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Semester 2 > Respiratory > Flashcards

Respiratory Flashcards

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
Q

What is the maximum amount of O2 that 1g of Hb will bind?

A

1.36 ml

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26
Q

What chains make up

a) HbA
b) HbA2
c) HbF?

A

a) two alpha, two beta
b) two alpha, two delta
c) two alpha, two gamma

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27
Q

What is thalassaemia?

A

A defect in the synthesis of globin chains, leading to decreased erythropoiesis and increased haemolysis.

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28
Q

If there is male to male transmission of a condition, what category is the condition?

A

Autosomal dominant

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29
Q

Name two de novo mutation conditions.

A

Cornelian de langer and pfeiffer.

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30
Q

If, instead of being oxygenated, the haem group of Hb is oxidised from Fe2+ to Fe3+, what is it then called?

A

Methaemoglobin

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31
Q

What concn is normal for Hb in blood, and what level is found in polycythaemia and anaemia?

A

Normal - 15g/100ml
Polycythaemia - ~20g/100ml
Anaemia - ~ 8g/100ml

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32
Q

At what percentage carboxyHb will a person die?

A

80%

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33
Q

What are the normal PCO2 in arterial and mixed blood?

A

Arterial - 5.3kPa

Mixed - 6.1kPa

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34
Q

How many times more soluble is CO2 than O2?

A

20 times

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35
Q

What is the buffer system equation?

A

HCO3- + H+ CO2 + H2O

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36
Q

What is a myoglobin molecule made up of?

A

One globin chain (different from in Hb) and one haem group

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37
Q

At what level is the sternal angle?

A

T4/5

38
Q

What is the definition (equation) of compliance of the lung?

A

Volume change per unit alveolar pressure change.

39
Q

What is the main lipid found in alveolar surfactant?

A

Phosphatidylcholine

40
Q

What is RDS?

A

Respiratory distress syndrome, lack of surfactant leading to grave consequences. Often seen in premature babies.

41
Q

What is the equation for alveolar ventilation (Va)?

A

(Tidal volume - dead space) x rate

42
Q

At sea level what is the inspired pressure of oxygen?

A

19.9kPa

43
Q

What is the alveolar gas equation?

A

PAO2 = PIO2 - PACO2/R

44
Q

Why do you tend to absorb more oxygen than you release CO2?

A

O2 is also used for metabolism of fats and other reaction that produce H2O instead of co2.

45
Q

At sea level, what is the quick way of identifying a VQ mismatch or shunt by looking at ABGs?

A

Normal if PaO2 + PaCO2 = 18

46
Q

Which type of lung neoplasm tends to occur peripherally in the lung tissue?

A

Invasive adenocarcinoma

47
Q

What features does cholesterol add to the membrane bilayer?

A

Less deformable and less water permeable

48
Q

Which enzyme synthesises cholesterol in the hepatocytes?

A

HMG CoA reductase

49
Q

Which parts of the adrenal gland are glucocorticoids and mineralocorticoids released from?

A

GC - zona fasciculeta

MC - zona glomerulosa

50
Q

What is the main GCS in the human body?

A

Cortisol

51
Q

Name two GCS drugs used to combat arthritis.

A

Prednisone and dexamethasone

52
Q

Which phospholipase A inhibitor do GCS induce?

A

Annexin-1

53
Q

Name eight symptoms of Cushing’s syndrome.

A

Buffalo hump, thin skin, muscle wasting, easy bruising, weight gain, poor wound healing, hypertension and euphoria

54
Q

What substance can inhibit endogenous over-production of cortisol?

A

Metyrapone

55
Q

What is the name of the main endogenous mineralocorticoid in the body? And what triggers its release?

A

Aldosterone, and low plasma Na+ and the renin-angiotensin system

56
Q

Where can mineralocorticoid receptors be found?

A

Cytoplasm of the kidney tubule epithelial cells.

57
Q

From superior to inferior what are the areas that make up the respiratory control centre in the brain stem?

A

Pneumotaxic area, apneustic area, medullary rhythmicity area

58
Q

Which reflexes are each of the nasal, epipharangeal, laryngeal and tracheal receptors responsible for, and which nerve is associated which each?

