Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pulmonary > Upper Respiratory Dr. Roane EXAM I > Flashcards

Upper Respiratory Dr. Roane EXAM I Flashcards

1
Q

Compartments of the Upper Respiratory Tract

A

-Nose and Nasal Cavity
-Sinuses
-Connections: Eustachian tube to the middle ear
Nasolacrimal ducts to the eye
-Mouth
-Pharynx
-Larynx (covered by the epiglottis)
Pharynx and Larynx share a pathway (food and air)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Compartments of the Lower Respiratory Tract

A

-Trachea
-Primary bronchi
-Lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Function of the Upper Respiratory Tract

A

-Warm and moisten incoming air
-Trap inhaled particles
-Front line of immunological defense
-Olfaction (smell)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Function of the Lower Respiratory Tract

A

-Ventilation (moving air in and out - Ribcage, Diaphram)

in the Alveoli: Gas exchange
O2 to the blood
CO2 out of the blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Pathophysiology of the Upper Respiratory Tract

A

Allergies
Infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the obstructive disorders?
Which part of the lung is affected?

A

-Obstruction: something is in the way

-Asthma, COPD, Bronchiectasis (inflammation of the walls of the bronchi (branches))
-Compromised exhalation !!!

–> Lower Respiratory tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the restrictive disorders?
Which part of the lung is affected?

A

elastic lung tissues (contracts, expands) is compromised by diseases:

-Fibrosis (thickening of the air sacs in the lungs), Sarcoidosis (autoimmune),
-Compromise inhalation !!!

Others:

–> Lower Respiratory tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Other Pathophysiologies of the lung

A

-Silicosis (caused by fine sand)
-Black lung (in mine worker)
-Cystic fibrosis (inherited)
-Pulmonary hypertension
-Infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the physiologic equation important for Lower Respiratory conditions?

A

-Poiseuille’s Law (Flow of fluids)

-Relation between Flow and change in pressure, the radius of the tube, length, and viscosity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which factor in Poiseuille’s equation is critical?

A

-Radius (diameter to the 4th power)
-small changes in the radius result in big changes in flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Equation #2 important for Lower Respiratory conditions?

A

-Ficks Law of Flux
-How fast a substance (gas, drug molecule) can move across a barrier

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Factors Fick’s equation
What is important regarding to Lower Respiratory conditions

A

Flux = (C1-C2)PSA/D
-C1-C2 (concentration difference) - movement from high to low
-Permeability
-surface area
-D distance across the barrier

-Changes in thickness of the wall !!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Where are the Turbinates and what is its function?

A

-in the Sinuses
-increases the surface area inside the folds of the tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the benefits of an increased surface area in the turbinates?

A

-inhaled air is exposed to more tissue
-more junk can be caught in the mucus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the bone-forming tissues posturing into the breathing passage and the spaces between those, called?

A

Bone-tissue:
Superior concha
Middle concha
Inferior concha

Space between concha:
Superior meatus
Middle meatus
Inferior meatus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are large spaces with narrow passages inside the nasal cavitiy?

A

-Sinuses

Examples:
-Frontal Sinus (above the eyebrow)
-Sphenoidal Sinus (in the back)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Where is the Maxilla sinus located?

A

Behind the cheekbone?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What causes pain in a sinus infection?

A

-Bacterial growth cause recrution of immune cells (neutrophils, macrophages)
-Filled space and included openings
-Swelling, increased pressure in an inelastic space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the function of alpha-agonists when exposed to tissues?

A

Vasoconstriction of blood vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the characteristics of the nasal cavity?

A

-lined with a thick mucosal cell layer
-rich blood supply (epistaxis)

-Large surface area: slows airflow, warms incoming air; mucosa traps microbes
-rich in immune cells: innate immunity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What types of fluids are secreted in the nasal cavity?

A

-Serous fluid: watery
-Mucus: thick and slimy
-vascular exudate from dilated blood vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Where are fluids in the nasal cavity produced?

