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EDIC MCQ > Respiratory physiology > Flashcards

Respiratory physiology Flashcards

1
Q

Alternative delivery method of Salbutamol if nebulization isn’t possible?

A

MDI + Spacer, 4 puffs every 10 mins until improvement

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2
Q

Side effects off nebulised salbutamol ?

A
  1. Tremors
  2. Anxiety
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3
Q

Is there an indication for oral Leukotriene antagonist like Motelukast in acute severe asthma?

A

No

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4
Q

Function and composition of Heliox?

A
  1. Oxygen & Helium
  2. Decreases airway resistance
  3. Heliox use requires recalibration of flow meter
  4. No role in the management of asthma
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5
Q

How to estimate static Auto-PEEP in dynamic hyperinflation ?

A

At end-expiratory pause and measuring rise in airway pressure

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6
Q

Pathophysiology of acute severe asthma?

A
  1. Airway resistance is very high
  2. Lung hyperinflation
  3. End-expiratory volume may be close to TLC
  4. Requires prolonged expiratory time
  5. Dynamic hyperinflation worsened by high PEEP
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7
Q

Complications of dynamic hyperinflation in acute severe asthma?

A
  1. Hypotension
  2. Ventilatory compromise
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8
Q

Ventilatory strategy in acute severe asthma ?

A
  1. Short I:E ratio - Prolonged expiratory time
  2. Low PEEP
  3. Permissive hypercapnia
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9
Q

Ventilatory strategy is ARDS?

A
  1. Inverse ratio ventilation which helps in lung recruitment
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10
Q

Delivery of drugs using pMDI in ventilated patients and HME filter? (Pressurised Metered Dose Inhaler)

A
  1. HME filter should be removed from between the ETT and ventilator
  2. pMDI should be connected to the inspiratory limb
  3. Increased dead-space if pMDI is between the ETT & Y-connector
  4. pMDI actuated at inspiration
  5. HME decreases the delivery of pMDI
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11
Q

How is duty cycle calculated in asthmatic patients?

A

Calculated as inspiratory time / Total breath time (Time spent in inspiation / Expiration)

This should be longer to increase delivery of drug

Inspiratory flow rate of 30-50L/min is appropriate

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12
Q

Disadvantages of high duty cycle?

A
  1. Increased dynamic hyperinflation
  2. Increased auto-PEEP
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13
Q

Steroid management in acute severe asthma?

A
  1. Short course of 5 days may be stopped without tapering
  2. Tapering not required provided inhaled corticosteroids are continued
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14
Q

What’s the gold standard test for diagnosis of Covid-19

A
  1. NAAT - Nucleic Acid Amplification test.
  2. Detects generic sequence in DNA or RNA
  3. RT-PCR - This is a type of NAAT - reverse transcriptase polymerase chain reaction
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15
Q

Covid-19 diagnosis using swabs?

A
  1. Nasopharyngeal swab true positive highest between 0-4 days.
  2. Chances of true positive drops between 10-14 days
  3. Induced sputum for testing is not recommended
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16
Q

What is “Bias flow”~?

A
  1. Small constant flow in the circuit
  2. Same flow reaches expiratory end if no pt effort
17
Q

Rapid antigen detects?

A
  1. Nucleocapside protein (N-Protein)
  2. It is highly specific
18
Q

What is the Nucleic Acid Amplification Test?

A
  1. Detects a particular genetic sequence in DNA or RNA
  2. RNA or DNA polymerase is one way of amplification
  3. RT-PCR is a type of NAAT
  4. NAAT is the gold standard for diagnosis of covid
19
Q

Demographic distribution of covid variants?

A
  1. Alpha = UK
  2. Beta = South Africa
  3. Gamma = Brazil/Japan
  4. Delta = India
  5. Epsilon = California
20
Q

Peak window for the infectiousness for transmission of covid?

A

Two days before onset of symptoms and one day after onset of symptoms

21
Q

What is the median duration of RNA infection ?

A

It is 18 days from onset of symptoms

22
Q

Effect of Tocilizumab in management for Covid-19?

A
  1. Increased levels of circulating interleukin-6 (peak levels 3-5 days)
  2. Increased risk of encephalopathy
  3. Increased risk of opportunistic infections
  4. CRP suppression for 14 days
23
Q

What is antibody dependent enhancement in Covid-19 patients?

A

SARS COV-2 binding to ineffective antibody and hence enhancing viral entry into host cells.

EDIC MCQ (12 decks)

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