Flashcards in Respiratory Deck (34)
Alpha-1 Antitrypsin does what?
reduces tissue damage caused by inflammation through the inhibition of neutrophil elastase.
What is seen histologically in a1antitrypsin deficiency?
red/[ink PAS positive granules in periportal hepatocytes.
What 2 organ systems are affected by a1 antitrypsin deficiency? and how are they affected.
Liver- FIRST. accumulation of A1AT molecules => cirrohsis, hepatocellular carcinoma
LUNGS- destruction of alveolar walls, large amounts of elastin, by tissue damaging enzyemes. => panacinar emphysema
What occurs in the lung when hypoxemia occurs in an underventilated area?
Why is this?
vasoconstriction occurs in the small muscular pulmonary arteries
diverts blood flow from underventilated area toward more well-ventilated areas
Where is the lowest pulmonary vascular resistance located on Lung volumes graph?
functional residual capacity (FRC) because here the
lung is maximally compliant,
intrathoracic and atmosphere pressures equal,
allveoli do not eert pressure on vasculature
2-4 weeks after initial TB infection what pathenogenesis occurs?
interferon secrtion by activated Tcells leads to M0 activation =>
M0 form epithelioid cells and improves their ability to kill intracellular TB
Characteristic of VIRULENT mycobacterial strains?
growth of thick ropelike cords of MB in serpentine = presence of cord factor (virulence factor):
inactivates neutrophils, magages mitochondria, induce rls of TNF
In the pathogenesis of Center acinar emphysema proteases such as elastase early strong which to type of cells?
DOC theophylline induced cardiac tachycardias?
Morbid SE of Theophyline?
What physiologic change in alveolar ventilation causes hypocapnia?
What directly indicates this change?
Cheyne-Strokes Respiration description:
When are they seen?
cyclic breathing-> increasing tidal vol, then decr. tidal volume. with intermittent apnea
Kussmal breathing is associated with what disease and what metabolic state?
3 main descriptions of Cluster headaches +3 others
unilateral, severe episodic, temporal
ptosis, lacrimation, nasal congestion
Reverse transcriptase inhibitors
CCR5 Receptor Inhibitors
RTi-tenofivir, lamovudine, efavirinez
defective enzymes in orotic aciduria
Oroate phosphoribyl transferase, OMP decarboxylase
Megaloblastic anemia, neuro abnormalities, growth retardation, orotic acid in urine
Proto Oncogenes 6
Tumor Suppressors 7
B-RSV-respiratory syncitial virus
Virion protein: host cell receptor
Erythrocyte P antigen
Pulmonary lungs chart: what does COPD increase?
NonNucleoside Reverse Transcriptase inhibitors-name3
What enzyme is necessary for NRTI's to fxn? name 2
Common problems associated with left ventricular infarct (4)
Left ventricular failure
Cardiogenic acute pulmonary edema
Pulmonary venous hypertension
Transudate of Plasma into lung intersitium/alveoli
Where should you perform thoracocentesis?
Posterior scapular line
MC- Above 7th Rib
MA- Above 9th Rib
PS- Above 11th Rib
where are meningiomas located?
what symptoms are seen in a parasagittal meningioma?
Adjacent to cerebral surface
contralateral spastic paresis of left leg.
Pleural aggitation will cause pain where? what is this called?
sharp "Referred" pain in C3-C5 due to phrenic nerve. SHoulders /back
WHat does an obstructive flow-volume loop profile look like & what 2 conditions would cause this?
Chronic Bronchitis- increased bronchial resistance
Emphysema- Decreased lung elasticity
Expiratory flow rate DEcreased
RV (Increased) blob moves left.
What can cause a restrictive flow-volume pattern?
Pulmonary fibrosis, Hyaline membranes, diffuse intraalveolar hemorrhage, Atelectasis
RV & Expiratory flow rate stay about the same
Decreased Lung volume & Compliance
What test is sensitive but not specific for testing the degree of bronchial hyperreactivity in asthma?
negative methacholine challenge test can RULE OUT.