A

-most come from exocrine glands and goblet-like mucous cells
-1L per day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What promotes fluid secretion in the nasal cavity?

A

Histamines -> binding to muscarinic receptors

24
Q

What are the effects of the H1 Histamine receptors?

A

-Sneezing, itching
-fluid secretion
-Vasodilation

DRUG TARGET

25
Q

What are the effects of the M3 muscarinic receptors?

A

Stimulate serous and some mucus secretion

DRUG TARGET

26
Q

What are the effects of the Alpha (a1) receptors?

A

-Stimulate Vasoconstriction
-countering the histamine effect, but are NOT part of an allergic response

DRUG TARGET

27
Q

What are the effects of the Leukotriene (LT-D4) receptors?

A

-Similar to H1

-Sneezing, itching
-fluid secretion
-Vasodilation

DRUG TARGET

28
Q

How does an allergic reaction develop?

A

-Allergen binds to IgE (IgE sits on mast cells)
-Degranulation and release of mast cell mediators (histamines, prostaglandins, leukotrienes, and more)

29
Q

What are the effects of mast cell mediators released after Degranulation?

A

-Stimulation of sensory nerve endings -> Sneezing and Itching

-Stimulation of mucous glands inducing hypersecretion -> Rhinorrhea

-Acting on blood vessels -> Vasodilation -> Tissues swell up -> Congestion

30
Q

What does atopic disorder mean?

A

-IgE response to an allergen (antigen, normal part of the environment)
-caused by an allergen that not everyone would respond to (only those allergic will respond)

31
Q

Effects of Histamines and other mediators

A

Increase nasal fluid production and cause severe
vasodilation

-Blocks airways (stopped up/runny nose)
-cause itchy, watery eyes* (composition of the tear depends on the stimulus - tears from crying due to sadness are different)
-Can create a sinus headache
-Facilitate sneezing

32
Q

What are the Histamine receptors involved in allergic diseases?

A

H1 - H4 Receptors

33
Q

Which cells responsible for acid secretion contain H2 receptors?

A

H2 receptors on Parietal cells -> gastric acid secretion

H2 blockers decreasing acid secretion are specific to H2 receptors -> they DON’T help with allergic reactions in the nose (H1)

34
Q

Which histamine receptor is associated with the function of the sleep cycle?

A

H3 Receptor
Benadryl is often used to help with sleep

35
Q

Histamine receptor associated with cytokine production, adhesion molecule production, vasodilation, bronchoconstriction, allergy, and inflammation

A

H1 Receptor

36
Q

Histamine receptor associated with Immunomodulators, Chemotaxis, Degranulation, Ca release from ER

A

H4 receptor

37
Q

Future research targets

A

H1-H4 receptors

-Wakefulness
-Appetite/body weight (why pts. on atypical
antipsychotics gain weight)
-Psychosis and a variety of mental disorders

38
Q

Question

A

Does Histamine behind unspecifically to different types of H receptors (H1, H2, H3, H4)

39
Q

Classes of older Gen Antihistamines

A

-Ethanolamines
Diphenhydramine and Doxylamine
-Propylamines
Chlorpheniramine
Brompheniramine
-Piperazines
Meclizine (Bonine for motion sickness)
Hydroxyzine

40
Q

What are the side effects associated with older Antihistamines?

A

Drowsiness
-> probably caused by blocking H1 receptors and/or 5-HT receptors in the brain
Histamines helps to in keeping people stay awake during the day
-f.e. Hydroxyzine sedative, anxiety before surgery

41
Q

Examples of Antihistamines with different effects

A

-Hydroxyzine: Anxiety
-Dimenhydrinate (Dramamine) an antihistamine for nausea
-Cyproheptadine: appetite stimulator

42
Q

What other receptors are blocked by Antihistamines?

