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2013 Biosciences and intro to pharmacology > Respiratory – asthma/COPD/Pneumonia > Flashcards

Respiratory – asthma/COPD/Pneumonia Flashcards

1
Q

What systemic changes can occur due to COPD?

A

Muscle weakness and weight loss.

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2
Q

What inherited deficiency is associated with some cases of COPD?

A

Alpha-1 antitrypsin deficiency.

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3
Q

What white cells are involved in the inflammatory response in COPD?

A

Neutrophils, macrophages, and lymphocytes.

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4
Q

What common irritant contributes to the development of COPD?

A

Tobacco smoke.

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5
Q

List four common symptoms of COPD.

A

Dyspnea (shortness of breath), chronic cough, hypoxemia (low blood oxygen levels), and hypercapnia (elevated blood carbon dioxide levels)

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6
Q

What changes occur in the airway due to COPD?

A

Airway obstruction, air trapping, and loss of surface area for gas exchange.

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7
Q

How does increased protease activity affect the lungs in COPD?

A

It breaks down elastin in the connective tissue of the lungs, leading to emphysema.

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8
Q

Define emphysema in the context of COPD.

A

Emphysema is the destruction of alveolar walls and loss of lung elasticity, resulting in difficulty exhaling air.

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9
Q

What characterizes chronic bronchitis in COPD?

A

Chronic bronchitis involves bronchial oedema, excessive mucus production, and bacterial colonization of the airways.

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10
Q

What leads to frequent exacerbations in COPD patients?

A

Infections and bronchospasm

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11
Q

How does continuing bronchial irritation contribute to COPD progression?

A

It sustains inflammation and further airway damage, perpetuating the disease cycle.

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12
Q

What is the catalyst for carbon dioxide transport in erythrocytes?

A

Carbonic anhydrase

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13
Q

Name the three main types of chemoreceptors involved in respiratory regulation.

A

Central chemoreceptors, peripheral chemoreceptors, carotid bodies, and aortic bodies​

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14
Q

What factors influence respiratory regulation besides chemoreceptors?

A

Higher centers (eating, talking, temperature, pain) and reflexes (irritant and stretch)​

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15
Q

Define respiratory acidosis and its cause.

A

Respiratory acidosis is the lowering of blood pH due to increased hydrogen ion generation​

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16
Q

What is the normal pH range of arterial blood?

A

7.35–7.45

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17
Q

What is the normal HCO3- range of arterial blood?

A

19-29mmol

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18
Q

What is the normal PaCO2 range of arterial blood?

A

4.7 - 6kPA

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19
Q

What steps are involved in arterial blood gas (ABG) analysis?

A
  1. Check pH
  2. Check 𝑃𝑎𝐶𝑂2
    ​3. Check 𝐻𝐶𝑂3−
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20
Q

How do you detect respiratory acidosis?

A

Low Ph + High 𝑃𝑎𝐶𝑂2 + Normal 𝐻𝐶𝑂3−

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21
Q

How do you detect metabolic acidosis?

A

Low Ph + normal 𝑃𝑎𝐶𝑂2 + low 𝐻𝐶𝑂3−

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22
Q

How do you detect respiratory alkalosis?

A

High Ph + Low 𝑃𝑎𝐶𝑂2 + Normal 𝐻𝐶𝑂3−

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23
Q

How do you detect metabolic alkalosis?

A

High Ph + Normal 𝑃𝑎𝐶𝑂2 + High 𝐻𝐶𝑂3−

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24
Q

What are some signs and symptoms of altered respiration?

A

Sounds (stridor, wheeze)
Cough
Sputum (colour, type, smell)
Hemoptysis (coughing up blood)
Chest pain
Cyanosis
Pursed-lip breathing (like blowing out a candle)
Finger clubbing (Swelling of fingertips)

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25
Q

What is the characteristic feature of COPD?

A

Airflow limitation that is not fully reversible and is progressive

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26
Q

Name two genetic or environmental contributors to COPD.

A
  • Chronic particulate inhalation
  • α1-antitrypsin deficiency
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27
Q

How does smoking contribute to COPD pathophysiology?

