Week 9 Flashcards

1
Q

What traps dust and smoke

A

hair and mucus

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2
Q

What prevents food and liquid from entering lower respiratory tract

A

epiglottis

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3
Q

Where does conducting zone start and end

A

trachea to bronchus

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4
Q

where does respiratory zone begin

A

bronchioles with alveoli

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5
Q

where does gas exchange occur at

A

respiratory zone (bronchioles with alveoli)

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6
Q

What prevents alveoli walls from collapsing and sticking together

A

slightly oily surfactant

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7
Q

What monitors PaCO2

A

Central chemoreceptors in medulla oblongata

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8
Q

what monitors PaO2 and blood pH

A

Peripheral chemoreceptors in carotid and aortic arch

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9
Q

What is respiratory failure

A

when lungs fail to oxygenate arterial blood adequately to prevent carbon dioxide retention

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10
Q

hypoxemia

A

partial pressure of oxygen <60mmHg

Reduced PaO2 in arterial blood

Leads to tissue hypoxia

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11
Q

hypoxemia AKA

A

type I respiratory failure

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12
Q

hypocapnia

A

partial pressure of carbon dioxide > 50 mmHg

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13
Q

hypocapnia AKA

A

type II respiratory failure

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14
Q

Mild symptoms of hypoxemia

A

Decreased mental power, visual, tachypnea

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15
Q

profound symptoms of hypoxemia

A

CNS, CVS, Respiratory

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16
Q

Tissue hypoxia

A

inadequate cellular oxygenation

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17
Q

tissue hypoxia effects

A

CNS, Myocardium, Renal, Vascular

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18
Q

CNS effect of tissue hypoxia

A

hypoxic ischemic encephalopathy

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19
Q

How to identify respiratory failure

A

Vital signs, GCS, Respiratory findings

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20
Q

How to stabilize patients with respiratory failure

A

airway, breathing, circulation

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21
Q

what needs to be investigated for respiratory failure

A

arterial blood gas, CXR, CT scans

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22
Q

ABG is taken from ___

A

radial, brachial, femoral arteries

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23
Q

lung cancer symptoms related to __

A

primary lesion, intrathoracic spread, distant metastasis, paraneoplastic (unusual hormone expression)

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24
Q

ways to diagnose lung cancer

A

CXR, CT scan, PET scan, biopsy

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25
Q

what is the most common screening test for lung cancer

A

CXR

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26
Q

radiological findings for lung cancer

A
  • coin lesions
  • large irregular masses
  • alveolar consolidation
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27
Q

stage 1 of lung cancer signs

A

tumor is 1-4cm

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28
Q

stage 2 of lung cancer signs

A

tumor is 3-7cm, may be in lymph nodes / surrounding tissues

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29
Q

stage 3 of lung cancer signs

A

tumor is 3-7cm, disease in more than 1 lymph node / surrounding tissues

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30
Q

stage 4 of lung cancer signs

A

metasized cancer

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31
Q

NSCLC stage I

A

local disease

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32
Q

NSCLC stage II

A

resectable

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33
Q

NSCLC stage IIIa

A

locally advanced resectable

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34
Q

NSCLC stage IIIb

A

locally advanced unresectable

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35
Q

NSCLC stage IV

A

far advanced

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36
Q

diff types of NSCLC

A
  • adenocarcinoma
  • squamous cell carcinoma
  • large cell carcinoma
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37
Q

diff types of small cell lung carcinoma

A
  • combined small cell carcinoma
  • oat cell carcinoma
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38
Q

what is the lung test function to diagnose asthma

A

spirometry

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39
Q

factors of asthma

A

wheezing
dyspnea
cough
chest tightness

40
Q

increased probability of asthma

A
  • > 1 symptom
  • worsens at night
  • varying intensities
  • multiple triggers
41
Q

decreased probability of asthma

A
  • isolated cough
  • chronic sputum
  • dyspnea with giddiness & paresthesia
  • chest pain / stridor
42
Q

goals of asthma treatment

A
  • control symptoms
  • maintaining lung function
  • prevent exacerbations, asthma death
  • minimize side effects
43
Q

