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Apex Review > Respiratory pathophysiology > Flashcards

Respiratory pathophysiology Flashcards

(48 cards)

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1
Q

Chemicals that contribute to increased airway resistance include:
a. nitric oxide
b. inositol triphosphate
c. vasoactive intestinal peptide
d. phospholipase C
e. leukotrienes
f. cyclic adenosine monophosphate

A

b. inositol triphosphate
d. phospholipase C
e. leukotrienes

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2
Q

All other thing being equal, the ___________ has the most significant contribute to airflow resistance.

A

radius of the airway

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3
Q

What physiologic systems determine airway diameter?

A

PNS (vagus nerve)
mast cells & non-cholinergic PNS
non-cholinergic PNS (nitric oxide)
SNS (circulating catecholamines)

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4
Q

What physiologic systems lead to bronchoconstriction?

A

PNS (vagus nerve)
mast cells & non-cholinergic PNS

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5
Q

What physiologic system lead to bronchodilation?

A

Non-cholinergic PNS (nitric oxide)
SNS (circulating catecholamines)

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6
Q

__________ supplies parasympathetic innervation to airway smooth muscle.

A

Vagus nerve (CN 10)

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7
Q

Stimulation of the ______ receptor produces bronchoconstriction

A

M3

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8
Q

_____________ & ______________ also release chemicals that promote bronchoconstriction

A

Mast cells & non-cholinergic c-fibers

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9
Q

There are no __________________ in airway smooth muscle

A

sympathetic nerve endings

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10
Q

B2 receptors embedded in airway smooth muscle are activated by

A

catecholamines in the systemic circulation

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11
Q

Non-cholinergic PNS stimulation produces ____________ which also promotes_______________

A

nitric oxide; bronchodilation

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12
Q

Smooth muscle contraction leads to

A

decreased airway diameter–> increased airway resistance–> reduce airflow

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13
Q

Smooth muscle relaxation leads to

A

increased airway diameter–> decreased airway resistance–> improved airflow

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14
Q

Mediators that lead to bronchoconstriction include

A

histamine
prostaglandins
leukotrienes
platelet activating factor
bradykinin
substance P
neurokinin A
calcitonin gene related peptide

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15
Q

Pulmonary medications can be broken down into

A

direct acting bronchodilators
anti-inflammatories
methylxanthines

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16
Q

Direct acting bronchodilators include

A

Beta 2 agonists
anticholinergics

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17
Q

Examples of direct acting bronchodilating anticholinergics include

A

atropine
glycopyrrolate
ipratropium

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18
Q

Examples of direct acting bronchodilating beta 2 agonists include

A

albuterol
metaproterenol
salmeterol

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19
Q

Anti-inflammatory drugs include

A

Cromolyn
leukotriene modifiers
inhaled corticosteroids

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20
Q

Examples of inhaled corticosteroids include

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A

beclomethasone
fluticasone
triamcinolone
budesonide
flunisolide

21
Q

Examples of leukotriene modifiers include

Study These Flashcards
A

zileuton
montelukast
pranlukast
zafirlukast

22
Q

Methylxanthines include

23
Q

Anesthetic agents with bronchodilating properties include

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A

volatile anesthetics
ketamine

24
Q

How do steroids work in the airway?

Study These Flashcards
A

stimulates intracellular steroid receptors
regulates inflammatory protein synthesis leading to decreased airway inflammation and hyperresponsiveness

25
How do leukotriene modifiers work?
inhibits 5-lipoxygenase enzyme reducing leukotriene synthesis
26
How do anticholinergics work in the airway?
prevent Ach from binding to M3 receptors leading to decreased IP3 and decreased iCa2+
27
How does cromolyn work in the airway?
stabilizes mast cell membranes
28
How do beta 2 agonists work in the airway?
block cytokines, leukotrienes and histamine from leaving the mast cell and stimulate B2 receptors in the smooth muscle leading to increased cAMP & decreased Ca2+
29
Side effects of beta 2 agonists include
tachycardia, dysrhythmias, hypokalemia, hyperglycemia, tremors
30
Side effects of anticholinergics include
inhibits secretions--> dry mouth urinary retention blurred vision cough increased intraocular pressure with narrow angle glaucoma
31
Side effects of corticosteroides include
dysphonia myopathy of laryngeal muscles oropharyngeal candidiasis possible adrenal suppression
32
Side effects of cromolyn include
negligible
33
Side effects of leukotriene modifiers include
negligible
34
How does theophylline work?
inhibits phosphodiesterase--> increased cAMP, increased endogenous catecholamine release inhibits adenosine receptors
35
Side effects of theophylline are dependent on
plasma concentrations
36
At a plasma concentration of >20 mcg/mL of theophylline, side effects include
N/V, diarrhea, HA, disrupted sleep
37
At a plasma concentration of >30 mcg/mL of theophylline, side effects include
seizures tachydysrhythmias CHF
38
Which pulmonary function test is the MOST sensitive indicator of small airway disease? a. forced expiratory volume in 1 second b. forced expiratory flow 25-75% c. forced vital capacity d. diffusion capacity of carbon monoxide
b. forced expiratory flow 25-75%
39
_____________ measure how much air the lungs can hold at a single point in time
Static lung volumes
40
Examples of static lung volumes include
RV, ERV, Vt, IRV, FRC, IC, VC, TLC
41
__________ measure how quickly air can be moved in and out of the lungs over time
FEV1, FVC, FEV1/FVC ratio, and MMEF
42
____________ measures how well the lungs can transfer gas across the alveolocapillary membrane
Diffusing capacity
43
Examples of diffusing capacity include
diffusing capacity of carbon monoxide (DLCO)
44
A normal FEV1 value is
>80% of the predicted value
45
A normal FEV1/FVC ratio value is
>75-80% of the predicted value
46
Lung volumes and capacities are measured with
spirometry
47
The most sensitive indicator of small airway disease is
forced expiratory flow at 25-75% vital capacity (mild maximal expiratory flow rate)
48
A normal diffusing capacity (DLCO) is
17-25 mL/min/mmHg

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