Respiratory Flashcards
Describe asthma
a type of obstructive lung disease that involves bronchial hyperresponsiveness that yields reversible bronchoconstriction
Name an inhaled β2-agonist that is commonly used to treat asthma exacerbations
Salbutamol
Which drug is a mast cell stabilizer used for asthma prophylaxis as it prevents mast cell degranulation and who is in used for?
cromoglycate- no SE so good for children
Which muscarinic agonist is used in bronchial provocation challenges to diagnose asthma?
methacholine
Which monoclonal antibody used to treat allergic asthma that is resistant to inhaled steroids and long-acting β2-agonists?
Omalizumab
Name an antileukotriene used in asthma that inhibits the 5-lipoxygenase pathway, blocking the conversion of arachidonic acid to leukotrienes
Zileuton
Name a methylxanthine drug used to treat asthma and give some side effects…
Theophylline = narrow therapeutic index and causes cardiotoxicity and neurotoxicity
What is status asthmaticus?
a severe, unrelenting state of asthma where medication and therapies are ineffective
Name an anti-leukotrienes particularly useful in treating aspirin-induced asthma…
Montelukast
What is the inspiratory: expiratory ratio seen in asthma?
Decreased
In adults I:E = 1:2
In young children I:E = 1:3
What is the action of theophylline in asthma patients?
cause bronchodilation by inhibiting phosphodiesterase thereby increasing cAMP levels due to diminished cAMP hydrolysis
Which asthma drug can cause tachycardia?
Salbutamol
Although it acts mainly on beta-2-receptors to relax bronchial smooth muscle, it does have cross-reactivity and can cause tachycardia.
Which beta blocker should not be given to asthmatics and why?
Propranolol is a nonselective B-blocker (antagonising both beta-1 and beta-2 receptors). Asthmatics should not be prescribed anything that blocks beta-2 receptors. Blocking this receptor may lead to bronchoconstriction and therefore a worsening of respiratory symptoms.
Which type of beta blockers should be used when treating a patient with a history of lung disease (e.g. asthma, COPD, emphysema)?
beta-1 selective agent e.g. atenolol, bisoprolol, metoprolol
What would you see on an ECG in hyperkalaemia?
Hyperkalemia causes tall, peaked T-waves on ECG
What would you see on an ECG in hypokalaemia?
Increased amplitude and width of the P-wave, prolongation of the PR interval, T-wave flattening and inversion, ST-depression, and Prominent U-waves
What is the classic finding for a pulmonary embolism on an ECG?
S1Q3T3 (an S-wave in Lead I, and Q-waves and T-wave inversions in Lead III)
What is mesothelioma?
a cancer of the pleura that may present as hemorrhagic pleural effusions and pleural thickening
What is seen on histology in mesothelioma?
Psammoma bodies
Which two markers are present in almost all mesotheliomas?
Cytokeratin and calretinin
In a tension pneumothorax what would you see on X-ray?
trachea deviates AWAY from pneumothorax
Patients with what syndrome are prone to recurrent pneumothoraces?
Marfans syndrome
In a pneumothorax what are the signs on examination?
Absent breath sounds and hyperresonnance on percussion
What is vocal fremitus and in what conditions is it increased and decreased?
vocal fremitus (VF) transmission of the spoken voice to the chest wall, detectable by auscultation or palpation; it is increased with lung consolidation and decreased with pleural effusion, pneumothorax, and airway obstruction.
What is a tennis pneumothorax?
where air can enter the pleural space but cannot exit, therefore, increasing the amount of trapped air with each breath»_space; hyper inflated chest that doesn’t move on respiration
What is the immediate treatment for a pneumothorax?
The immediate treatment for a tension pneumothorax is needle aspiration at the second-intercostal space at the midclavicular line