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Module Two > Respiratory pathology > Flashcards

Respiratory pathology Flashcards

1
Q

The majority of common, transmissible viruses that circulate every year, have what genetic material?

A

Ss-RNA

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2
Q

What is an antigenic subtype?

A

Slight differences in the same virus that mean they can keep evading the immune system

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3
Q

What is the most common cause of viral URTIs?

A

Rhinovirus

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4
Q

What virus causes infectious mononucleosis?

A

EBV

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5
Q

What is meant by a non-aetiological diagnosis?

A

Unknown cause, diagnosed from signs and symptoms

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6
Q

What would the blood smear of Glandular fever look like and what cells does it infect?

A

Activated CD8+ (Tc) cells which are larger and have larger amount of cytoplasm to nucleus. Mono infects B Cells.

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7
Q

What is the leading cause of death among infectious diseases in the human population?

A

LRTIs

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8
Q

What is the typical size for most inspired, common respiratory viruses?

A

90-120nm

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9
Q

What are haemagglutinin and neuraminidase?

A

Viral spike proteins of influenza

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10
Q

What does monocistronic mean?

A

Encode for a single protein

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11
Q

What function does Heamagglutinin have?

A

Attachment to host cell

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12
Q

What common receptor lies on the surface of most animals respiratory cells and is the reason for the easily transmissible and zoonotic nature of influenza?

A

Sialic acid

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13
Q

What proteins are important in transcription of negative strand RNA to positive strand, ready for translation?

A

Polymerase complexes

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14
Q

What allows for the transport of viral genetic material across the cytoplasm to the nucleus?

A

NSL (nuclear localisation sequences)

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15
Q

What can happen with a positive strand of viral RNA?

A

Can be directly translated in the ribosomes to form viral proteins

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16
Q

What is viral load?

A

The amount of virus in the blood

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17
Q

What was the viral cause of 1918 Spanish flu?

A

Influenza A

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18
Q

What is the term for a virus that infects cells of the respiratory tract?

A

Pneumotropic

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19
Q

What is a cytolytic infection?

A

Kills the cells that are infected

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20
Q

What two innate defence mechanisms are destroyed from the cytolytic nature of pneumotropic viruses?

A

Mucous secretion and ciliary clearance

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21
Q

Interleukins have what systemic effect?

A

Pro-inflammatory. Cause fever, malaise, headache etc (coryzal symptoms)

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22
Q

What do interferons do?

A

Signal neighbouring cells (that are currently unaffected) to slow protein synthesis and trigger apoptosis.

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23
Q

What are the two types of pneumonia occurring from a viral illness?

A

Primary and secondary (bacterial)

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24
Q

What affect could viral infections have on the heart?

A

Viral induced myocarditis

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25
Q

What is the difference between an epidemic and pandemic?

A

While an epidemic is large, it is also generally contained or expected in its spread, while a pandemic is international and out of control.

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26
Q

Influenza viruses have a designation that describes its subtype. Decode this one : A/duck/Alberta/35/76 (H1N1)

A

Influenza A, first discovered in ducks, first discovered in Alberta, Canada, strain number, year of isolation 1976, (subtypes of haemagglutinin and neurominadase)

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27
Q

What mechanism is responsible for a sudden, dramatic change resulting in a new subtype of virus?

A

Antigenic shift

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28
Q

What are the three major types of vaccine?

A

Recombinant, inactivated and live-attenuated

29
Q

What is the incubation period of RsV?

A

4-5 days

30
Q

What is the attachment protein called on the surface of RSV virus?

A

Attachment protein G

31
Q

What is the target receptor for SARS COV 2?

A

Angiotensin converting enzyme (ACE) receptor 2

32
Q

Surfactants in the respiratory tract help kill inhaled pathogens, there are two types, what are their functions?

A

SP-A directly kills pathogens through lysis. SP-D assists in the phagocytosis process.

33
Q

What are the afferent nerves involved in the cough reflex?

A

Rapidly adapting stretch receptors (RARs), slowly adapting stretch receptors (SARs) and C-fibres

34
Q

What are the three phases of the cough reflex?

A

Inspiratory, Compression, Expiratory

35
Q

What complication can arise, mainly in children, from a Group A strep infection?

A

Scarlet fever

36
Q

Name the most common bacterial causes of sinusitis

A

Strep pneumoniae, Haemophilus influenza, Staph aureus, Strep pyogenes (A)

37
Q

What is the most common cause of pharyngitis, tonsilitis and laryngitis?

A

Strep pyogenes (Group A Strep)

38
Q

Bronchitis is usually caused by what pathogen?

