B6- Examining Respiratory System II Flashcards

1
Q

What is pulse oximeter put on finger estimating

A

Estimates saturation of peripheral oxygen (Spo2). (Estimation of aretial Sao2)

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

How does it use absorbance

A

Uses difference in absorbance of infrared and red light by deoxygenated venous and oxygenated arterial to determine Spo2

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

What saturation indicates normal oxygen saturation using pulse oximetry

A

90%

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

What would affect the readings

A

Circulation to hand, nailvarnish, co poisoning, skin pigmentstion affects readings

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

What is better accurate measure

A

Arterial blood gas analysis abga

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

Does pulse oxometry indicate levels of co and co2

A

No whcih is an issue as significant

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

What would happen if no hb eg in antarctic ice fish

A

Lack of aaturation of oxygen

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

Does blood have more cpascity to carty o2 or co2

A

Co2 but much lower at around 40 compared to 100mmhg because tight regulatio

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

What is added to blood in agba and why

A

Heparin to dtop coagulation of blood sample

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

How is blood drawn

A

Aneribically to block changes in gases

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

What does agba measure

A

Ph, pao2,paco2, hco3 bicarbonate levels all in arrterial blood

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

What should ph be and what would cause increqse or decrease leading to cell death

A

7.35-45. If lower emans more co2 if higher more hco (alkalosis)

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

What are normal paco2 from agba unless hypo/hypervent

A

35-50 mmhg

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

What do low levels or high lrvels of hco indicate

A

Low means metabolic issue

High means its a compensatort effect eg in chronic diseases

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

What is normal pao2 in agba

A

75-105mmhg (venous is 60)

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

What is an acid base and buffer

A

Acid is a proton donator

Base is proton acceptor

Buffer reversibly binds protons/h ions = resistance to ph change

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

How much co2 is dissolved in blood freely

A

10%

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

30% of co2 are in carbamino compounds with proteins. Give an example

A

Carbaminohaemogoblin (co2Hb)

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

What happens to the rest of co2 (60%)

A

Teacts with water eg in rbc via carbonic anhydrase and produces carbonic acid which is dissociated to h and hco

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

What protein acts as a buffer by binding H through 38 hidtidine residues

A

Haemoglobin

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

What type of haemoglobin bunds H only

A

Reduced (oxyfen would displace it)

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

Other than the hb buffer. What else allows buffering in acid response/coping wirh co2

A

H+ can be removed by distal tubule cells in kidney and hco can be released

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Why is co2 exchnage out of lungs important

A

Reduces lecels of carbonic acid restoring ph

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which arrucle discusses ph refulstion in co2 increase by chemorecetors

A

Nattie 1999

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What did nattie 1999 find

A

Peripheral chemo csrotid body glomus cels have a ph snesitice k channel which closes in reduced during metabolic acidosis causinf depolarisation and gkuramate release allowing hyperventilating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Which article discusses carrying of co2

A

Arthurs et al 2005

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Why when carbonic acid dissociates to hco in rbc is hco removed and how (arhturs 2005)

A

Removed by cl exhcnage so cell doesnt rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What does co2 bind to to form carbamino compounds (arthurs)

A

The uncharged amino group on proteins eg haemoglobin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Which part of the 38 histidines acts as a base when hhb forms in reduced haemoglobin

A

Imidazole

30
Q

What forms if H is increased too much eg due to haldene effect

A

Co2 whixh is rhen removed forn lungs

31
Q

What does reducing co2 from lungs reduce

A

Hco and h lecels

32
Q

How many ml/min of co2 is exhaled

A

200ml/min from lungs = cope with co2

33
Q

What is acute tespiratory acidosis

A

Increased co2 (no change in hco)

This is due to hypoventilation or v/q mismatch.

