acid fast
What is a normal pulmonary artery sys/dias blood pressure?
25/8 mmHg
What is the role of neuraminidase in influenza infection?
NA (neuraminidase) cleaves the sialic acid off the epithelial receptor to prevent newly released virus particles from re-infecting that very cell
What are 2 conditions that can cause hypoventilation through neuropathy?
Polio virus
Guillain-Barre syndrome
What is the range of normal respiration rates for an adult person at rest?
12 to 16 breaths per minute
What is a normal mixed venous CO2?
46 mmHg
Where are peripheral chemoreceptors that contribute to respiratory regulation?
Carotid bodies and aortic arch
What percentage of acute sore throats are caused by viruses?
70%
What is a typical total lung capacity?
5.7L
Where are pulmonary veins always situated within the hilum?
Anterior and inferior
If the radius of a small airway is halved, by how much will resistance increase?
16 times
Define emphysema
Permanent and abnormal enlargement of the airways distal to the terminal bronchioles
What is the order of pharmacological agents used to treat COPD as disease severity increases?
1 Short acting bronchodilator if FEV1 >80?
2 Long acting bronchodilator if FEV1 = 50-80?
3 Inhaled GCS if FEV1 = 30-50%
4 Oxygen if FEV1
What are the most common bacterial causes of atypical pneumonia?
mycoplasma pneumonia,
Coxiella Burnetti,
Chlamydophila pneumoniae
Legionella spp
What is the normal range for arterial pH?
7.35 - 7.45
Alveolar pneumonia is characterised by what?
Consolidation (neutrophils) in the alveolar spaces
What is the best imaging modality for the lung parenchyma?
CT
Yellow sputum suggests what are present in the sputum?
Neutrophils
What does a CXR classically show in atypical pneumonia?
Reticulonodular infiltrate: “dots and dashes” throughout both lung fields
What are the most common causes of a flu-like sickness?
Influencza
Respiratory syncytial virus
In which species is Type B influenza virus found?
Humans only
How does consolidation of pneumonia appear on CXR?
Hyperdense = white
What is the most common viral cause of pharyngitis?
Adenovirus
What is the major cause of empyema?
Staph. aureus
What’s the most common bacterial cause of a sore throat?
Streptococcus pyogenese