Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Phase 2a LM > Respiratory > Flashcards

Respiratory Flashcards

(161 cards)

Start Studying
1
Q

How many respiratory deaths are due to workplace exposures

A

12,000

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

What are the causes of occupational lung disorders

A

Historical exposures, current exposures, future exposures

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

Give 4 examples of historical exposures

A

Vapour, gases, dust, fumes

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

What are the 2 types of occupational asthma

A

Asthma induced by sensitisation (allergy) at work - 90%

Asthma induced by massive accidental irritant exposure - 10%

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

Give examples of common occupational asthma inducers

A

Isocyanates, flour, cleaning products, wood dusts, enzymes

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

What is the % of adult onset asthma that is due to occupation

A

9-15%

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

Describe the acute phase of extrinsic allergic alveolitis

A

Alveoli are infiltrated with acute inflammatory cells

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

Describe the chronic stage of extrinsic allergic alveolitis

A

Granuloma formation and obliterative bronchiolitis occur

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

Give some causes of extrinsic allergic alveolitis

A 
Bird/pigeon fancier's lung (proteins in the droppings)
Fish meal and rodent handlers
Farmer's and mushroom's lung (MOs)
Vegetation (coffee and wood)
Chemicals (insecticide, isocyanates)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Name 5 things that fall under asbestos-related lung disease

A
  1. Pleural plaques
  2. Diffuse pleural lining
  3. Asbestosis
  4. Lung cancer
  5. Mesothelioma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Briefly describe asbestosis

A

Pulmonary fibrosis that can occur with or without plaques. There is no effective treatment

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

Briefly describe mesothelioma

A

Rapidly progressive and usually incurable pleural cancer- the lung is encased by tumour

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

What is an acute obstruction caused by

A

Tumour or foreign body

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

What does an acute obstruction cause

A

Distal lung collapse (atelectasis) or over expansion (valve effect)

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

What can extrinsic asthma be caused by

A

Atopic (IgE/ type 1 sensitivity)

Occupational (type 3 sensitivity)

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

What can intrinsic asthma be caused by

A

Aspirin, cold, infection, stress, exercise, pollutants

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

Describe the pathogenesis of asthma

A

Bronchial obstruction with distal overinflation or collapse
Mucus can plug the bronchi
Bronchial inflammation

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

Name 3 diseases that are examples of chronic obstruction

A

Chronic bronchitis and/or emphysema
Asthma
Bronchiectasis

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

What is needed to diagnose chronic bronchitis

A

Cough and sputum for 3 months in 2 consecutive years

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

Who does chronic bronchitis typically affect

A

Affects middle aged heavy smokers

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

What can chronic bronchitis lead to

A

Hypercapnia
Hypoxia
Cyanosis (BLUE BLOATERS)
Right sided heart failure

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

What is the pathology behind emphysema

A

Enlargement of the alveolar air spaces with destruction of elastin in the walls

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

What are some causes of emphysema

A

Smoking predominantly, alpha-1-antitrypsin deficients, coal dust exposure, cadmium toxicity