A

Viral pathogens

39
Q

Bronchiolitis is most commonly caused by what virus?

A

RSV

40
Q

What pathogen is the most common cause of CAP?

A

Strep pneumoniae

41
Q

What is a common pathogen associated with HAP?

A

Klebsiella pneumoniae

42
Q

True or False: Anatomical dead space is increased in disease

A

False. Physiological dead space is INCREASED in disease due to the alveoli that is not perfused. Anatomical dead space is based on anatomy, size, posture and tidal volume.

43
Q

What measure could you use to estimate someone’s anatomical dead space?

A

Weight in lbs

44
Q

Name the two types of irreversible COPD

A

Chronic bronchitis and emphysema

45
Q

What is an obstructive pulmonary disease?

A

Limitation of airflow resulting from increased resistance in the bronchial passages

46
Q

True or False: Obstructive pulmonary diseases mainly affect exhalation.

A

True, restrictive mainly affect inhalation

47
Q

Pulmonary fibrosis, ankylosing spondylitis and pleural effusion are all what type of pulmonary disease?

A

Restrictive

48
Q

What is the distal respiratory tree?

A

The respiratory portion of the airways (respiratory bronchioles and alveoli)

49
Q

What might you find on a histological sample of a patient with emphysema?

A

Enlarged air spaces, destruction of alveolar walls, loss of alveolar attachment and accumulation of inflammatory cells

50
Q

What is the main aetiology of irreversible COPD?

A

Smoking

51
Q

Describe the pathogenesis of emphysema

A

A toxin/pollutant causes irritation and stimulates an increase in macrophages. Chemoattractants released by macrophages stimulate neutrophils. Neutrophils secrete elastase. Alpha-1 antitrypsin neutralises elastase. Persistent exposure to the stimulant continues the production of elastase and alpha-1 antitrypsin levels decrease. Elastase destroys elastin in the elastic fibres surrounding the alveoli.

52
Q

Name some differential diagnoses of COPD

A

Lung ca, pulmonary fibrosis, heart failure

53
Q

True or False: it is unusual for COPD to cause haemoptysis

A

True

54
Q

What scale is NICE recommended scale to assess the impact of the breathing difficulty in COPD patients?

A

Medical Research Council’s 5 point dyspnea scale

55
Q

What does an obstructive disease show in spirometry?

A

FEV1/FVC < 0.7.
The patient’s overall lung capacity is not as bad as their ability to blow air out of their lungs.

56
Q

For a COPD patient: if a beta-2-agonist is given for inhalation, and a spirometry test is run again, will the result show a dramatic improvement?

A

No, it is irreversible so shouldn’t show dramatic improvement on the chronic condition. Beta 2 agonists can improve symptoms of acute exacerbations of COPD though.

57
Q

What are the common symptoms of asthma?

A

Bilateral, polyphonic, expiratory wheeze. Dry cough. Symptoms are episodic, diurnal and/or triggered by external factors.

58
Q

What are the main tests that can be performed to diagnose asthma?

A

Fractional exhaled NO, Spirometry and bronchodilator reversibility, Peak flow expiratory rate

59
Q

Between exacerbations of asthma, what might you find on respiratory examination?

A

There might be no abnormalities

60
Q

What’s Hoover’s sign?

A

During assessment of chest expansion, thumbs move towards each other at the costal margins instead of away, this happens during COPD due to overexpansion of the lungs.

61
Q

How would you describe TB under a microscope?

A

Acid-fast bacilli that are stained red under Ziehl-Neelson stain.

62
Q

Secondary pulmonary TB usually localises to what segments of the lungs?

A

Apical and posterior segments of the upper lobes

63
Q

Name some tests for TB

A

Sputum smear microscopy
Mantoux test
Interferon-Gamma release assay
PCR
Nucleic acid amplification test (only for very at risk)

64
Q

What is a granuloma?

A

Compact collection of immune cells formed in response to an infection like TB

65
Q

When the centre of a granuloma starts to die, what happens?

A

A caseous necrotic core develops. Surrounding immune cells and fibroblasts form scar tissue to encapsulate the necrotic tissue.

66
Q

What is the Ghon complex?

A

The initial site of infection of pulmonary TB and the spread to the hilar lymph nodes.

67
Q

Spread of TB to the spine is called what?

A

Pott’s disease

68
Q

What is miliary TB characterised by?

A

Millet seed sized tubercles spread all over the lung fields, it is rare and has a poor prognosis.

69
Q
A

Module Two (9 decks)

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