Brainscape's Knowledge GenomeTM

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


See full index

Third year > Week 8 - Respiratory > Flashcards

Week 8 - Respiratory Flashcards

1
Q

What is spirometry?

A

Forced expiration from total lung capacity followed by full inspiration. Best of 3

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

What are some pitfalls to spirometry?

A

Trained technician, effort and technique dependent, patient frailty, pain or too unwell.

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

What would spirometry show in COPD

A 
Obstrucitve. FEV1/FVC <70%
FEV1 >80% mild
50-79% moderate
30-49% severe
<30% very severe
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are some causes of restrictive spirometry?

A

Interstitial lung disease (IPF, sarcoidosis), Obesity, pneumonia, poor effort and technique, neuromuscular disease

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

What effect does smoking have on the lungs?

A

Reduced filial motility, airway inflammation, mucus and goblet cell hypertrophy, increased protease activity and reduced anti-protease activity. Squamous metaplasia

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

What might reduced transfer factor show?

A

Restrictive lung disease

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

What are some conditions that cause transudate?

A

Heart failure, cirrhosis, hypothyroidism, renal failure

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

What are some condition cause exudate?

A

Malignancy, infection, TB, AI , drug induced

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

What is obstructive sleep apnoea?

A

Recurrent episodes of parietal or complete upper airway obstruction during sleep, intermittent hypoxia and sleep fragmnetation

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

Define chronic bronchitis.

A

Production of sputum on most days for at least 3 months in at leats 2 years.

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

Define emphysema

A

Abnormal, permanent enlargement of the airspaces distal to the terminal bronchioles.

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

Explain the mechanism of airflow obstruction in COPD

A

Loss of elasticity and alveolar attachments due to emphysema. The airways collapse on expiration. This leads to air-trapping and so hyperinflation ->increased work of breathing –> breathless.
Goblet cell metaplasia with mucus plugging. Inflammation, thickening of bronchiolar wall.

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

What drug may cause non-idiopathic pulmonary fibrosis?

A

Methotrexate

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

What are the clinical effect of allergies on the airways?

A

Thickening of the septae, filling of alveolus with fluid, loss of oxygen, air space shadowing on CXR.
chronic exposure: Fibrosis, interstitial destruction from neutrophilic enzymes

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

What is primary pneumothorax?

A

Development of sub pleural blebs or bull at the lung apex.
Spontaneous rupture leads to tear in visceral pleura.
Elastic lung collapses

Treat conservatively

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

What is Secondary pneumothorax?

A

Underlying lung condition
Weakness in lung tissue
Increased airway pressure
Increased lung elasticity

Aspirate or ICD

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

What is the pathogenesis of lung cancer?

A

Chronic irritation/ stimulation of cells by carcinogens
Increased cell turnover
Progressive accumulation of genetic abnormalities in molecules involved in the cell cycle, signalling and angiogenesis

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

What do Azole drugs do?

A

Inhibit ergosterol, an essential component of fungal plasma membranes. - Destroy Fingal plasma mem

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

Define a positive bronchial hypersensitivity test.

A

Fallen FEV1 by 20% brought about by less than 8mg per ml of methacholine (or histamine or mannitol)

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

What causes a veil sign on a CXR?

A

Left upper lobe collapse

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

What causes the sail sign on CXR?

A

Left lower lobe collapse

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

What might a right upper lobe collapse look like on CXR?

A

Golden S sign
Elevation of horizontal fissure
Elevation of right hilum

23
Q

What are some methods of measuring lung volume?

A

Helium dilution

Body plethysmography

24
Q

Define apnoea.

A

The cessation or near cessation of airflow for more than 10 seconds. 4% oxygen desaturation

25
Q

How does the antifungal Amphotericin B work?

A

Binds sterols in the fungal membrane. it creates a transmembrane channel allowing changes in permeability. Leakage of IC components - cell death

26
Q

What does Omalizumab do?

A

Monoclonal Anti-IgE. SC every 4 wks (SE hypersensitivity)

27
Q

What does Mepolizumab do?

A

Anti-IL5 reduces circulating Eosinophils

28
Q

What are some causes of Type 1 respiratory failure?

A

Pneumonia, PE, Pulmonary oedema, pulmonary fibrosis

29
Q

What are some causes of Type 2 respiratory failure?

A

COPD, neuromuscular disease, obesity, hypoventilation.

30
Q

What type of lung cancer tends to arise peripherally?