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

What are the signs of emphysema

A

Reduced PaCO2
Normal PaO2
This is due to hyperventilation to maintain oxygen
PINK PUFFERS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is bronchiectasis
The permanent dilation of bronchi and bronchioles
26
What are the common symptoms of bronchiectasis
Chronic cough with expectoration of large quantities of foul smelling sputum, flecked with blood sometimes
27
Name 2 common complications of bronchiectasis
``` Pneumonia Fungal colonisation Emphysema Septicaemia Meningitis Amyloid formation Metastatic abscesses ```
28
What is the pathology of interstitial lung diseases
Increased amount of lung tissue, alveolar-capillary wall is the site of the lesion
29
What are the signs of an interstitial lung disease
Reduced Tco Reduced VC Reduced FEV1 Relatively normal FEV1/FVC ratio and PEFR
30
What is the site of the lesion in interstitial lung diseases
Alveolar-capillary wall
31
Name an acute interstitial lung disease
Adult respiratory distress syndrome (ARDS)
32
Give some causes of adult respiratory distress syndrome
``` Drug and toxin reactions gastric aspiration radiation pneumonitis diffuse intrapulmonary haemorrhage shock trauma infections gas inhalation ```
33
Name some chronic interstitial lung diseases
``` Fibrosis alveolitis Pneumoconioses Sarcoidosis Rheumatoid diseases Diffuse malignancies ```
34
What is pneumoconiosis
Lung disease caused by inhaled dust
35
Describe the pathogenesis of coal workers' pneumoconiosis
The coal is ingested by alveolar macrophages They aggregate around bronchioles Can cause trivial discolouring, or nodules, or emphysema
36
What is silicosis
Inhalation is silicates (inorganic minerals abundant in stone and sand)
37
What happens if you have silicosis
Tissue destruction and fibrosis, after years of exposure nodules form
38
Define incidence
The rate at which new cases occur in a population during a specific time period
39
Define prevalence
The proportion of a population that have the disease at a point in time
40
Define mortality
The incidence of death from a disease
41
In COPD what happens to the FEV1/FVC ratio
It's less than 70% or 0.7 of the predicted value
42
What is the estimation of prevalence of COPD in the UK
3.7 million
43
Which study confirmed that there was COPD mortality in smokers
Doll and Bradford-Hill study (1951-2001)
44
What are the reasons for the geographical variation of COPD seen across the UK
Socio-economic differences Socio-economic deprivation Historic industry Passive smoking
45
What is the incidence of lung cancer in the UK
Nearly 40,000 new cases per year
46
Is lung cancer a disease of the young or elderly
Elderly
47
What is the most common cancer to cause death
Lung cancer
48
How many adults in the UK smoke
9.5 million
49
What % of COPD and lung cancers are preventable
90%
50
Briefly define palliative care
Improves the Q of L of patients and families with life-threatening illnesses, pain and symptom relief, support from diagnosis to the end of life and bereavement
51
Describe some aspects of palliative care
Holistic/ humanistic Individualised Patient and carer Multidisciplinary approach
52
What are 4 difficulties with COPD regarding palliative care
1. Unpredictable illness trajectory 2. Difficulties with prognostication 3. Poor patient understanding 4. Limited access to specialised palliative care
53
What is the % of lung cancer patients that receive palliative care
30%
54
What is the % of COPD patients that receive palliative care
0%
55
What % of people die within 2 years of an exacerbation of COPD
50%
56
Nomenclature: | ....mab
Monoclonal antibodies
57
Nomenclature | ...sone
Corticosteroid
58
Nomenclature | ...terol
Bronchodilators
59
Nomenclature | ...lone
Corticosteroid
60
Nomenclature | ...nib
Kinase inhibitor
61
What are the 4 delivery systems for inhaled drugs
1. Pressurised metered-dose inhalers (PMDI) 2. Spacer devices 3. Dry powder inhalers (DPI) 4. Nebulisers
62
Give some advantages of inhaled drugs
Lungs are robust Medicines can act directly on lung or enter systemic circ Very rapid absorption Lungs are naturally permeable to peptides Large s a Fewer metabolising enzymes than blood/liver Non invasive port of entry into systemic system Potentially fewer side effect
63
What two classes of drugs are used to reduce bronchoconstriction
Adrenergic - beta 2 adrenoreceptor agonists | Anti-cholinergic - muscarinic antagonists
64
Name a SABA
Salbutamol
65
Name a LABA
Salmetrol or formoterol
66
What is the class of drugs used to treat inflammation of the lungs
Glucocorticoids (corticosteroids)
67
What is the most effective anti-inflammatory for asthma
Glucocorticoids
68
How do inhaled corticosteroids reduce inflammation
Reduce no of infl cells in airways Suppress the production of chemotactic mediators Reduce adhesion molecule expression Suppress infl gene expression in airway epithelial cells
69
What are the long term side effects of inhaled corticosteroids
Loss of bone density Adrenal suppression Cataracts, glaucoma
70
What percentage of bronchial tumours are malignant
95%
71
What are the two classifications of malignant bronchial tumours
Non small cell lung cancer (NSCLC) | Small cell lung cancer
72
What are the causes of lung cancer