A

Smoking inhibits α1-antitrypsin, leading to inflammation and damage to airway and lung tissues​

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28
Q

Describe the lung function test equation to calculate the Forced Expiratory Ratio (FER).

A
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29
Q

What is Chronic Obstructive Pulmonary Disease (COPD)?

A

COPD is a progressive and chronic lung disease characterized by persistent respiratory symptoms and airflow limitation due to airway and/or alveolar abnormalities. It is commonly caused by exposure to harmful particles or gases (e.g., smoking) and involves an abnormal lung inflammatory response.

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30
Q

What is the initial trigger for asthma pathophysiology?

A

Exposure to an allergen or irritant

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31
Q

Which immune system components are activated during an asthma response?

A

IL-4, IL-5, IL-8, IL-13 cytokines and IgE production

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32
Q

What happens when mast cells degranulate in asthma?

A

It leads to bronchospasm, vascular congestion, mucus secretion, and increased contraction of smooth muscle in bronchioles

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33
Q

What are chemotactic mediators, and what do they do in asthma?

A

Chemotactic mediators attract inflammatory cells like neutrophils, lymphocytes, and eosinophils to the airway

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34
Q

How does vasodilation contribute to asthma symptoms?

A

Vasodilation increases capillary permeability, leading to swelling and inflammation in the airway​

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35
Q

What structural changes occur in the airway due to chronic asthma?

A

Thickening of airway walls due to fibrosis and increased muscle thickness (airway remodeling)​

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36
Q

What role do toxic neuropeptides play in asthma?

A

They contribute to autonomic dysregulation, worsening airway reactivity and inflammation​

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37
Q

What is bronchial hyper-responsiveness in asthma?

A

It is an exaggerated airway narrowing in response to stimuli, leading to obstruction​

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38
Q

What two major outcomes result from cellular infiltration in asthma?

A

Airway obstruction and bronchial hyper-responsiveness​

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39
Q

What are some hallmark features of asthma?

A
  • Bronchospasm (Narrow airways due to smooth muscle contraction)
  • Mucus hypersecretion (Excessive mucus production)
  • Vascular congestion (Swelling of blood vessels in the airway due to inflammation)
  • Airway remodelling (Structural changes in the airway walls due to chronic inflammation)
  • Hyper-responsiveness​ (Exaggerated airway narrowing in response to stimuli)
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40
Q

What is asthma?

A

Asthma is a chronic inflammatory condition that can cause death, of the airways characterized by recurrent episodes of wheezing, shortness of breath, chest tightness, and coughing. It involves airway hyper-responsiveness and obstruction, often triggered by allergens, irritants, or infections, and is usually reversible with treatment.

41
Q

What is pneumonia?

A

Pneumonia is an infection that inflames the alveoli in the lungs, causing them to fill with fluid or pus. This leads to symptoms like cough, fever, chills, and breathing difficulties.

42
Q

What are the main types of pneumonia?

A
  • Community-Acquired Pneumonia (CAP): Occurs outside of healthcare settings.
  • Hospital-acquired pneumonia (HAP): Develops during hospital stays, often caused by antibiotic-resistant bacteria.
  • Ventilator-Associated Pneumonia (VAP): A subtype of HAP occurring in people on mechanical ventilation.
  • Aspiration Pneumonia: Caused by inhalation of food, liquids, or vomit into the lungs
43
Q

What are the common pathogens causing pneumonia?

A

Bacterial: Streptococcus pneumoniae (most common), Haemophilus influenzae, Mycoplasma pneumoniae.

Viral: Influenza virus, respiratory syncytial virus (RSV), SARS-CoV-2 (COVID-19).

Fungal: Histoplasma, Coccidioides, Cryptococcus (more common in immunocompromised individuals).

44
Q

What are the hallmark symptoms of pneumonia?

A
  • Persistent cough (may produce green, yellow, or bloody phlegm).
  • Fever and chills.
  • Shortness of breath.
  • Chest pain that worsens with breathing or coughing.
  • Fatigue and confusion (especially in elderly patients).
45
Q

What are the risk factors for pneumonia?

