Transition Flashcards
Why high O2 bad for patients with COPD
Increase v/q mismatch- (inc o2= vasodilation= blood travelling to non functioning alveoli)
Halden effect (inc o2 = inc release of CO2= inc hypercapnia)
What us pulmonary compliance and how is it affected in emphysema
Pulmonary compliance is increaseed in emphysema due to loss of elastic recoil
(Emphysema is the loss of elasticity in alveoli. Therefore easy to inflat the lungs- expiration hard)
Pulmonary compliance is the ease with which the lungs inflate
At what kpa will haemoglobin start dropping off oxygen
8- 90% saturated
This allows for moderate changes in po2 to not affect haemoglobin picking up oxygen from the lubgs
What is saturation dependant on
Partial pressure of oxygen! Not haemoglobin dependant as saturation is a percentage
What is oxygen content of arterial blood dependant
Hb concentration and saturation of hb
1.34 x hb x SaO2
What is the fev1/fvc ratio for obstructive disease (eg. Copd)
<70%
What does metabolic compensation (abg) indicate
Chronic issue- as metabolic compensation takes days (kidneys responsible for HCO3)
where are the respiratory centres
medulla oblongata
DIVE
Dorsal- inspiration
Ventral - expiration
effect of increased intrathoracic pressure on cardiac output
dec cardiac output
(inc thoracic pressure> dec venous return> dec end diastolic volume> dec cardiac output)
Qrs
Pr
Interval times
QRS <0.1 s
Pr- 0.12-0.2
How to calculate heart rate ecg
Irregular- No. of QRS complexes in 30 large squares and x by 10
Regular- 300 divided by the amount of boxes between QRS’s
TNF inhibitor mechanism of action, used in and example drug
Anti-inflammatory
Many rheumatic and inflammatory diseases
Adalimumab
anti-pd1 - MOA, used in and example drug
pembrolizumab
activates T-cells
used in cancer
anti-interleukin 17- MOA, used in, example drug
Blocks ONE inflammation pathway
Psoriasis, arthritis, (MS)
secukinumab
biologic drugs- dependant on liver or renal function- true or false
FALSE
transplant rejection txs
hyperacute- none
acute cellular- immunosupression
acute vascular- immunosupression ++
chronic allograft failure- minimise drug toxicity, treat hypertension & hyperlipidaemia
types of hypersensitivity
I- ige mediated, immediate, mast cells/basophils release granules etc- eg anaphylaxis
II- IgG, IgM mediated- directly binds to cell and kills
III- IgG, IgM mediated, free floating complexes eg. serum sickness, venom
IV- T cell mediated, delayed hypersensitivity
examples of inactivated vaccines
polio (whole)
pertussis (fractional- subunit)
dipthera & tetanus (fractional toxoid)
haemophilus influenza type b (polysacharride)
examples of live attenuated vaccines
viral:
measles
mumps
rubella- MMR vaccine
Therefore pregnant women cant get it
When would you want to measure immunoglobulins
In the case of immunodeficiency
Eg common variable immune deficiency (CVID)
study design hierarchy
what is a cohort study
study in which people who presently have a certain condition or receive a particular treatment are followed over time and compared with another group of people who are not affected by the condition
two types:
prospective- cohort followed forward in time from present
- Retrospective - cohort formed in the past and followed up to the present
what is a case control study
begin with the outcomes and do not follow people over time; researchers choose people with a particular result (the cases) and interview the groups or check their records to ascertain what different experiences they had