A

Nasal - sneeze - trigeminal nerve
Epipharangeal - aspiration - glossopharangeal nerve
Laryngeal and tracheal - cough - vagus nerve

59
Q

What are two examples of thoracic cage abnormality that cause hypoventilation?

A

Kyphoscoliosis and ankylosing spondylitis

60
Q

What is the clinical word for high CO2 ?

A

Hypercapnea

61
Q

In hypoxaemia, at what paO2 do symptoms start?

A

Below 6.7 kPa

62
Q

What is special about dust mite faeces (Der P1) that helps it to cross the epithelial barrier?

A

It is a cysteine protease.

63
Q

In the costimulatory signal, which two CD molecules on the dendritic cell interact with the CD28 on the Th cell?

A

CD80 and 86

64
Q

What do activated Th cells do?

A

Secrete cytokines which regulate inflammation, proliferation and differentiation, and present antigen fragment to B cells

65
Q

Other than histamine, what else do mast cell granules contain? Also which newly synthesised mediators are released?

A

Proteolytic enzymes (including tryptase, chymase and some other cytokines), proteoglycans. New - leukotrienes and prostaglandins

66
Q

What are the four actions of histamine?

A

Vasodilation of capillaries, increased capillary permeability, constriction of smooth muscle and leukocyte recruitment to tissue.

67
Q

What to CysLeukotrienes do in an asthmatic reaction?

A

Cause smooth muscle contraction - broncoconstriction

68
Q

Name the seven changes in an asthmatic lung.

A

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
Q

Roughly how many cilia does each cell have and how often do they beat?

A

200 cilia, and 12-14 times per second

70
Q

Name two non-mucin airway secretions that give broad spectrum anti microbial action?

A

Defensins and cathelicidin

71
Q

Which two immunoglobulins act as opsonins in non-mucin airway secretions?

A

IgA and IgG

72
Q

What are the actions of the two lacto……. which make up part of the non-mucin airway secretions.

A

Lactoferrin - sequesters bacteria iron

Lactoperoxidase - forms oxygen radicals

73
Q

What does lysozyme do?

A

Hydrolyses peptidoglycan from gram +ve cell wall.

74
Q

In reference to alveolar macrophages, what do PRR, TLR and PAMP each stand for?

A

PRR - pattern recognition receptors
TLR - Toll like receptors
PAMP - pathogen associated molecular patterns

75
Q

What are 6 underlying causes of bronchiectasis?

A

Postpneumonic, mechanical obstruction (foreign body, tumour), immunological disease, gamma globin chain deficiency, immotile cilia syndrome, cystic fibrosis

76
Q

What happens in HIV?

A

CD4+ve T lymphocyte depletion, functional deficit in CD8+ve T cells and B cells.

77
Q

Which pathogen is responsible for TB?

A

Mycobacterium tuberculosis

78
Q

What is a DALY?

A

Disability Adjusted Life Year - One lost year of “healthy” life

79
Q

What is epidemiological transition?

A

A characteristic shift in disease pattern of a population.

80
Q

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
A 
Increase
Increase
Increase
Decrease
Increase
81
Q

In what three ways is co2 carried in the blood?

A

Dissolved in blood, carbamino (carried at Hb globin chains) and as HCO3-

82
Q

What enzyme is the bicarbonate buffer reaction catalysed by?

A

Carbonic anhydrase

83
Q

What occurs when high glucose leads to plasma glucose forming covalent bonds with B-chains?

A

Forms HbA1c - no direct consequences. Good indicator of diabetes management.

84
Q

How many times greater is the affinity of haem for CO than for O2?

A

240x

85
Q

What is the function of myoglobin?

A

Has a higher affinity for O2 than Hb. Facilitates dissuasion of O2 from membrane to mitochondria and can act as a store.

86
Q

Which piece of apparatus is used to measure lung volumes?

A

Spirometer

88
Q

What are the four layers of adrenal gland, from superficial to deep?

A

Z. Glomerulosa, Z. Fasciculeta, Z. Reticularis and Adrenal Medulla

89
Q

What colour is sputum in pneumonia?

A

Rusty

90
Q

What virus is the main cause of the common cold?

A

Rhinovirus

91
Q

What is the main cause of hospitalisation in the first year of life?

A

Bronchiolitis

Semester 2 (6 decks)

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