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Semester 2 > Respiratory > Flashcards

Respiratory Flashcards

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1
Q

What is the normal range of blood pH?

A

7.35 - 7.45

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2
Q

How do you calculate pH?

A
  • log (H+)
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3
Q

Give three examples of non volatile acids in the body.

A

Lactic, keto, uric

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4
Q

What is the usual ratio of bicarbonate to carbonic acid?

A

20:1

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5
Q

In acidic condition, is the reaction of the body to increase or decrease ventilation?

A

Increase

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6
Q

Is alkalosis associated with hypo or hyper kalaemia?

A

Hypo

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7
Q

What is the Henderson Haselbalch equation?

A

pH = pK + log A-/HA

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8
Q

If the primary change in an acid base disorder is with the concentration of plasma bicarbonate is it respiratory or metabolic?

A

Metabolic

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9
Q

What does the haem group consist of?

A

Four pyrrole groups arranged in a porphyrin ring around an Fe2+ group.

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10
Q

What is a rare type of lung inflammation of unknown aetiology that is not infective?

A

Interstitial pneumonia

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11
Q

Give three viruses that can cause pneumonia.

A

Influenza, respiratory syncital virus and rhinoviruses

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12
Q

Name two types of pneumonia caused by fungi.

A

Pneumocystis carinii pneumonia and aspergillus

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13
Q

Which three types of bacteria are the most common causes of pneumonia in the community?

A

Strep pneumoniae, mycoplasma pneumoniae and haemophilus influenzae.

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14
Q

Which three bacteria most often cause pneumonia in hospitals?

A

Strep pneumoniae, staph aureus, coliforms and pseudomonas aeruginosa.

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15
Q

What is the full name of the type of epithelium found in the respiratory mucosa?

A

Pseudostratified, ciliated, columnar epithelium with goblet cells

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16
Q

What is epistaxis?

A

Nosebleed

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17
Q

Name four effects of b2-agonists.

A

Bronchodilator, inhibit mediator release from mast cells, inhibit TNF-a release from macrophages and increase mucus clearance.

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18
Q

At what value of plasma ppO2 is Hb normally fully saturated?

A

10.6kPa

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19
Q

What is angina?

A

Ischaemia of the heart

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20
Q

Roughly what percentage of the cardiac output goes to the kidney?

A

25%

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21
Q

What three major factors affect Hb affinity?

A

Temperature, pH and BPG (2,3-bisphosphoglyceric acid)

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22
Q

What does Dalton’s law state?

A

Total pressure = sum of pp’s of individual gases.

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23
Q

What does Henry’s law state?

A

Conc of gas = partial pressure x solubility coefficient

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24
Q

Why is Hb important?

A

Allows much more O2 to be carried, without it the cardiac output would have to be huge.