A

Adenocarcinoma

31
Q

What type of lung cancer tends to arise centrally?

A

Small cell and squamous

32
Q

Where are the local sites of lung cancer metastasis?

A

Pleura - haemorrhagic effusion, hilar LN, pericardium - pericardial effusion or pericarditis, mediastinum, adjacent lung tissue, Recurrent laryngeal nerve compression (hoarse voice), phrenic nerve compression (hemidiaphragm paralysis)

33
Q

What is the histological appearance of small cell carcinoma? (arise from neuroendocrine APUD cells)

A

Oval-spindle shaped cells, nuclear moulding

scant cytoplasm, inconspicuous nucleoli, apoptotic bodies

34
Q

What is an Exacerbation of COPD?

A

Sustained worsening of the patients symptoms from their usual stable state which is beyond normal day to day variation and is acute onset worsening: breathlessness, cough, increased sputum and change in colour

35
Q

How does Roflumilast work in COPD?

A

Reduces release of pro-inflammatory mediators and cytokines. ORAL. Reduces exacerbations

36
Q

What are some signs of a mesothelioma?

A

Decreased expansion, stony dull percussion, diminished breath sounds on affected side, vocal resonance reduced

37
Q

Aspergillioma can be caused by aspergillum fumigates, what is it?

A

A fungal ball that develops in an area of past lung disease or lung scarring

38
Q

What is interstitial lung disease?

A

Non-infective, non-malignant infiltration of the lung parenchyma

39
Q

What is sarcoidosis?

A

Multisystem granulomatous disorder, predominantly affecting lungs and intrathoracic LN.
Asteroid bodies
Non-caeseating granulomas

40
Q

What are some features of squamous carcinomas in lung cancer?

A

P53 mutation, Central, block airway and cause pneumonia or collapse, may cause cavitation, intercellular bridges and keratinisation

41
Q

What are some features of adenocarcinoma in lung cancer?

A

Mucin producing, glandular, check EGFR, commonest in females and non-smokers, peripheral

42
Q

What are some signs of a mesothelioma?

A

Decreased expansion, stony dull percussion, diminished breath sounds on affected side, reduced tactile vocal remits and resonance. Tracheal deviation away from effusion.

43
Q

How might you visualise the pleura directly?

A

Thoracoscopy

44
Q

How would you manage a mesothelioma?

Asbestos bodies

A

Chest drain +/- talc pleurodesis

45
Q

What is interstitial lung disease?

A

Non-malignant, non-infective infiltration of the lung parenchyma. Chronic inflammation and progressive interstitial fibrosis

46
Q

What results might you get in a person with sarcoidosis if you perform a bronchoalveolar lavage?

A

Active disease - Increased lymphocytes (+ increased mast cells in hypersensitivity pneumonitis)

Pulmonary fibrosis - increased neutrophil

47
Q

How might someone with sarcoidosis present?
Acute - bed rest and NSAIDs
Prednisolone 4-6weeks
severe - IV methylprednisolone, methotrexate, TNF-alpha
lung trasplant

A

Dry cough, progressive dyspnoea, reduced exercise capacity and chest pain. Fever, night sweats, anorexia, weight loss, fatigue
Conjuctivitis, uveitis, glaucoma,
Dermatological, neurological and cardiac manifestations

48
Q

What might you see in an acute and chronic extrinsic allergic alveolitiis X-ray?

A

Acute - upper zone consolidation, hilarity lymphadenopathy

Chronic - upper zone fibrosis and honeycombing

49
Q

What are the treatment options for IPF?

A

Non-specific Interstitial pneumonia - NASIAs, steroids
Unusal IP - Pifenidone (antifibrotic, slows lung function decline)
Nintedanib (IC inhibitor of TK)
N-acetyl cystine

50
Q

What are some signs of a pneumothorax?

A

Hyper-resonant to percuss
Reduced vocal resonance
Tracheal deviation AWAY
Reduced expansion on affected side

51
Q

How would you treat the fungal infection with crytococcus neoformins (causes meningitis)?

A

IV amphotericin B

Fluconazole

52
Q

What is Allergic bronchopulmonary aspergillosis?

A

Allergic reaction to a fungal infection

Prednisolone

53
Q

What is invasive pulmonary aspergillosis?

A

It becomes systemic and spreads throughout the body

Amphotericin B

54
Q

What is an aspergilloma?

A

A fungal ball that Develops in an areas of past lung disease or lung scarring

Third year (15 decks)

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