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BDS2 BAMS > Respiratory Medicine > Flashcards

Respiratory Medicine Flashcards

1
Q

What are the 2 components (issues) to the respiratory system?

A

=issues which affect ventilation
= gas exchange

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2
Q

Name 2 issues which can affect ventilation?

A

=airway patency - how wide or narrow airways are
= active muscles - ability of muscles to move rib cage to allow ventilation to take place

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3
Q

What factors allows for successful gas exchange?

A

= adequate number of alveoli
= no fibrosis of alveolar wall

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4
Q

How many lobes does the left lung have?

A

2

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5
Q

Name the 2 lobes of the left lung?

A

= superior
= inferior

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6
Q

How many lobes does the right lung have?

A

3

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7
Q

Name the 3 lobes of the right lung?

A

= superior
= middle
= inferior

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8
Q

If there were a tumour of a singular lobe how can this be treated and what is the procedure called?

A

= individual loves can be removed by sectioning the airways if there is a tumour
= lobectomy

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9
Q

What is the function of the ribs?

A

allow a change in intrathoracic volume

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10
Q

What happens when the ribs are lifted up?

A

= increases volume of chest, sucks gas in through trachea

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11
Q

What is the purpose of the accessory muscles of ventilation ?

A

= to elevate ribs if ventilation is compromised

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12
Q

Name 7 examples of accessory muscles of ventilation?

A

= major pectoralis
= minor pectoralis
= sternocleidomastoid
= external intercostal
= internal intercostal
=internal oblique
= external oblique

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13
Q

What happens to the size of the large airways as they go from the trachea to the alveoli? - what effect does this have and how is it overcome?

A

they become narrower

= radius of vessel reduces therefore the ability to transfer gas becomes less
== overcome by an increased number of airways

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14
Q

Why might a patient be using their accessory muscles? and examples of accessory muscles

A

It breathing is compromised - sternocleidomastoid, pectoralis major and minor

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15
Q

Inadequate ventilation can affect the levels of what …. (2)

A

Oxygen and CO2

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16
Q

What is type 2 respiratory failure?

A

ventilation inadequate to deliver enough oxygen to the blood

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17
Q

What type of respiratory failure is ‘ventilation inadequate to deliver enough oxygen to the blood’

A

Type 2

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18
Q

How does gas exchange occur?

A

In the alveoli by diffusion

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19
Q

What is the term for destruction of alveoli?

A

emphysema

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20
Q

What is emphysema?

A

air sacs join up to form larger spaces with reduced surface area
= ability of blood to be oxygenated properly and CO2 removes becomes more difficult

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21
Q

When there is adequate ventilation, what problem can still occur and why might this problem happen?

A

= ability of alveoli to get oxygen in and CO2 out of the blood
- thickening of alveolar wall (difficult diffusion)
- inadequate number of alveoli (emphysema)
- mismatch between where the air goes in to the lungs and where the blood goes to in the lungs (V-Q mismatch0

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22
Q

What type of respiratory failure is gas exchange failure?

A

Type 1

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23
Q

What is Type 1 respiratory failure?

A

Gas exchange failure

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24
Q

Name 5 respiratory symptoms?

A

=cough
= wheeze
= stridor
= dyspnoea
= pain

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25
Q

What type of noise is wheeze?

A

expiratory noise

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26
Q

What type of noise is stridor?

A

inspiratory noise

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27
Q

What is dyspnoea?

A

short of breath

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28
Q

Name 5 respiratory symptoms?

A

= chest movement with respiration
= rate of respiration (12-15 min)
=air entry (symmetrical, reduced?)
= if patient speaks with stethoscope then this should be heard
= percussion note

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29
Q

With regards to percussion not being a symptom of respiratory failure, what are 2 examples of sounds which might be heard

A

= resonant - air
= dull - consolidation with either liquid or solid region filling lung air

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30
Q

Name 5 types of respiratory diseases?

A

= ventilation disease
= gas exchange diseases
= respiratory infections
= inflammatory diseases
= lung malignancy

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31
Q

Name 3 ventilation diseases?

A

= asthma
= chronic obstructive pulmonary disease COPD
= bronchiectasis

32
Q

Name 3 gas exchange diseases?

A

= chronic obstructive pulmonary disease (emphysema)
= pulmonary fibrosis
= ventilation-perfusion mismatch

33
Q

Name 2 inflammatory diseases?

A

= cystic fibrosis
= sarcoidosis

34
Q

Name 6 respiratory investigations?

A

= sputum examination
= CXR
= CT scan
= pulmonary function
= bronchoscopy
= VQ scan

35
Q

What should be checked on a sputum examination? and some examples

A

= quantity and colour
= green - pus - infection
= yellow/white - excess production of normal sputum (asthma)
= blood- inflammatory condition in airways or malignancy

36
Q

What test can be used to test pulmonary function?

A

spirometry

37
Q

What three measurement can be taken to measure pulomonary function?

A

= PEFR- maximum flow rate
= FEV1 - forced expiratory volume
= fev1/VS - measure or resp. function

38
Q

What is a bronchoscopy?

A

scope passed into lungs - allows doctor to look at airways and maybe take a biopsy

39
Q

What can a VQ scan be used for?

