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Year 3 > Transition block > Flashcards

Transition block Flashcards

1
Q

Where is resp rhythm generated?

A

Medulla

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2
Q

Where are peripheral chemoreceptors found?

A

Carotid body and aortic arch

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3
Q

Where are central chemoreceptors found?

A

Surface of the medulla

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4
Q

Function of central chemoreceptors

A

Respond to H+ of the CSF

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5
Q

Function of peripheral chemoreceptors?

A

Sense tension of O2, CO2 and H+ in the blood

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6
Q

What is permeable and impermeable to CSF?

A

Impermeable- H+ and HCO3
Permeable- CO2 diffuses readily

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7
Q

What is the most potent stimulant of respiration in normal people?

A

Arterial PCO2 (H+ in CSF) acting on central chemoreceptors

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8
Q

When does the hypoxic drive of respiration kick in?

A

Stimulated when PO2 falls low
Important in patients with chronic CO2 retention eg COPD
Important at high altitudes

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9
Q

Result of increased PCO2/H+

A

Hyperventilation to to eliminate CO2 (CO2 can generate H+ so reduces load on body)

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10
Q

What is the transmural pressure gradient?

A

Difference between intrathoracic and intra alveolar pressure

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11
Q

What happens to intrapleural pressure during inspiration?

A

Falls

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12
Q

What happens to intrapleural pressure during expiration?

A

Rises

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13
Q

What is cardiac ouput?

A

Volume of blood pumped by each ventricle per minute

CO= SV x HR

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14
Q

What is the stroke volume?

A

Volume of blood ejected by each ventricle per heart beat

EDV-ESV

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15
Q

What is the Frank-Starling curve?

A

The more the ventricle is filled with blood during diastole (EDV) the greater the volume of ejected blood in the next systolic contraction (stroke vol)

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16
Q

Tidal Volume?

A

Volume of air entering or leaving lungs during a single breath

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17
Q

Inspiratory Reserve Volume?

A

Extra volume of air that can be maximally inspired over and above the typical resting tidal volume

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18
Q

Inspiratory capacity?

A

Maximum volume of air that can be inspired at the end of a normal quiet expiration (IC =IRV + TV)

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19
Q

Expiratory reserve volume?

A

Extra volume of air that can be actively expired by maximal contraction beyond the normal volume of air after a resting tidal volume

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20
Q

Residual Volume?

A

Minimum volume of air remaining in the lungs even after a maximal expiration

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21
Q

Functional Residual Capacity?

A

Volume of air in lungs at end of normal passive expiration (FRC = ERV + RV)

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22
Q

Vital capacity (VC)

A

Maximum volume of air that can be moved out during a single breath following a maximal inspiration (VC = IRV + TV + ERV)

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23
Q

Total lung capacity (TLC)

A

Maximum volume of air that the lungs can hold (TLC = VC + RV)

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24
Q

What is atrial fibrilliation?

A

Chaotic and disorganised atrial activity leading to an irregular heartbeat

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25
Q

Classifications of atrial fibrillation

A

Paroxysmal, persistent or permanent

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26
Q

What is paroxysmal atrial fibrillation?

A

Lasts less than 48 hours
Recurrent

27
Q

What is persistent AF?

A

Episode lasting greater than 48 hours, can be cardioverted into NSR
Unlikely to spontaneously reverse

28
Q

What is permanent AF?

A

Inability to convert to NSR

29
Q

What does an ECG for AF show?

A

Atrial rate >300bpm
Irregularly irregular
Absent P waves

30
Q

What medication can be used for rate control during AF?

A

Digoxin, beta blockers, verapamil

31
Q

What medication can be used for rhythm control during AF

A

Anti-arrthymic eg amiadarone
Direct current cardioversion
Catheter ablation

32
Q

What are class 1 antiarrhythmic drugs?

A

Lignocaine
Flecainide
Quinidine
Propafenone

33
Q

What are class 2 antiarrhythmic drugs?