A
  • Age (children under 5 and adults over 65).
  • Chronic diseases like COPD, asthma, or heart disease.
  • Smoking.
  • Weakened immune system (HIV/AIDS, cancer treatments).
  • Hospitalization or ventilator use.
46
Q

How is pneumonia diagnosed?

A
  • Physical Examination: Listening for abnormal lung sounds (crackles or wheezing).
  • Chest X-ray: To detect lung inflammation or fluid accumulation.
  • Blood Tests: To identify infection markers or specific pathogens.
  • Sputum Analysis: To determine the causative organism.
  • Pulse Oximetry: Measures blood oxygen levels.
47
Q

What are the treatments for pneumonia?

A
  • Antibiotics: For bacterial pneumonia.
  • Antiviral Drugs: For viral pneumonia (e.g., influenza, COVID-19).
  • Antifungal Medications: For fungal infections.
  • Supportive Care: Includes oxygen therapy, fluids, fever-reducing medications, and rest.
48
Q

How can pneumonia be prevented?

A
  • Vaccinations: Pneumococcal vaccines and annual influenza shots.
  • Hygiene: Regular handwashing, covering coughs and sneezes.
  • Lifestyle Changes: Avoid smoking and maintain good overall health.
49
Q

What are the potential complications of pneumonia?

A
  • Pleural Effusion: Fluid accumulation around the lungs.
  • Lung Abscesses: Pockets of pus in the lungs.
  • Bacteremia: Infection spreads to the bloodstream, potentially leading to sepsis.
  • Acute Respiratory Distress Syndrome (ARDS): Severe respiratory failure.
50
Q

What is the difference between bacterial and viral pneumonia?

A
  • Bacterial Pneumonia: Often more severe; treated with antibiotics; symptoms include high fever, productive cough.
  • Viral Pneumonia: Milder; no antibiotic response; symptoms may include a dry cough and muscle aches.
51
Q

What is aspiration pneumonia?

A

Pneumonia caused by inhaling food, liquids, vomit, or foreign objects into the lungs, often occurring in people with swallowing difficulties or altered consciousness.

52
Q

What is aspiration pneumonia?

A

Pneumonia caused by inhaling food, liquids, vomit, or foreign objects into the lungs, often occurring in people with swallowing difficulties or altered consciousness.

53
Q

What signs indicate severe pneumonia requiring immediate medical attention?

A
  • High fever (>39°C).
  • Rapid breathing or difficulty breathing.
  • Bluish lips or fingertips (cyanosis).
  • Severe chest pain.
  • Confusion or altered mental state.
54
Q

What does the Tidal Volume (TV) represent on a spirometry graph?

A

Tidal Volume is the volume of air inhaled and exhaled during normal breathing. It is labelled as “1” on the graph

55
Q

What is Inspiratory Reserve Volume (IRV), and how is it measured?

A

Inspiratory Reserve Volume is the maximum additional air that can be inhaled after a normal inhalation. It is labeled as “2” on the graph, shown as the space above the tidal volume during a deep breath.

56
Q

What does Expiratory Reserve Volume (ERV) represent?

A

Expiratory Reserve Volume is the additional air that can be exhaled forcefully after a normal exhalation. It is labeled as “3” on the graph, below the tidal volume line.

57
Q

What is Forced Vital Capacity (FVC), and how is it shown on the graph?

A

Forced Vital Capacity is the total volume of air exhaled forcefully after a deep inhalation. It includes the tidal volume, IRV, and ERV. It is labeled as “4” on the graph, showing the full capacity range from maximum inspiration to full expiration.

58
Q

What does Residual Volume (RV) indicate on the graph?

A

Residual Volume is the amount of air remaining in the lungs after a maximum exhalation. It is labeled as “5” on the graph and is below the ERV line.

59
Q

How do you calculate Total Lung Capacity (TLC) using this graph?