A

ventilation/ perfusion mismatch
- also to check for obstructions

40
Q

What does perfusion mean?

A

blood flow

41
Q

What does ventilation mean?

A

airflow

42
Q

Name 3 ways in which respiratory drugs can be administered

A

= inhalation
= oral
= intravenous

43
Q

What 2 things can drugs used in ventilation do?

A

= improve airway patency
= prevent mast cell degranulation

44
Q

Name 2 types of drugs which can improve airway patency?

A

= bronchodilators
= anti-inflammatory

45
Q

name 2 types of bronchodilators?

A

= B2 agonists
= anticholinergic

46
Q

What do anticholinergic drugs do? and give 1 example

A

relax tone of smooth muscle and allow airways to open

= corticosteroid

47
Q

Name the 2 most common drugs/combination which improve airway patency..

A

= bronchodilators
= bronchodilators and corticosteroids

48
Q

Why do we want to prevent mast cell degranulation in patients with respiratory failure?

A

= reduce inflammatory mediators released into the airway wall which will cause narrowing of airways

49
Q

Give 2 drugs which can prevent mast cell degranulation?

A

= chromoglycate
= leukotriene receptor antagonists

50
Q

What 2 types of drugs will impair ventilation?

A

= b - blockers
= respiratory depressants

51
Q

How do B-blockers work?

A

make airways narrower- increase effect of smooth muscle constriction

52
Q

Give some example of respiratory depressants and how they impair ventilation?

A

= benzodiazepines - muscle relaxation
= opiods - reduce stimulus for patient to breath

53
Q

Which drug can improve gas exchange? and how does it work when given to a patient with respiratory failure

A

OXYGEN
= diffuses from alveoli into the blood and higher conc of gas in alveolus the more drug will move into the blood

54
Q

Give 3 examples of inhaled drug delivery

A

= Meter dose inhaler - puffer
= breath activated device - spinhaler, turbohaler

55
Q

name 2 aids for drug delivery (inhaled)

A

= nebuliser
= spacer

56
Q

How does a nebuliser work

A

= liquid drug
= drug is held in a small chamber and compressor will blow air through the tube causing it to bubble through the liquid drug and the bubble is coated with the drug and into the airway

57
Q

Name 2 types of b2 agonist drugs which can be inhaled? and what they do

A

= short-acting - reliever drugs
= long -acting - prevent acute asthma attack

58
Q

Name 2 short acting b2 agonists and the colour of inhaler?

A

= salbutamol - blue
= terbutaline - blue

59
Q

Name 1 long-acting b2 agonist and the colour of inhaler?

A

= salmeterol - green

60
Q

For short acting B2 agonists: onset, last…. hours, route of administration, used to…

A

quick onset 2-3 mins
lasts 4-6 hours
inhaled, oral and IV
used to treat acute bronchial constriction

61
Q

For long acting B2 agonists: onset, last…. hours, route of administration, used to…

A

slow onset 1-2 hours
last 12-15 hours
inhaled
used to prevent acute bronchial constriction - ALWAYS used with an inhaled steroid

62
Q

What is long acting B2 agonist used with?

A

inhaled steroid

63
Q

what happens if a long acting b2 agonist inhaler is not used with a steroid inhaler

A

increased risk of suffering from an acute coronary syndrome

64
Q

How do anticholinergics work>

A

=inhibit muscarinic nerve transmission in autonomic nerves
= different mechanism to B2 agonist due to the fact it causes relaxation of the smooth muscle and opening of the airways

65
Q

Example of an anticholinergic and colour of inhaler

A

ipratropium - GREY

66
Q

How can corticosteroids be administered ?

A

topically- inhaler
systemically

67
Q

how do corticosteroids work

A

reduce inflammation in the bronchial walls

68
Q

What are the 2 standard corticosteroids ? and what colour are the inhalers

A

= beclomethasone - BROWN
= budesonide - BROWN

69
Q

Name 2 other corticosteroids and what they are usually combined with? (INCLUDE COLOUR)

A

= Fluticosone (orange)
= Mometasone (pink)

both usually combined with long acting B2 agonist

70
Q

Simple difference between brown inhaler and blue inhaler?

A

blue- to treat any acute episode which arises
brown- prevent asthma from happening

71
Q

Name three types of inhaled steroid mixed with long acting B2 agonist? and name both the steroid and the b2 long acting agonist

A

= Seretide- fluticasone and salmeterol
= fostair - beclomethasone and fomoterol
= symbicort - budesonide and fomoterol

72
Q

Name 4 other types of asthma drugs ?

A

=mast cell stabilisers
= leukotriene inhibitors
= biologic medicines
= oxygen

73
Q

Example of mast cell stabiliser

A

chromoglycate (inhaler)

74
Q

example of leukotriene inhibitor

A

montelukast (tablet)

75
Q

What do biologic medicines do?

A

target specific immune modulators within inflammatory process

76
Q

name 4 examples of biologic medicines

A

Xolair (omalizumab)
Nucala (mepolizumab)
Cinqaero (reslizumab)
Fasenra (benralizumab)

BDS2 BAMS (8 decks)

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