``` Smoking Asbestos Radon Coal and tar Chromium ```
73
What are the main symptoms someone with lung cancer has
``` Cough Haemoptysis Dyspnoea Chest pain Hoarseness Recurrent pneumonia Anorexia/weight loss ```
74
Where does lung cancer typically spread to
``` Lymph nodes Bone Brain Liver Adrenal glands ```
75
What are some of the symptoms of metastatic disease originating from lung cancer
``` Bone pain Headache Seizures Neurological deficit Abdo pain Hepatomegaly ```
76
What are 3 symptoms of paraneoplastic syndrome
Hypercalcaemia Hyponatraemia (SIADH) Finger clubbing
77
What is the incidence of lung cancer
Nearly 40,000 new cases per year
78
What are some of the signs of lung cancer
``` Cachexia Anaemia Clubbing Consolidation/ collapse of lung Pleural effusion ```
79
Why are respiratory tract infections so common
No thick skin barrier No room for immune cells/response Large s a for gas exchange means lots of room for pathogens No acid
80
What protection is there against respiratory tract infections
``` Commensal flora Swallowing - reflex, epiglottis Mucociliary escalator Cough reflex and sneezing Immunity ```
81
What are the common viruses that cause pharyngitis
Rhinovirus and adenovirus
82
What do: tonsillar exudate, tender anterior cervical adenopathy, fever over 38 degrees and absence of cough all indicate
Bacterial infection (not virus)
83
What is the incidence of pneumonia
350 per 100,000 per year
84
What is the mortality of pneumonia
1% in community 10% in hospital 30% in ITU
85
Who is most at risk of getting pneumonia
``` Infants and elderly COPD and other chronic lung diseases Immunocompromised Nursing home Diabetes ```
86
What is heard when you listen to the chest of someone with pneumonia
Crackles
87
Why does the chest crackle with pneumonia
The alveoli are trying to open but the mucous/fluid doesn't allow it to do so properly
88
What does the percussion sound like in someone with pneumonia
Dull
89
What are the common symptoms of pneumonia
``` Fever Cough Sputum --> rusty brown = S. pneumoniae SOB Pleuritic chest pain ```
90
What are some of the abnormal vital signs someone with pneumonia has
``` Increased HR and RR Decreased BP and air entry Fever Dehydration Dull percussion ```
91
What aids a diagnosis of pneumonia in a full blood count
Increased White blood cell numbers
92
What are the main treatments of pneumonia
Co Amoxiclav 625 mg TDS PO | Clarithromyocin 500 mg BD PO
93
What can pneumonia lead to
Sepsis
94
What score is used to assess the severity of Community Acquired Pneumonia (and sepsis)
CURB65
95
What does the CURB65 score stand for
``` Confusion Urea >7 mmol/L Respiratory rate >30/min BP systolic <90 or diastolic <60 Age >65 ```
96
Briefly describe the pathogenesis of pneumonia
Bacteria 'translocate' to the alveoli Alveolar macrophages engulf however immune system becomes 'overwhelmed' Cytokines and chemokines start inflammatory response Neutrophils and exudate fill the alveolar air space - difficult to exchange gases
97
What are the investigations done if pneumonia is suspected
``` CXR FBC U+E (renal = severity) LFT (liver = complications) CRP (inflammation) Pulse oximetry (severity) ```
98
What two viruses commonly cause the common cold
Rhinovirus and coronavirus
99
What two viruses commonly cause a sore-throat
Adenovirus | EBV * Epstein-Barr virus
100
What's the common respiratory rate for a child <5yrs old
30-40
101
What's the common respiratory rate for a child <1yr old
40-50
102
What's the normal respiratory rate for an adult
<20
103
What 3 things can you look for in a child who's in respiratory distress
Increased respiratory rate Grunting Subcostal regions
104
Describe influenza virus
Acute respiratory illness caused by infection with influenza viruses
105
What are the 2 key surface antigens that influenza A is subdivided into
Haemagluttinin (H) 15 subtypes | Nueraminidase (N) 9 subtypes
106
What are minor antigenic variations in viral genomes called
Antigenic drift
107
What are major reassortments of a viral genome called
Antigenic shift
108
What are some common symptoms of an influenza virus
URT and LRT symptoms Fever Headaches Myalgia and weakness
109
What is a common complication of influenza infection
Bacterial pneumonia
110
What are the treatment options for someone with influenza infection
``` 'Supportive care': Oxygenation Hydration/nutrition Maintain homeostasis Prevent/treat secondary infections ```
111
What is the role of antiviral medication 'tamiflu'
Reduce transmission to others e.g. In a care home
112
Define outbreak
2 or more linked cases
113
Define epidemics
More cases in a region/country
114
Define pandemic
Epidemics that span international boundaries
115
What is type 1 respiratory failure
Low oxygen levels
116
What is type 2 respiratory failure
Low oxygen levels and increased CO2 levels
117
What are the causes of type 2 respiratory failure in lungs that appear normal on a CXR
Sedatives Neuromuscular disorders Upper airway obstruction
118
What are the causes of type 2 respiratory failure in lungs that look abnormal on CXR
COPD | Acute asthma
119
What are the chronic respiratory disorders that cause type 1 respiratory failure
COPD Acute asthma Diffuse interstitial lung disorders
120
What are the localised acute respiratory disorders that cause type 1 respiratory failure
