Week 10- Resp and CVD

Question 1

smoking down stream affects

Answer 1

smoking–>alevoli disrupiton/damage–>increase in local lung inflamm–>involvement in other systems as smoking becomes chronic–>impacts gut microbiota directly or because of increase in systmeic inflamm

the systmeic inflamm can cause increase in imm cells in the gut or a difference of mcirobiota composure also more bacteria/harmful bacteria in other tissues

Question 2

HIV downstream affects

Answer 2

HIV–>pulmonary hypertension–>local and systemic inflamm–>affects the heart

Question 3

strokw downstream affects

Answer 3

stroke can cuase significant increase in inflamm and exasterbate damage in brain but also lead to increase in immune cells ending up in places like the lung(thought to becontribtuing to lung infection) and gut.
we also see chnages in gut microbiota where its been found in the urinary tract(many stroke patients get UTIs)

Question 4

how many of the surviving stroke patients get a recurring storke? and if they do what are the implications

Answer 4

10%

icnreased chnage of severe stoke and increased chnace of death

Question 5

Why do we treat with aspirin?

Answer 5

to prevent recurring storke particularly as these patients tend to have clotting complications and other risk factors (atrial fibrillation and hypertension-main risk fatcro)

Question 6

infarct damage is caused by …

Answer 6

Immediate necrosis or and delayed apoptosis

Question 7

Which type of stroke has the best survival probability over 15 yr period?

Answer 7

subarachnoid

Question 8

Which types of stroke have the worst survival probability over 15 years?

Answer 8

intracerebral hemorrhage and cerebral ischemia have worst outcomes, with quite low probability of survival after 15 yrs(20%)

Question 9

what is the most likely cause of death after the first nonfatal stroke?

Answer 9

recurring stroke

Question 10

TIA is an indicator of…

Answer 10

a more severe stoke potentially occurring afterwards

Question 11

How many stroke patients in an acute time end up with pneumonia?

Answer 11

6%

Question 12

Why is pneumonia risk increased post stroke?

Answer 12

after stroke–> rapid increase in imm cell infiltration into brain–>?3-4 days post stroke, brain shuts down imm system to creased inflitration and the dmaage associated.–> patientsa re now immunosuppressed leading to increased risk of infection

Question 13

The spleen reduces in size post stroke because…

Answer 13

an huge influx of imm cells infiltrating the brain and because of increased apoptosis

Question 14

Why was it first thought that storke patients got pneumonia?

Answer 14

because the patients are in the hopsital

Question 15

After inducing ischeamic attack in a mouse CFU were found as early as …. in the lungs

Answer 15

12hrs

Question 16

Were CFU foudn int he lungs of blood first and what does this mean?

Answer 16

in the lungs first, propsed that potentilaly it invades the lungs and then leeches into blood but still ubknown

Question 17

histological changes in the mouse lungs after MCAO

Answer 17

chnage in lung strutcure, increased imm cell infiltration(inflamm), increased in neutrphil infiltration, evidence of E.coli pneumonia

Question 18

When anaylysing the bacteria found in the lungs of MCAO mice they foudn…

Answer 18

the genus types were very simialr to gut microbiota, showing that it may be getting out of the gut anf being found in other tissues

Question 19

How did we confirm that this bacteria was leeching to other tissues post stroke?

Answer 19

germ free mice used and stroke induced to see if there was this similar infiltration and inflammation after the stroke. normal mice had signoifcant amount of bacteria in the lungs but there was not in the germ free mcie

Question 20

mechanism that is driving increased bacteira in the lungs?

Answer 20

stroke–> increase in symp output–>(gut and spleen are very symp acitvated)–> more bacteria infiltration

Question 21

By using increasing propanolol(a b2 antag) to decrease symp activation post stroke what was found…

Answer 21

wiht increasing doses we see decrease in CFU in both lung and blood.
also found that there was a decrease in mortality when propanolol was administered

Question 22

antibacterial treatment was found to…

Answer 22

increase functional mobility, decrease mortality, decrease infarct damage

Question 23

Preventative antibiotics for stroke

Answer 23

foudn that infections were siginicantly reduced but pneumonia reduction was not significant
all clinical trials have found the same thing.