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Respiratory JC > Week 2 > Flashcards

Week 2 Flashcards

1
Q

What is DPLD? What part of the lung does it effect?

A

Diffuse parenchymal lung disease, it is an umbrella term for conditions that affect the interstitium of lungs causing fibrosis, lack of compliance,

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2
Q

Give an example of a condition that could cause dpld?

A

Extrinsic allergic alveolitis

Infection

Amiodarone (antiarrythmic drug)

Sarcoidosis
Heart failure

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3
Q

How can DPLD present?

A 
With finger clubbing, cough but no wheeze 
Breathless on exertion
Inspiratory lung crackles
Central cyanosis if hypoxic
Pulmonary fibrosis
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4
Q

How do you treat DPLD?

A

Avoidance of trigger
Treat underlying cause
Corticoid steroids to suppress immune system
Drugs to prevent further deposition of collaen like pirfenidone and nintedanib

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5
Q

What are the locations of the respiratory centres?

A

Ventral and dorsal neurones in the botzinger complex within the medulla

Pneumotaxic centre in pons

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6
Q

What do the ventral neurones control?

A

Upon excessive stimulation of the dorsal neurones they cause the activation of the internal intercostal muscle and abdominal muscle to carry out active expiration

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7
Q

What do the dorsal neurones control?

A

Firing of these neurones cause the contraction of the inspiratory muscles, diaphragm and the external intercostal muscles.

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8
Q

What occurs when the dorsal neurones stop firing?

A

Passive expiration

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9
Q

What is the term for brief expiration

A

Apneusis

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10
Q

How can the pneumotaxic centre modify the rate of inspiration

A

By inhibiting the dorsal neurones firing

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11
Q

What is the main function of the peripheral chemoreceptors

A

To sense oxygen saturations and H+ ion concentrations. If metabolic acidosis will undergo hyperventilation

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12
Q

What is the main function of the central chemoreceptors?

A

Sense arterial Co2 and Hydrogen ions in the brain

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13
Q

Why is there increased respiratory rate during exercise?

A

Joint receptors activated causing increase in resp

Accumulation of CO2 and H+

Adrenaline acting on beta 2 adrenoceptors

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14
Q

What is the term for increased RBC production?

A

Polycthaemia

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15
Q

What is the function of 2,3 BPG production in RBC’s

A

O2 easier offloaded to tissues

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16
Q

What is the negative predictive value for a test?

A

The % of people who have a negative test who actually dont have the disease. True negative vs false negative

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17
Q

What is the positive predictive value?

A

% of people who have a positive test for a disease who actually have the disease

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18
Q

What is the normal proportion for a lung volume test of FEV1/FVC

A

75%

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19
Q

What happens to the FEV1/FVC ratio is asthma and Copd

A

Is reduced

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20
Q

What happens to the FVC in asthma and COPD

A

Athma fvc the same

Copd fvc reduced

21
Q

Describe the inflammatory cascade in asthma

A

Eosinophillic inflammation

Th2 activation
Cytokines

Twitchy smooth muscle

22
Q

What are the two main classes of drugs for airflow obstruction diseases?

A

Preventers; antiinflammatory

Relievers; bronchodilators

23
Q

Name some anti-inflammatory drug classes

A 
Steroids
Cromones
Leukotriene receptor antagonists
Anti-ige
Anti-IL5
PDE4 inhibitors
24
Q

Name some bronchodilator drug classes

A

Beta agonists

Muscarinic receptor antagonists

25
Q

What are the two drugs in the corticosteroid antiinflammatory class?

A

Inhaled; beclomethasone

Oral; predinisalone

26
Q

What is the main drug used in the cromones anti-inflammatory class? What is its function

A

Sodium cromoglycate- a mast cell stabiliser

27
Q

Name the drug in Leukotriene receptor antagonists, how does this work? What drug is it used in conjuction with?

A

Monteleukast orally taken

Inhibits receptor on eosinophils that leukotrienes bind

ICS

28
Q

Name an anti-ige medication and an anti-il5 and their modes of action

A

Anti ige- inhibits TH2 response that attracts eosinophils. OmaliZUMAB

Anti-il5- inhibits the IL-5 that acts on eosinophils. mepoliZUMAB or resliZUMAB

29
Q

What is a PDE4 drug, what condition does it treat, what is it prescribed with?

A

Roflumilast, COPD, prescribed with a LABA or LAMA

30
Q

Name muscarinic receptor antagonists long and short acting

A

Short acting- ipratropium

Long acting - tiatropium

31
Q

What do methylxanthines treat? What is prescribed for an acute attack Vs management

A

COPD and asthma

Theophylline for maintenance
Aminophylline for acute attacks (A for A)

32
Q

Describe how activation of muscarinic M3 receptors cause bronchial smooth muscle contraction

A

Acetylcholine acts on M3 receptors to activate a G protein that activates the phospholipase C pathway causing an influx in calcium ions that allow contraction of the smooth muscle

33
Q

Name some causes of respiratory acidosis

A

Choking
Bronchopneumonia
COAD (chronic obstructive airway disease)

34
Q

Name some causes for respiratory alkalosis

A

Mechanical Hyperventilation
Hysterical hyperventilation
Raised intracranial pressure (stimulating respiratory centres driving ventilation)

35
Q

What are some causes for metabolic acidosis

A

Impaired H+ excretion (renal failure)

Increased H+ production from ingestion

Loss of HCO3-

36
Q

What are some causes for metabolic alkalosis

A

Vomiting (loosing H+ ions)

Alkali ingestion

Potassium deficiency

37
Q

What is involved in respiratory alkalosis

A

Loss of CO2

38
Q

What is involved in metabolic acidosis

A

Increased presence of H+ ions

39
Q

In healthy individuals what is the range of SaO2 saturations?

A

94-98%

40
Q

What is type 1 resp failure?

A

Where there is lack of oxygen

41
Q

What is type 2 resp failure?

A

When lack of oxygen and too muchco2

42
Q

What is VQ mismatching

A

When ventilation and perfusion are not the same due to infarct, poor diffusion

43
Q

What is the haldane effect?

A

That when haemoglobin is empty from o2, co2 will bind to it

44
Q

What is the bohr effect

A

As acidity and co2 concentration increases, haemoglobins affinity for oxygen decreases

45
Q

What two vitamins are required for the maturation of RBCs

A

B12 and folate

46
Q

What is the maximum volume of air that can be expired in a single breath following maximum inspiration ?

A

Vital capacity

47
Q

What is equivalent to inspiratory reserve volume plus tidal volume, plus expiratory reserve volume?

A

Vital capacity

48
Q

What is the volume of air in the lungs following passive normal expiration?

A

The functional residual capacity

Respiratory JC (11 decks)

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