A

Total Lung Capacity is the sum of all lung volumes: TLC = Tidal Volume (TV) + Inspiratory Reserve Volume (IRV) + Expiratory Reserve Volume (ERV) + Residual Volume (RV).

60
Q

How can spirometry help diagnose lung conditions?

A

By measuring values like FVC, TV, and RV, spirometry can identify obstructive conditions (e.g., asthma, COPD) or restrictive conditions (e.g., fibrosis) based on abnormalities in airflow or lung volumes.

61
Q

What does a flat or abnormal curve on a spirometry graph suggest?

A

It could indicate a problem with airway resistance, lung elasticity, or muscle strength, depending on whether it affects inspiration, expiration, or both.

62
Q

How do you interpret a low FVC or ERV in spirometry results?

A

A low FVC or ERV may suggest restrictive lung disease, where lung expansion is limited, reducing overall lung volumes.

63
Q

How is Forced Expiratory Volume in 1 second (FEV1) different from FVC?

A

FEV1 is the volume of air exhaled in the first second of a forced expiration, while FVC is the total volume of air exhaled during the entire forced expiration. The FEV1/FVC ratio helps determine obstruction

64
Q

What does FEV₁ stand for in spirometry?

A

Forced Expiratory Volume in 1 second (FEV₁) is the amount of air exhaled during the first second of a forced breath.

65
Q

How is Forced Expiratory Ratio (FER) calculated?

A

FER = (FEV₁ ÷ FVC) × 100%, where FVC is the total air exhaled forcefully after a deep breath.

66
Q

What does a reduced FEV₁/FVC ratio indicate?

A

A reduced ratio indicates airway obstruction, common in conditions like COPD and asthma.

67
Q

What is considered “mild” COPD severity based on spirometry?

A

Stage 1 - Mild: FEV₁ ≥ 80%.

68
Q

At what FEV₁ % is COPD classified as “very severe”?

A

Stage 4 - Very Severe: FEV₁ < 30%.

69
Q

At what FEV₁ % is COPD classified as “severe”?

A

Stage 3 - Severe: FEV₁ 30–49%.

70
Q

At what FEV₁ % is COPD classified as “moderate”?

A

Stage 2 - Moderate: FEV₁ 50–79%.

71
Q

What is the significance of FVC in spirometry?

A

Forced Vital Capacity (FVC) is the total volume of air that can be exhaled forcefully after a deep inhalation.

72
Q

How is spirometry used to diagnose COPD?

A

A FEV₁/FVC ratio of less than 70% combined with reduced FEV₁ % predicted confirms airway obstruction indicative of COPD.

73
Q

How do stages of COPD affect patient symptoms?

A

Mild (Stage 1): Minimal symptoms like occasional cough.

Moderate (Stage 2): Shortness of breath with activity.

Severe (Stage 3): Increased breathlessness and fatigue.

Very Severe (Stage 4): Life-threatening respiratory failure.

74
Q

What is the relationship between FER and COPD severity?

A

FER remains reduced in COPD (< 70%), while FEV₁ % predicted determines the severity stage.

75
Q

What is the anatomy of the respiratory tract?

A
  • Upper respiratory tract: Includes the nose, nasal cavity, pharynx, and larynx.
  • Lower respiratory tract: Includes the trachea, bronchi, bronchioles, and lungs, where gas exchange occurs.
76
Q

What is the function of the nose and nasal cavity in the respiratory tract?

A

The nose and nasal cavity filter, warm, and moisten the air as it enters the body.

They also contain sensory receptors for smell and help in speech resonance.

77
Q

What is the function of the pharynx in the respiratory system?

A

The pharynx (throat) serves as a passageway for air to move from the nose and mouth to the larynx and for food to move from the mouth to the oesophagus.

It plays a role in both respiration and digestion.

78
Q

What is the role of the larynx in respiration?

A

The larynx (voice box) is responsible for producing sound (vocalization) and acts as a passage for air from the pharynx to the trachea.

It also prevents food from entering the trachea during swallowing.

79
Q

How does the trachea contribute to the respiratory system?