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25
What is the maximum amount of O2 that 1g of Hb will bind?
1.36 ml
26
What chains make up a) HbA b) HbA2 c) HbF?
a) two alpha, two beta b) two alpha, two delta c) two alpha, two gamma
27
What is thalassaemia?
A defect in the synthesis of globin chains, leading to decreased erythropoiesis and increased haemolysis.
28
If there is male to male transmission of a condition, what category is the condition?
Autosomal dominant
29
Name two de novo mutation conditions.
Cornelian de langer and pfeiffer.
30
If, instead of being oxygenated, the haem group of Hb is oxidised from Fe2+ to Fe3+, what is it then called?
Methaemoglobin
31
What concn is normal for Hb in blood, and what level is found in polycythaemia and anaemia?
Normal - 15g/100ml Polycythaemia - ~20g/100ml Anaemia - ~ 8g/100ml
32
At what percentage carboxyHb will a person die?
80%
33
What are the normal PCO2 in arterial and mixed blood?
Arterial - 5.3kPa | Mixed - 6.1kPa
34
How many times more soluble is CO2 than O2?
20 times
35
What is the buffer system equation?
HCO3- + H+ CO2 + H2O
36
What is a myoglobin molecule made up of?
One globin chain (different from in Hb) and one haem group
37
At what level is the sternal angle?
T4/5
38
What is the definition (equation) of compliance of the lung?
Volume change per unit alveolar pressure change.
39
What is the main lipid found in alveolar surfactant?
Phosphatidylcholine
40
What is RDS?
Respiratory distress syndrome, lack of surfactant leading to grave consequences. Often seen in premature babies.
41
What is the equation for alveolar ventilation (Va)?
(Tidal volume - dead space) x rate
42
At sea level what is the inspired pressure of oxygen?
19.9kPa
43
What is the alveolar gas equation?
PAO2 = PIO2 - PACO2/R
44
Why do you tend to absorb more oxygen than you release CO2?
O2 is also used for metabolism of fats and other reaction that produce H2O instead of co2.
45
At sea level, what is the quick way of identifying a VQ mismatch or shunt by looking at ABGs?
Normal if PaO2 + PaCO2 = 18
46
Which type of lung neoplasm tends to occur peripherally in the lung tissue?
Invasive adenocarcinoma
47
What features does cholesterol add to the membrane bilayer?
Less deformable and less water permeable
48
Which enzyme synthesises cholesterol in the hepatocytes?
HMG CoA reductase
49
Which parts of the adrenal gland are glucocorticoids and mineralocorticoids released from?
GC - zona fasciculeta | MC - zona glomerulosa
50
What is the main GCS in the human body?
Cortisol
51
Name two GCS drugs used to combat arthritis.
Prednisone and dexamethasone
52
Which phospholipase A inhibitor do GCS induce?
Annexin-1
53
Name eight symptoms of Cushing's syndrome.
Buffalo hump, thin skin, muscle wasting, easy bruising, weight gain, poor wound healing, hypertension and euphoria
54
What substance can inhibit endogenous over-production of cortisol?
Metyrapone
55
What is the name of the main endogenous mineralocorticoid in the body? And what triggers its release?
Aldosterone, and low plasma Na+ and the renin-angiotensin system
56
Where can mineralocorticoid receptors be found?
Cytoplasm of the kidney tubule epithelial cells.
57
From superior to inferior what are the areas that make up the respiratory control centre in the brain stem?
Pneumotaxic area, apneustic area, medullary rhythmicity area
58
Which reflexes are each of the nasal, epipharangeal, laryngeal and tracheal receptors responsible for, and which nerve is associated which each?
Nasal - sneeze - trigeminal nerve Epipharangeal - aspiration - glossopharangeal nerve Laryngeal and tracheal - cough - vagus nerve
59
What are two examples of thoracic cage abnormality that cause hypoventilation?
Kyphoscoliosis and ankylosing spondylitis
60
What is the clinical word for high CO2 ?
Hypercapnea
61
In hypoxaemia, at what paO2 do symptoms start?
Below 6.7 kPa
62
What is special about dust mite faeces (Der P1) that helps it to cross the epithelial barrier?
It is a cysteine protease.
63
In the costimulatory signal, which two CD molecules on the dendritic cell interact with the CD28 on the Th cell?
CD80 and 86
64
What do activated Th cells do?
Secrete cytokines which regulate inflammation, proliferation and differentiation, and present antigen fragment to B cells
65
Other than histamine, what else do mast cell granules contain? Also which newly synthesised mediators are released?
Proteolytic enzymes (including tryptase, chymase and some other cytokines), proteoglycans. New - leukotrienes and prostaglandins
66
What are the four actions of histamine?
Vasodilation of capillaries, increased capillary permeability, constriction of smooth muscle and leukocyte recruitment to tissue.
67
What to CysLeukotrienes do in an asthmatic reaction?
Cause smooth muscle contraction - broncoconstriction
68
Name the seven changes in an asthmatic lung.
Increased mucus production, loss of epithelium, thickening of the lamina reticularis, migration of mast cells to surface, infiltration of eosinophils and T cells, increased blood eosinophilia and hypertrophy/hyperplasia of bronchial smooth muscle
69
Roughly how many cilia does each cell have and how often do they beat?
200 cilia, and 12-14 times per second
70
Name two non-mucin airway secretions that give broad spectrum anti microbial action?
Defensins and cathelicidin
71
Which two immunoglobulins act as opsonins in non-mucin airway secretions?
IgA and IgG
72
What are the actions of the two lacto....... which make up part of the non-mucin airway secretions.
Lactoferrin - sequesters bacteria iron | Lactoperoxidase - forms oxygen radicals
73
What does lysozyme do?
Hydrolyses peptidoglycan from gram +ve cell wall.
74
In reference to alveolar macrophages, what do PRR, TLR and PAMP each stand for?
PRR - pattern recognition receptors TLR - Toll like receptors PAMP - pathogen associated molecular patterns
75
What are 6 underlying causes of bronchiectasis?
Postpneumonic, mechanical obstruction (foreign body, tumour), immunological disease, gamma globin chain deficiency, immotile cilia syndrome, cystic fibrosis
76
What happens in HIV?
CD4+ve T lymphocyte depletion, functional deficit in CD8+ve T cells and B cells.
77
Which pathogen is responsible for TB?
Mycobacterium tuberculosis
78
What is a DALY?
Disability Adjusted Life Year - One lost year of "healthy" life
79
What is epidemiological transition?
A characteristic shift in disease pattern of a population.
80
In an inflammatory response in the alveolar capillaries, does each of these increase or decrease? - permeability of endothelium to proteins - hydrostatic pressure within the lumen - expression of cell adhesion molecules by endothelium - oncotic pressure of capillary plasma - flow of lymphatic fluid
``` Increase Increase Increase Decrease Increase ```
81
In what three ways is co2 carried in the blood?
Dissolved in blood, carbamino (carried at Hb globin chains) and as HCO3-
82
What enzyme is the bicarbonate buffer reaction catalysed by?
Carbonic anhydrase
83
What occurs when high glucose leads to plasma glucose forming covalent bonds with B-chains?
Forms HbA1c - no direct consequences. Good indicator of diabetes management.
84
How many times greater is the affinity of haem for CO than for O2?
240x
85
What is the function of myoglobin?
Has a higher affinity for O2 than Hb. Facilitates dissuasion of O2 from membrane to mitochondria and can act as a store.
86
Which piece of apparatus is used to measure lung volumes?
Spirometer
88
What are the four layers of adrenal gland, from superficial to deep?
Z. Glomerulosa, Z. Fasciculeta, Z. Reticularis and Adrenal Medulla
89
What colour is sputum in pneumonia?
Rusty
90
What virus is the main cause of the common cold?
Rhinovirus
91
What is the main cause of hospitalisation in the first year of life?
Bronchiolitis

Semester 2 (6 decks)

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