main determinants of oxygen delivery are __

A

cardiac output, hemoglobin & arterial oxygen saturation

44
Q

most common cause of hypoxemia

A

mismatch between ventilation & perfusion

45
Q

causes of hypercapnia are __

A

neurological, lungs & blood flow

46
Q

ABG measures

A

amount of O2 & CO2 dissolved in arterial blood

47
Q

NCS

A

nerve conduction study

48
Q

EMG

A

electromyography

49
Q

surgical evaluation of lung cancer done via __

A

VATS & thoracotomy

50
Q

asthma involves inflammation of ___

A

airways

51
Q

allergic asthma onset caused by __

A

childhood, atopy, eczema, food/drugs

52
Q

non allergic asthma onset caused by __

A

obesity, adult, smoking

53
Q

adult onset caused by __

A

late onset, female, no allergies

54
Q

persistent airflow limited asthma onset caused by __

A

persistent chronic asthma

55
Q

cellular involvement of allergic asthma

A

eosinophils & inflammation

56
Q

cellular involvement of non allergic asthma

A

neutrophils, inflammation

57
Q

cellular involvement of adult onset asthma

A

paucigranulocytic

58
Q

cellular involvement of chronic asthma

A

airway wall remodelling

59
Q

cellular involvement of asthma with obesity

A

less eosinophilic

60
Q

AIR

A

anti-inflammatory reliever

61
Q

MART

A

maintenance & reliever therapy

62
Q

SABA

A

short acting beta agonists

63
Q

triage escalation for asthma only occurs if __ are present

A

drowsiness, confusion, silent chest

64
Q

genetically determined COPD / COPD-G

A

alpha-1 antitrypsin deficiency

65
Q

COPD from infections / COPD-I

A

childhood, tuberculosis, WHIV

66
Q

COPD-A

A

childhood asthma

67
Q

COPD-D

A

COPD from abnormal development

68
Q

COPD-P

A

biomass and pollution exposure COPD

69
Q

COPD-C

A

cigarette smoking COPD

70
Q

COPD-U

A

COPD of unknown causes

71
Q

chronic bronchitis causes

A

inflammation & excess mucus

72
Q

emphysema causes

A

alveolar membrane breakdown

73
Q

biomarkers involved in systemic inflammation of COPD

A

IL-6, IL-1beta, TNF-alpha

74
Q

dyspnea signs before considering COPD

A

progressively worse over time esp with exercise

75
Q

follow up assessments after spirometry

A

pharmacology, alternative diagnosis, interventional procedures

76
Q

spirometry assesses for __

A

airflow obstruction severity

77
Q

COPD classification workflow

A
  1. spirometry confirmation
  2. airflow obstruction assessment
  3. exacerbation / symptom assessment
78
Q

ABE assessment involves ___

A

exacerbations, mMRC, CAT

79
Q

mMRC

A

modified medical research council

80
Q

COPD medication categories

A

short acting bronchodilators
long acting bronchodilators
combination inhalers

81
Q

LAMA

A

long acting muscarinic antagonist

82
Q

ICS

A

inhaled corticosteroid

83
Q

LABA

A

long acting beta2-agonist

84
Q

Group E treated using

A

LABA + LAMA (+ICS if blood eos > 300)

85
Q

Group A treated using

A

A bronchodilator

86
Q

Group B treated using

A

LABA + LAMA

87
Q

what factors strongly favor ICS initiation

A

> 2 exacerbations annually
blood eosinophils > 300 microlitre
concurrent asthma

88
Q

what factors strongly prohibit ICS initiation

A

repeated pneumonia
blood eosinophils < 100 microliter
mycobacterial infections

89
Q

5A’s to quite tabacco

A

ask, advice, assess, assist, arrange

90
Q

if patient is not viable for bullectomy, ELVR, LVRS, what can they consider?

A

lung transplant

91
Q

interventions of bronchodilators

A

LABA, LAMA

92
Q

interventions of corticosteroid containing regimens

A

LABA, LAMA, ICS

93
Q

interventions of anti-inflammatory non-steroids

A

roflumilast

94
Q

interventions of mucoregulators

A

N-acetylcysteine, carbocysteine, erdosteine

95
Q

breakdown of alveoli wall is due to __

A

loss of surface area for gas exchange, pulmonary capillaries, elastic fibers

altered ventilation-perfusion ratio

decreased support for small bronchi

96
Q

a post-bronchodilator FEV1/FVC ___ confirms the
presence of persistent airflow limitation

A

< 0.70

97
Q

COPD surgery includes ___

A

bullectomy, lung volume reduction strategy