A

Propanolol

34
Q

What are class 3 antiarrhythmic drugs?

A

Amidaraone, sotalol, dronedarone

35
Q

What are class 4 antiarrhythmic drugs? - Ca channel antagonists

A

Verapamil

36
Q

What is atrial flutter?

A

Rapid and regular form of atrial tachycardia- paroxysmal or persistent

Re-entrant circuit usually right atrium

37
Q

Treatment for atrial flutter?

A

RF ablation
Pharmacological
Cardioversion
DOAC for stroke prevention

38
Q

What is a granuloma?

A

A non-specific organised collection of activated macrophages and T lymphocytes

39
Q

Function of natural killer cells

A

Kill cells that lack MHC molecules on the surface- no antigen specificity

40
Q

How is there innate recognisation of receptors?

A

PAMPS expressed on phagocytes and dendrites

41
Q

What does TNF alpha do?

A

Releases proinflammatory cytokines in response to stressors eg microbes, stress, chemicals

42
Q

What do TNF biologics do?

A

Have TNF blocking antibodies to reduce immune response

43
Q

What does vaccination do?

A

Produces memory in B and T cells

44
Q

MMR is an example of what kind of vaccine?

A

Live attenuated

45
Q

What are common URT colonisers?

A

Gram +ve: strep pneumoniae, strep pyogenes, staph aureus

Gram-ve: Haemophilus influenzae, moraxella

46
Q

Common bacteria in acute otitis media?

A

H.influenzae, strep pneumoniae, strep pyogenes

47
Q

First line treatment of middle ear infection if non resolving and likely bacterial?

A

Amoxicillin or erythromycin

48
Q

Bacteria in conjunctivitis?

A

Staph aureus
Strep pneumoniae
H.influenzae

49
Q

Tx of bacterial conjunctivitis?

A

Chloramphenicol- treats most bacteria apart from pseudomonas

50
Q

A panic attack/hyperventiliation leads to what blood gas abnormality?

A

Respiratory alkalosis due to blowing off more CO2 so carbonic anhydrase equation shifts to become more alkalotic

51
Q

What blood gas abnormality would COPD show?

A

respiratory acidosis due to the retention of carbon dioxide

52
Q

What muscles are involved in quiet inspiration?

A

Contraction of the diaphragm and external intercostal muscles

53
Q

What happens to to FVC/FEV1 ratio in obstructive lung disease?

A

Reduced <0.7

54
Q

What are the spirometry patterns in obstructive lung disease?

A

Reduced FEV1 (<80% of the predicted normal)
Reduced FVC (but to a lesser extent than FEV1)
FEV1/FVC ratio reduced (<0.7)

55
Q

What are the spirometry patterns in restrictive lung disease?

A

Reduced FEV1 (<80% of the predicted normal)
Reduced FVC (<80% of the predicted normal)
FEV1/FVC ratio normal (>0.7)

56
Q

What does the dorsal respiratory group do?

A

Inspiratory centre that generates the frequency of inspiration and the basic rhythm for respiration

57
Q

What does the pneumotaxic centre do?

A

Pneumotaxic centre inhibits inspiration, reduces tidal volume and regulates respiratory rate

58
Q

What is a cross sectional study?

A

Collection of data from a population in a specific time point- good for detecing prevelance of disease

59
Q

What is a randomised control trial?

A

Those with or without an intervention, are compared and randomly assigned to the group this reduces selection bias. Does not look at outcomes

60
Q

What is a cohort study?

A

A group of people with a common characteristic is followed over time to find how many reach a certain health outcome of interest

61
Q

What is sensitivity?

A

The ability of a test to correctly identify patients with a disease

62
Q

What is specificity?

A

The ability of a test to correctly identify people without the disease.

63
Q

A more specific test will have a greater ___ value?

A

Positive predictive value as less likely an individual with a positive test will be free from disease

64
Q

A more sensitive test will have a greater ___ value?

A

Negative predictive value

Year 3 (12 decks)

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