A

The trachea (windpipe) is a rigid tube that transports air from the larynx to the bronchi. It is lined with cilia and mucus to trap and remove foreign particles and pathogens from the air.

80
Q

What do the bronchi do?

A

The bronchi are the main airways that carry air from the trachea into the lungs and divide into smaller branches (bronchioles).

81
Q

What do bronchioles do?

A

Bronchioles are small airways that carry air to the alveoli (air sacs) where gas exchange happens.

82
Q

What do the alveoli do?

A

Alveoli are tiny sacs in the lungs where oxygen enters the blood and carbon dioxide is removed

83
Q

What is the physiology of breathing (inhalation and exhalation)?

A

During inhalation, the diaphragm and intercostal muscles contract, expanding the chest and decreasing pressure in the lungs, causing air to flow in.

During exhalation, these muscles relax, and the chest volume decreases, pushing air out of the lungs.

84
Q

What are stretch receptors?

A

Stretch receptors are found in the lungs and detect lung inflation, helping regulate breathing patterns and protect against over-expansion.

85
Q

What is the role of neurological control in respiration?

A

Neurological control of respiration is managed by the medulla oblongata and pons, which monitor CO2 levels and blood pH.

They adjust breathing rate and depth to maintain homeostasis.

86
Q

What is ventilation-perfusion (V-Q) mismatch?

A

Ventilation-perfusion (V-Q) mismatch occurs when there is an imbalance between air reaching the alveoli (ventilation) and the blood flow to those alveoli (perfusion), leading to inefficient gas exchange.

This can happen in conditions like pneumonia or pulmonary embolism.

87
Q

Define bronchospasm.

A

Bronchospasm is the sudden constriction of the muscles in the walls of the bronchi (airways), leading to difficulty breathing, often seen in conditions like asthma.

88
Q

Define Laryngospasm

A

Laryngospasm is a sudden involuntary contraction of the muscles in the larynx (voice box), which can cause temporary airway closure and difficulty breathing, often triggered by irritants or infections.

89
Q

Define Apnoea

A

Apnoea is the temporary cessation of breathing, typically occurring during sleep (as in sleep apnoea) or due to an obstruction or neurological issue.

90
Q

Define Dyspnoea

A

Dyspnoea refers to shortness of breath or difficulty breathing, often associated with respiratory conditions like asthma, pneumonia, or heart failure.

91
Q

Define Tachypnoea

A

Tachypnoea is abnormally rapid breathing, typically occurring due to fever, anxiety, or respiratory distress.

92
Q

Define Rhonchi.

A

Rhonchi are low-pitched, wheezing sounds heard in the chest during breathing, often caused by obstruction or secretions in the larger airways, as seen in conditions like bronchitis or pneumonia.

93
Q

Define Stridor

A

Stridor is a high-pitched wheezing sound caused by an obstruction in the upper airway, typically heard during inhalation, and may indicate a medical emergency like croup or anaphylaxis.

94
Q

Define Cor pulmonale

A

Cor pulmonale is the enlargement and failure of the right side of the heart due to chronic lung disease, such as chronic obstructive pulmonary disease (COPD) or pulmonary hypertension.

95
Q

What is bronchitis?

A

Bronchitis is the inflammation of the bronchial tubes, usually caused by infection or irritation (e.g., smoking).

It results in coughing, mucus production, and wheezing. Chronic bronchitis is a form of COPD.

96
Q

What is emphysema?

A

Emphysema is a chronic lung condition where the alveoli are damaged, leading to difficulty breathing.

It is commonly caused by long-term smoking and is a type of COPD.

97
Q

What is pneumothorax?

A

Pneumothorax is the collapse of a lung due to air entering the pleural space, often as a result of trauma, lung disease, or spontaneously.

It causes sudden chest pain and difficulty breathing.

98
Q

What is the difference between atopic and non-atopic asthma types?

A
  • Atopic asthma is triggered by allergens, often associated with a family history of allergies.
  • Non-atopic asthma is triggered by factors like exercise, cold air, or respiratory infections without an allergic component.

2013 Biosciences and intro to pharmacology (12 decks)

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