Watson S2 Flashcards
What does FEV1 stand for
Forced expiratory volume in 1 second
What is a mitogen?
Mitogens are endogenous regulators of growth they are produced and released during inflammation
Name 4 mitogens
Platelet derived growth factors
Endothelin (peptide)
Cytokines
Histamine
What are modulators
They are endogenous regulators of growth that suppress growth of smooth muscle
Name 3 modulators
Heparin
Nitric oxide
Prostaglandins E2
What does PEFR stand for
Peak expiratory flow rate
What are the predominant nerves in airways?
Cholinergic nerves
How does increased cholinergic muscle tone occur?
1) stimulate parasympathetic nerve
2) ACh release
3) stimulates M3 receptors on airway smooth muscle
4) Gq -> PLC -> Ca2+
5) contraction
When a muscarinic receptor is stimulated what ultimately initiates contraction?
Phosphorylation of myosin light chain
Circulating adrenaline works on what receptors
Acts on beta-adrenoceptors on airway smooth muscle
What are the effects of adrenaline on airway smooth muscle
Dilation
What does iNANC stand for
Inhibitory non-adrenergic non-cholinergic transmitters
Name two dilator Neuropeptides
CGRP
Vasoactive intestinal polypeptide (VIP)
What does neuronally derived NO act in and what does it cause
Soluble guanylate cyclase
Dilation of smooth airways
Are there many neuroadrenergic receptors in the airways?
No
Name three ways in which activation of G-alpha s via stimulation of beta2 adrenoreceptors causes bronchodilation
Stimulates PKA which:
1) opens k+ channels
2) inactivates MLCK
3) calcium uptake
Via what is MLC phosphatase activated by when beta 2 adrenoreceptors are stimulated?
G-beta-gamma
Name a short acting beta-2 adrenoceptor agonist?
Salbutamol
Name two long acting beta-2 adrenoceptor agonists
Formoterol
Salmeterol
Name a phosphodiesterase inhibitor
Theophylline
How do phosphodiesterase inhibitors work
Inhibit breakdown of cAMP so more bronchodilation
Name two types of phosphodiesterase in the airway smooth muscle?
PDE III and IV
Name two types of asthma
Extrinsic- atopic
Intrinsic- non-atopic
Heparins are a mast cell product that are protective: true or false
TRUE
List 7 mast cell products
Histamine TNF and cytokines Proteases Heparins Leukotrienes Prostanoids Platelet activating factor
Why can’t asthmatics have NSAIDs?
Because it blocks COX which can increase arachidonic acid so more leukotrienes
Name two leukotrienes that are potent constrictors of airway smooth muscle
LTC4 and LTD4
Name a leukotriene that is chemotactic for leukocytes
LTB4
How is the prostanoid PGE2 involved in asthma
Relaxes airway smooth muscle may decrease leukocyte activation sensitises irritant receptors- cough
How is the prostanoid PGD2 involved in asthma
Chemotactic
Bronchoconstrictor
Name three classes of stimuli that stimulate eosinophils
Cytokines
Lipid mediators (LTB4 & PAF)
Chemokines (eotaxin)
Name two anti inflam steroids
Prednisolone
Budesonide
If you inhibit phosphodiesterase IV in leukocytes what happens?
Increased intracellularly cAMP which in turn inhibits chemotaxis, granule release and respiratory burst
Name two leukotriene receptor antagonists
Montelukast
Zafirlukast
Name a leukotriene synthesis inhibitor
Zileuton (inhibits the enzyme 5-lipoxygenase)
Drugs ending in lukast are what and block what?
Leukotriene antagonists
Block LTC4 and LTD4
Name two anti-allergic ‘cromones’
Disodium cromoglycate (DSCG) Nedocromil
Name 3 H1 receptor antagonists
Chlorpheniramine
Astemizole
Cetirizine
Name an anti-IgE antibody
Omalizumab
Name a non- specific muscarinic antagonist
Ipratropium
Why are non specific muscarinic antagonists a bit shit?
The block M2 as well as M3 so loss of negative feedback so increased ACh release can overcome M3 block
Name two M3 selective muscarinic antagonists
Tiotropium
Aclidinium
Name a phosphodiesterase IV selective inhihitor
Rofulimast
Name a mucolytic that breaks disulphide binds in mucin
N-acetyl cysteine
What does HAT stand for and what is it
Histone acetyltransferase- it acetylates histones hence unpacking chromatin to allow RNA polymerase binding to DNA
What does HDAC stand for and what does it do
Histone deacetylase it represses inflammatory gene expression
True or false: theophylline promotes HDAC (restoring sensitivity)
TRUE
What’s the name of the deletion gene mutation that’s 70% most common in western populations for CF
Triangle F508
What’s the Guthrie test?
Test for inmunoreactive trypsinogen (IRT) it’s elevated in CF in the bloodstream as isn’t secreted into gut
If the Guthrie test and genetic screening is negative what test do you do for CF?
Sweat test- elevated Cl- levels
Below 30mM CF unlikely
Above 60mM CF likely
What does CFTR stand for what do you have if its defective?
Cystic fibrosis transmembrane conductance regulator
CF
Is CFTR a pump?
NO it’s an ion channel DUHHHH
What’s the name of the faulty gene in class 1 CF
GF42X (nonsense mutation)
What’s the name of the deletion mutation in class 2 CF
F508
Give an example of a mutation in class 3 CF
G551D
Name a mutation in class 4 CF
R117H
Ataluren is a drug used in class 1 CF- how does it work?
Forces read through of premature termination code
What is amiloride?
Drug used in CF to block ENaC so blocks sodium resorption
