Final exam FC Flashcards

(41 cards)

1
Q

There were two Polio vaccines, what is the main difference? How many people were accidentally injected with Polio?

A
  1. Attenuated live virus (weakened engineered virus)
  2. Dead virus (wasn’t dead and about 10,000 people got injected with this vaccine and contracted Polio)
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2
Q

What enzyme is responsible for cleaning up cellular debris in the lungs?

A

Trypsin

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3
Q

Trypsin is always_____.

What molecule keeps this enzyme in check?

A

active, but it’s activity is low and kept in check by alpha-1 antitrypsin.

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4
Q

1 in every 3,000 people have an inherited deficiency of alpha-1 antitrypsin. What are these people a good candidate for?

A

They are great candidates for lung transplants. This can buy them about another 30 years of life.

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5
Q

What are three things we talked about in class that can lead to chronic emphysema?

A
  1. alpha-1 antitrypsin deficiency
  2. smoke
  3. liver disease
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6
Q

Where is alpha-1 antitrypsin synthesized?

A

in the liver

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7
Q

What happens to Ferrous iron (Fe2+) in conditions of high oxidative stress?

A

It gets oxidized to Ferric iron (Fe3+) –> loses an e-

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8
Q

How much of our Hb is made up of Ferric iron? What significance does this have?

A

1.5% of our Hb is Ferric. This is why our SaO2 is 97.4% (Hb saturation from arteriolar sample)

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9
Q

What enzyme is responsible for reducing Fe3+ to Fe2+?

A

methemoglobin reductase (adds an e-)

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10
Q

If you have the sickle cell trait what can you do to reduce severity of symptoms?

A

Limit physical activity.

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11
Q

What causes sickle cell anemia?

A

The sickled RBC’s get stuck in the capillaries, eventually these RBC’s get pulled out of circulation and the body has to make new ones leading to anemia

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12
Q

What are two treatment options for sickle cell anemia?

A
  1. Transfusion of donor blood
  2. Hydroxyurea drug
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13
Q

How does Hydroxyurea work?

A

It turns on the fetal genes –> produces fetal Hb instead of the defective sickled Hb

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14
Q

What does sickle cell disease effect w/ regards to O2 and CO2 and Hb binding?

A

O2 is not released to the tissues where it is needed. Similarly, CO2 buildup can occur as is not able to bind to and get carried away by the Hb.

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15
Q

Sickle cell trait is beneficial how? (Why it is still lingering in the gene pool)

A

It is resistant to malaria

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16
Q

What is HbA1C?

A

acetylated Hb. Excess sugar can stick to Hb (A for adult and 1C is the position where the extra sugar hangs out)

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17
Q

How much of our Hb is occupied by carbon monoxide? HbCO?

A

about 1 %

unless you smoke or work at an auto shop, then it can be higher

18
Q

Bicarb is a______ conjugate base than ____ is an acid…

19
Q

Why do patients with emphysema lose their drive to breathe if they have a high Hb saturation?

A

Their chemical receptors are looking at changes in pO2 to make pH adjustments since the body is chronically acidotic (high pCO2 and low pH)

20
Q

Why do we not use ALL the alveoli ALL of the time?
Why do we sigh/ yawn?

A

minimizes exposure to environmental irritants and alveolar damage
to open up or recruit alveoli that are not consistently used and disperses surfactant

21
Q

How often does the average adult sigh?

A

12-15x per hour

22
Q

If you have a really bad brain injury what areas can get physically separated and lead to apneustic breathing?

A

physical separation between the pons and the medulla

23
Q

With Obstructive disease, what gets reduced? What gets bigger?

A

Reduced ERV, IRV, IC, VC (d/t increased RV)
Increased RV, TLC, Vt (d/t increased alveolar dead space)

24
Q

What would you expect to see with lung volumes in a patient with restrictive lung disease?

A

All volumes get smaller

25
Why can't smoke get filtered out of the nose?
Smoke is a small particle and doesn't have inertia so it can't get filtered out of the nose
26
Which nerve is responsible for sensory info to stimulate a sneeze?
V2- maxillary branch of the trigeminal nerve
27
What lateral inhibition can be used to stop the sneeze reflex?
Can drink water or pinch your upper lip
28
Which nerves control our ability to speak?
recurrent laryngeal nerves
29
Which nerve takes care of 5 of the 6 sets of internal laryngeal muscles?
Inferior laryngeal nerve
30
What takes care of the motor innervation of the cricothyroid muscle? (1 of 6 sets)
The external branch of the superior laryngeal nerve (a branch of the vagus nerve)
31
Which nerve stimulates the signal to cough?
The internal branch of the superior laryngeal nerve (from the vagus nerve)
32
What is Galen's anastomosis?
where the superior and inferior laryngeal nerves meet (not a functional anastomosis, no signals are transmitted back and forth)
33
Name the 4 Suprahyoid muscles...
1. Diagastric muscle anterior belly and posterior belly 2. Stylohyoid 3. Mylohyoid 4. Geniohyoid
34
Name the 4 infrahyoid muscles...
1. Omohyoid 2. Sternohyoid 3. Thyrohyoid 4. Sternothyroid
35
What are J receptors?
Stretch receptors in the lung that are involved in shutting down inspiration in response to overstretching of the lung.
36
Name some things that can cause increases in CO2 waveform...
fever bicarb infusion release of a tourniquet Increased CO/ BP hypoventilation MH Pregnancy belching
37
What are some factors that can decrease the CO2 waveform?
hypothermia decreased CO (MI), decreased BP PE hyperventilation extubation airway obstruction circuit disconnection alveolar dead space esophageal intubation
38
If your patient is paralyzed, intubated and sedated on a ventilator and supine, what is their operational lung volume?
800-1000mL (less than residual volume)
39
Which part of the lung is ventilated most in an intubated, sedated, paralyzed supine surgical patient? Which part is getting the most blood flow? What is happening as a result of this?
Most ventilation is going to the anterior portion of the supine lung. The majority of the blood flow is going to the posterior portion of the supine lung. This causes a V/Q mismatch.
40
What can you do to correct VQ mismatch in the patient with lower than RV lung volume? What is the downside to this intervention?
Increase air in the lung between breaths (PEEP) The downside of this is it strains the right heart
41
If your patient is awake and spontaneously breathing, but supine, where is most of the air going and blood flow?
The operational lung volume in the supine position is 2L instead of 3L. This isn't that much lower, so most of the air is going into posterior portion of the lung. This is also where the majority of the blood flow is, so there is no V/Q mismatching.