34
Q

What diseases xause this hypoventilation

A

Neuromuscular diseases, obstrcutivr diseases eg asthma or copd

35
Q

What increases in chronic resp acidosis

A

Both co2 but compensatory effect causes also increased hco

36
Q

Does chronic reap acidosis have same causes ie neuromusc, obstructive, v/q mismatch

A

Yes as hypovent causes increased co2 and so does v/q

37
Q

Does eenal compensatory effect inly occur in chronic acidosis

A

Yes

38
Q

What is respiratory alkalosis and give where it can occur

A

Increase in ph and low co2 due to hyperventilation ef during stress or in altitude

39
Q

What can happen if respiratory alkalosis is prolonged

A

Renal compensation

40
Q

Which articel discusses respiratort alkalosis

A

Alan et al 2020

41
Q

What did alan et al 2020 say about renal comp in resp alkalosis

A

Found refuced hco reabsoprtion by distal and also refuced ammonihm which gathers if too kuch h is exceeted, meaning h is beint retained to stop alkalosis

42
Q

How can diabetes cause mrtwbolic acidosis (not to do eith co2 levels)

A

Ketogenesis

43
Q

How can renal failure cause metabolic scidosis

A

If too much hco is excreted

44
Q

Which response occurs in metabolic scidosis (nattie 1999)

A

Rhe peripheral carotid reaponse of hyperventilation to reduce ph via co2

45
Q

What 2 things is metabolic alkalosis caused by

A

Increased hco ef if ingested alkaline substance, or reduced H eg cia vomiting

46
Q

Respiration evetnually compensates for metabolic alkalosis. How

A

Hypogentilstion to increase co2 and redcue ph

47
Q

Ehcih artucle discusses alternstive increase of hco other than ingesting alkaline substajces

A

Emmett 2020

48
Q

Which organ otrhet than kidney can increase hco snd how (emmett 2020)

A

Stomach increase hco via secretion of hcl to counteract hcl gastic acid

49
Q

Which ion is needed to be reabsorbed at proximal tubule in order to traffic hco out via reabsoroption too causing m alaklosis (emmett 2020)

A

Na vis the na hco cotransporter

50
Q

Which diseases/meds increqae na reabsorption therefore HCO reabsorption

A

Aldosterone

Or mineralocorticoid excess syndrome

51
Q

How does resp alkalosis drcrease in co2 (hypervent) have effect on prrson eg at high altitude (alan 2020)

A

Seizures, dizziness rtc due to lsck of cerebral flow

52
Q

How di you stand for radiology (taken at full inspiration)

A

Erect and anterooosterior

53
Q

Loss of lung markings/loss of signal is caused by what if 1 or both lungs

A

If 1 lung means could be pneumothorax where air gets to pleura of a lung

If borh irs likely emphysema air increases

54
Q

If there is hazy patches on 1 or both lyngs what is it

A

If 1 its usually infection

If both its likely fiboriss /ards/resitrcivie

55
Q

Dense shadowing/whiteness on xray is callef what

A

Consolidation

56
Q

What can cause consolidation

A

Fluid build up or collapse of lung

57
Q

What can cause consolidwtion and collapsed lung

A

Obstruction eg food in trachea or carcinoma or mycus blocking oxygen in lung

58
Q

What does no wherzing with asthma indicate

A

Collapsed lung

59
Q

What happens to the outer tissue of lungs in consolidation other than fluid filled or collapsed

A

Can be hardened or thickened eg fibrosis

60
Q

What 2 patterns of fibrosis haziness is rhete

A

Net like / reticular or nodular

61
Q

What does honeycomb pattern in advanced fubrosis cause on xray

A

Circular translucencies where there is permanent loss of tissue

62
Q

What is rhe opacification sround the tranlucent honeycomb

A

Deposits

63
Q

Which scan gives better tissue scanning of finrosis patients

A

Ct scan

64
Q

What is high attenuation eg seen in fubrosus

A

Loss of intesnitity heroygh medium due ti fluid, thickness of mass or tissue ie same as consolidation

65
Q

What are ground glass opacities xaused by (opacification is shadowing)

A

Increased thickening of interstitium by interstitial diseases like fibrosis, or air sspace diseases

Caused by increwsed mucus, pus, ifnlammation, oedema, fibrosis in alvroli

66
Q

What does loss of attenuation shadowing indicate

A

Loss of lung tossue = translucent

67
Q

Other rhan honeycombinng whag kther examples of loe attentuation are there / transucency

A

Cysts

Bronchiectasis

Emphysema

68
Q

What is traction bronchiectasis with low attentuation

A

Irreversible dilation due to fibrosis

69
Q

What are nodules of opacitity/densitity indication of

A

Infections, dusts or metastases

70
Q

Which scan indicates through a radioactivr drug can indicate activr cells eg metastatic cells

A

Pet scans

71
Q

What is a pulmonary ct angiogram

A

Ehere a contrast dye is injected to cisualise the pulmonary arteries and indicate pulmonary embolisms