A

Muscarinic receptors
Muscarinic effects: Parasympathetic: Urinating, nasal mucus secretion, salvation,…

-> Antimuscarinic effects: difficulty urinating in men with benign prostatic hyperplasia (BPH)

43
Q

Which Antihistamine binds to different histamine receptors and has multiple effects?

A

Promethazine (Class: Phenothiazines)

-Antihistaminic (allergy symptoms)
-Anticholinergic (helps with diarrhea)
-Antidopaminergic (Anti-nausea and potentiates narcotic effects - make pain meds work better)
-Anti-alpha receptor effects in the CNS (sedation)

44
Q

Why are 2nd Gen Antihistamines more successful than the 1st Gen Antihistamines?

A

-more specific to H1 and lower CNS penetration (less drowsiness)
-2nd Gen: Loratidine, Certirizine
-3rd Gen: Desloratadine, Fexofenadine

45
Q

How is Desloratdine different from Loratidine?

A

Desloratadine is an active metabolite of Loratidine
-metabolized by CYP3A4 or 2D6
-more effective in people no-function CYP2D6 allele
-more hydrophilic, less CNS effect
-increases the effect of isotretinoin (for acne)

46
Q

Which initial Antihistamine was withdrawn from the market?

A

-Terfenadine (Seldane)
-due to fatal arrhythmias secondary to prolonged QTc interval

-> the active metabolite (CYP3A4) Fexofenadine is not toxic

47
Q

Levocetirizine (Xyzal) (l-isomer) is more active than its isomer Cetirizine (Zyrtec)
T or F

A

True

48
Q

Effect of Alpha-1 agonist and where is it used for treatment

A

-Vasodilation causes a stuffy nose
Alpha-1 Agonist binds to Alpha-1 receptor -> Vasoconstriction

Alpha-1 Agonist - Decongestant
-Ephedrine
-Phenylephrine
-Pseudoephedrine (1 CH3 away from methamphetamine)
-Naphazoline (mostly ophthalmic – “gets the red out”)
-Oxymetazoline (12 hour due to enzyme resistance)

49
Q

What might happen if alpha-agonists are taken periodically or systemic (oral)

A

-periodically: Tachyphylaxis (decrease in response), rebound stuffy nose

-systemically (oral): Vasoconstriction -> raises blood pressure

50
Q

What does the “D” indicate in Combination products?

A

Decongestants (alpha agonist)
-often in antihistamine products

51
Q

What is the MOA of Leukotriene inhibitors?

A

Antagonist (Blockage) of the LTD4 receptors
LTD4 (inflammatory mediator) mediates vascular permeability, mucus secretion, attracts other immune cells -> ALLERGY reaction

-f.e. Monteklust (Singulair)

BOXED WARNING: neuropsychiatric signs
AVOID in patients with a psychiatric history

52
Q

MOA of Glucocorticoids

A

-f.e. Fluticasone converted to Cortisol
Cortisol binds to the cytosolic receptor and moves to the nucleus -> together with a co-factor it represses transcription in immune cells (in other cells f.e. fat cells it can activate transcription)

-> IMMUNOSUPPRESSIVE

53
Q

Why should patients on Glucocorticoids not discontinue the drug abruptly?

A

Negative Feedback loop of Glucocorticoids -> suppressing CRH and ACTH -> in the Hypothalamus pathway -> low levels of natural cortisol

-adrenal deficiency -> stopping the glucocorticoids abruptly will result in the patient having insufficient steroids in the body -> fatigue, muscle weakness, weight loss

54
Q

What does the BLACK BOX WARNING

A

-avoid in patients with mental disease, if they have mild allergic reactions
-For allergic rhinitis: only use if patients can’t tolerate other allergy medicines

55
Q

NEED TO KNOW

A

-Identify the Gen by the name
-Function of the H receptors
1-anti allergic
2-gastric acid
3-drowsiness
-LTD4 receptors - BLACK BOX WARNING
-Function of Glucosteorides

Pulmonary (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions