Resp

Question 1

What is pulmonary ventilation rate?

Answer 1

resp rate x tidal volume

Question 2

what is vapour pressure? What is saturated vapour pressure dependent on?

Answer 2

vapour pressure - pp of water above a surface of water

dependent on temp

Question 3

what is tension

Answer 3

gases tendency to escape a liquid

Question 4

Which ribs are typical and which are true ribs?

Answer 4

3-9 typical

1-7 true

Question 5

describe the appearance of ribs 1 and 2

Answer 5

1 - shorter and wider with groove for subclavian artery. oonly 1 articular facet
2 - rough area for attachment of serratus anterior

Question 6

What is the costal margin?

Answer 6

upside down V formed by cartilage of ribs 7 - 10

Question 7

What is the direction of fibres of the external and internal intercostals?

Answer 7

external - anterior and inferior (hands in pocket)

internal - anterior and superior

Question 8

What do the intercostal veins drain into?

Answer 8

azygous vein

Question 9

what can be found in the superior mediastinum? What is its superior and inferior boundary

Answer 9

arch of aorta, trachea, oesophagus, SVC, phrenic nerve

Boundary - thoracic inlet to T4

Question 10

What can be found in the anterior mediastinum?

Answer 10

thymus in kids, long thoracic artery and vein

Question 11

Posterior mediastinum?

Answer 11

oesophagus, thoracic aorta, azygous vein, vagus nerve

Question 12

What is the nitrogen washout used for and how does it owrk?

Answer 12

used to measure serial dead space.

forced expiration then inspire 100% o2 and measure n2 released in expiration

Question 13

Is asthma obstructive or restrictive?

Answer 13

obstructive

Question 14

what does helium dilution measure and how does it work?

Answer 14

measures residual volume. Helium doesnt enter blood, measure difference in conc.

Question 15

What gas molecule is used to measure transfer conductance/

Answer 15

CO

Question 16

How does haem buffering prevent fluctuations in pH?

Answer 16

increase in co2 results in addition of H+ to form HCO3

Decrease in co2 results in addition of water to form H+

Question 17

what are the effects of acidosis and alkalosis?

Answer 17

acidosis - seizures, arrhythmia, vomiting

alkalosis - fainting, tetany

Question 18

Where are the central chemoceptors found? How does blood pH affect the central chemoceptors?

Answer 18

medulla

co2 can enter but hco3 cant

Question 19

what does chronic hypoxia result in?

Answer 19

pulmonary hypertension

Question 20

what are the symptoms of asthma?

Answer 20

polyphonic wheeze, SOB, dry cough, chest tightness

Question 21

how would you investigate asthma?

Answer 21

flow volume loop (obstructive) with a 12% increase in FEV with salbutamol, FENO (NO exhaled in inflammation)

Question 22

What are the symptoms of COPD?

Answer 22

hypercapnia (flapping), tachypnoea, accessory muscle usage

Question 23

what are the resp defences?

Answer 23

mucociliary escalator, cough and sneeze, macrophages, IgA and IgG

Question 24

how do you treat hospital and community acquired pneumonia?

Answer 24

hosp - co-amoxiclav

community - penicillin

Question 25

What are the common MOs that cause hosp and community pneumonia

Answer 25

hosp - MRSA, staph aureus, pseudomonas aeruginosia | community - strep pneumoniae, klebsiella pneumoniae, H.influenzae

Question 26

What are the symptoms of pneumonia?

Answer 26

productive cough, dyspnoea, inspiratory chest pain, vomiting, fever, dull percussion, wheezes crackles and bronchial breathing on auscultation

Question 27

How do you assess the severity of pneumonia?

Answer 27

``` CURB 65 U - >7 mmol R - >30 BP - less than 90/60 over 65 ```

Question 28

How can bronchial breath sounds be pathological?

Answer 28

if heard outside of trachea, indicates consolidation.

Question 29

How does clavulinic acid work?

Answer 29

suicide inhibitor of beta lacatamase

Question 30

Outline the pathophysiology of TB

Answer 30

primary - subpleural granuloma with granulomatous hilar lymph node infection

Question 31

What is the host reponse to TB?

Answer 31

macrophase ingestion. TB escapes and multiplies in cytoplasm. granuloma forms.

Question 32

What are the symptoms of TB?

Answer 32

sputum, haemoptysis, fever, weight loss

Question 33

How do you treat TB?

Answer 33

``` RIPE - RIPE for 2 months and then RI for another 4 months Rifampicin Isoniazide Pirazinimide Ethambutol ```

Question 34

What symptom suggests regional metastases of a lung cancer?

Answer 34

hoarsenss of voice

Question 35

What are the common lung cancer types/

Answer 35

squamous cell, adenocarcinoma, large cell, small cell

Question 36

what does pleural effusion look like on a CXR?

Answer 36

loss of costophrenic angles, meniscus

Question 37

What are the symptoms of ILS?

Answer 37

SOB, dry cough, tachypnoea, tachycardia, coarse crackles, cyanosis, RHF, restrictive

Question 38

What factors result in an increase in pleural fluid?

Answer 38

increased BP, increased permeability (infection or malignancy), decreased oncotic

Question 39

What factors results in decreaed reabsorption?

Answer 39

increased BP, lymph blockage

Question 40

define transudate

Answer 40

30g protein per litre or less

Question 41

What are the symptoms of PE?

Answer 41

SOB, chest pain on inspiration, cyanosis, tachycardia, haemoptysis

Question 42

How do you diagnose PE

Answer 42

d-dimer to exclude in those with low probability, CT pulmonary angiogram

Question 43

how do you treat PE?

Answer 43

heparin/warfarin

Question 44

What are the symptoms of pleurisy?

Answer 44

pleural rub, pain on inspiration, cough, sneeze, shoulder pain (referred)

Question 45

What is pleurisy caused by?

Answer 45

RA, SLE, infection, cancer, PE