Pneumonia | Pulmonary embolism
121
What are the diffuse acute respiratory disorders that cause type 1 respiratory failure
ARDS (results of sepsis - killer) | Cardiogenic oedema
122
What are the signs and symptoms of type 1 failure
``` Cyanosis Increased respiratory rate Accessory muscle use Tachycardia Hypotension Signs of underlying disease Confusion ```
123
Signs and symptoms of type 2 respiratory failure
``` Dyspnoea Anxiety Orthopnoea Drowsiness Frequent chest infections Disturbed sleep ``` ``` Confusion Warm peripheries Flapping tremor Bounding pulses Myoclonus jerks ```
124
What are the treatment options for respiratory failure
``` ABC Treatment for underlying condition Oxygen therapy CPAP NIV IPPV ```
125
What is CPAP in respiratory failure treatment
Continuous positive airways pressure Which is positive pressure applied throughout the respiratory cycle to a spontaneously breathing patient- improves ventilation and V/Q ratios
126
What is NIV in respiratory failure treatment
Non-invasive Ventilation | Bi-phasic positive airway pressure - increases ventilation
127
If the breathing tubes are involved in a respiratory disease is it obstructive or restrictive
Obstructive
128
If the lung parenchyma is involved in a respiratory disease is it obstructive or restrictive
Restrictive
129
If the chest wall is involved in a respiratory disease is it obstructive or restrictive
Restrictive
130
Briefly describe spirometry
Fill the lungs with as much air as possible Blow air out as fast as possible Keep on blowing air out as long as possible
131
What is the transfer coefficient test
A measure of the ability of oxygen to diffuse across the alveolar membrane
132
Briefly describe how the transfer coefficient test works
Inspire a low dose of carbon monoxide, and hold the breath for 10 seconds at total lung capacity. The gas transfer is measured and is equivalent to the rate of oxygen transfer.
133
What conditions would have a low transfer coefficient
Severe emphyema, fibrosing alveolitis, anaemia
134
What condition leads to a high transfer coefficient
Pulmonary haemorrhage
135
Briefly describe mycobacterium
Aerobic, non-motile, non-sporing and covered in waxy capsule
136
Are mycobacterium rapidly or slowly deciding organisms
Slowly - 15-20hour generation time
137
Where are the most endemic countries for TB
India, sub-Saharan Africa
138
What was the incidence of TB in the UK in 2012
13.5 per 100,000 per year
139
What are some risk factors for TB
``` Born in high prevalence area IVDU Homelessness Alcoholic Prisons HIV positive ```
140
What are two methods of catching TB
Spread in aerosol- spitting or sneezing and breathing in the bacilli Spread enterally - drinking milk from infected cows
141
What % of people don't develop the disease once they've been infected
>95%
142
In a pulmonary infection only, where do the bacilli settle in the lungs
Apex
143
Why do the bacilli tend to settle in the apex of the lungs
More oxygen (aerobic) and less blood/fewer immune cells
144
What is the immune response to pulmonary TB
Macrophages and lymphocytes seal in, contain and kill the majority of the bacteria
145
What happens to the bacilli that survive macrophage phagolysosomes
The macrophages travel to the draining lymph nodes and the bacilli multiply in the lymph nodes
146
Briefly describe pulmonary TB (PTB)
The bacilli and macrophages coalesce to form a granuloma. Mediastinal lymph nodes enlarge. The growing granuloma forms a cavity. The cavity can erode into the airway and bacilli can now be coughed out.
147
What is the granuloma of bacilli and macrophages known as
Primary focus
148
What is the primary focus and mediastinal lymph node enlargement known as
Ghon complex
149
What are the systemic features of TB
``` Weight loss Night sweats Low grade fever Anorexia Malaise ```
150
What are the features of pulmonary TB
Cough Chest pain Breathlessness Haemoptysis
151
What may be associated with PTB
Pleural effusion or pericardial effusion | Consolidation/collapse
152
What is haematogenous dissemination of TB
Bacilli spread through the bloodstream to other organs/parts of the body
153
What test results are abnormal in TB (diagnosing TB)
``` Anaemia - normochromic normocytic Thrombocytosis Raised ESR/CRP Hypoalbuminaemia Hypergammaglobulinaemia Hypercalcaemia Sterile pyuria ```
154
How do you diagnose latent TB
Tuberculin skin test 'Mantoux' | Interferon gamma release assays
155
Briefly describe the tuberculin skin test 'mantoux'
Protein derived from TB is injected into the skin, activates memory T cells if previously infected with TB, look at the size of the red infl reaction to see if memory cells activated
156
Briefly describe the interferon gamma release assays test
Use WBC from blood sample in lab, give TB antigens and if WBC release INF-gamma then there is a prior exposure
157
What are the four drugs used to treat TB
Rifampicin Isoniazid Pyrazinamide Ethambutol
158
What are the side effects of rifampicin
Red urine/secretions Hepatitis Drug interactions
159
What are the side effects of isoniazid
Hepatitis | Neuropathy
160
What are the side effects of pyrazinamide
Hepatitis Arthralgia/ gout Rash
161
What are the side effects of ethambutol
Optic neuritis

Phase 2a LM (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions