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Respiratory System Flashcards

(80 cards)

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1
Q

Which cells are involved in the acute phase of asthma?

A

Mast cells

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2
Q

Allergic rhinitis, urticaria and eczema precede which kind of asthma?

A

Atopic

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3
Q

Which three medications can induce asthma?

A

NSAIDs
Beta blockers
Aspirin

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4
Q

What would the lung function test of an asthmatic show?

A

Variable airflow obstruction

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5
Q

A patient presents with:

  • wheezing
  • cough
  • sputum production
  • chest tightness
  • shortness of breath

with symptoms worsening at night.

Which pathology could this be related to?

A

Asthma

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6
Q

Which lung function test is the gold standard for asthma diagnosis?

A

Spirometry

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7
Q

A blood test of an asthmatic could show:

Eosinophil count > ___%
____ IgE in serum

A

4

Increased

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8
Q

What is the mechanism of action of B-adrenergic receptor agonists?

A

Activate B2 receptor -> activate adenyl cyclase -> ultimately SM relaxation and inhibition of mediator release

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9
Q

What are two examples of SABAs?

A

Salbutamol and Albuterol

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10
Q

Epinephrine, Salmeterol and Formeterol belong to which class of asthma drugs?

A

LABAs

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11
Q

What is the mechanism of anticholinergic agents?

A

Non-selectively inhibit pathway where ACh stimulates submucosal glands

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12
Q

What is the mechanism of action of Xanthine drugs?

A
  • Non selective phosphodiesterase inhibitor
  • Anti-inflammatory effect
  • Non-selective antagonism of adenosine
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13
Q

What is the mechanism of action of mast cell stabilisers?

A

Inhibit IgE mediated release from mast cells

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14
Q

What class of asthma drugs do Cromolyn sodium and Nodocromyl sodium belong to?

A

Mast cell stabilisers

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15
Q

Which drugs are used for short term relief of asthma symptoms?

A

SABAs and anti-cholinergics

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16
Q

What are the side effects of SABAs?

A
  • Tremors
  • Tolerance
  • Increased HR
  • Arteriole vasodilation
  • Hypokalemia
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17
Q

Which anticholinergic agent has the least side effects and tachyphylaxis?

A

Ipatropium bromide

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18
Q

Which anti-cholinergic can cause dry mouth, constipation, blurred vision and urinary retention?

A

Tiotropium

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19
Q

____ and ____ are used for maintenance control of asthma

A

LABAs and inhaled corticosteroids

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20
Q

In which patients is use of Theophylline particularly dangerous?

A

Patients with heart disease (potential for serious cardiac side effects)

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21
Q

What is the most effective class of medication for asthma control?

A

Glucocorticoids

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22
Q

Why are glucocorticoids administered alongside LABAs?

A
  • Cause up regulation of B-adrenergic receptors

- Prevents tolerance of B-agonists

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23
Q

Which asthma drug is most suited to treat aspirin induced asthma?

A

Leukotrine receptor antagonists

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24
Q

What is the best method of administering asthma drugs to children?

A

Spacer

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25
A ____ allows multiple asthma medications to be administered at once
Nebuliser
26
How are asthma drugs administered in an emergency?
Endotracheal instillation
27
____ and ____ are two types of inhalers
Metered dose | Dry powder dervice
28
What is the defining clinical feature of chronic bronchitis?
Productive cough
29
What is the biggest risk factor for COPD?
Smoking
30
Clinical findings for COPD: __ FVC __ FEV1.0 __ FEV1.0/FVC __ TLC
Dec FVC Dec FEV1.0 Dec FEV1.0/FVC Inc TLC
31
Chronic bronchitis involves the hypertrophy and hyperplasia of ____ and ____
Mucinous glands and goblet cells
32
Why must patients with chronic bronchitis cough to get rid of mucus plugs?
- Excess mucus | - Poorly functioning cilia
33
What are the signs and symptoms of chronic bronchitis?
- Wheezing - Crackling - Hypoxemia - Hypercapnia - Cyanosis - RHS heart failure
34
What is the main approach to treating COPD?
- Reduce risk factors | - Manage associated illnesses
35
What is the defining feature of emphysema?
Structural changes in the airways
36
What is the pathogenesis of emphysema?
Irritants -> inflammatory reaction -> break down of structural proteins in CT -> weakened airway walls
37
Which pattern of emphysema is most common in smokers?
Centriacinar (upper lobes)
38
What are the symptoms of emphysema?
- Dyspnea - Exhale slowly through pursed lips - Weight loss - Hypoxemia (chronic) - Cough will small amount of sputum - Barrel shaped chest
39
What findings would there be on a CXR of a patient with emphysema?
- Increased A-P diameter - Increased lung field lucency - Flattened diaphragm
40
What is the most common mutation in CF?
DeltaF508
41
How may CF manifest in a newborn?
Meconium ileus - First still thick and sticky so becomes stuck in intestines
42
What is the most prominent effect of CF in early childhood?
Pancreatic insufficiency
43
What are symptoms of CF in early childhood?
- Poor weight gain - Failure to thrive - Steatorrhea
44
What is CF exacerbation?
Defective mucociliary action -> bacteria colonisation -> cough + fever
45
Which two bacteria are most commonly implicated in CF exacerbation?
S. Aureus + P. Aeruginosa
46
What is the leading cause of death in CF?
Respiratory failure
47
How are newborns screened for CF?
- Detection of IRT | - Sweat test
48
Which medications are available to treat the symptoms of CF?
N-acetylcystine and dornase alfa
49
Why are antibiotics ineffective for mycoplasmic pneumonia?
Mycoplasma have no cell wall
50
Which two organisms are problematic in causing hospital acquired pneumonia?
MRSA and Pseudomonas Aeruginosa
51
What happens following aspiration of stomach contents?
Chemical burn -> inflammatory reaction -> chemical pneumonitis -> weakened airways -> pneumonia
52
A patient's CXR shows patch areas of consolidation in the lower + right middle lobes. What kind of pneumonia is this due to?
Bronchopneumonia
53
What is the main causative organism of lobar pneumonia?
Streptococcus Pneumoniae
54
What are the four stages of lobar pneumonia?
Congestion -> red hepatization -> grey hepatization -> resolution
55
Which symptoms are associated with interstitial pneumonia?
Mild symptoms - Low fever - Minimal mucus - Non productive cough - Chest pains
56
Histologically how does interstitial pneumonia differ to the other kinds of pneumonia?
- No exudate/fluid | - Mononuclear infiltrate
57
Which non-small cell carcinoma of the lung is associated with smoking?
SqCC
58
SqCC of the lungs tend to arise in the ____ of the lung whereas AdenoCa arise in the ____
Major airways | Periphery
59
Which type of x-ray gives the most accurate dimensions of the heart?
P-A
60
In what instances would it be preferable to take an exhalation film?
Pneumothorax and atelectasis
61
What steps comprise the A-F of CXR analysis?
``` A - TracheA B - Bones C - Cardiac silhouette D - diaphragm E F - Equal lung Fields ```
62
Pleural effusion will cause tracheal deviation to the _____ side
Opposite
63
How would you observe compression fractures in a CXR?
Disruption of regular intervals between vertebrae
64
Which lung lobe does the RA abut?
Right middle lobe
65
Which division of the heart does the lingula abut?
The left border
66
What would be indicative of a bowel perforation in a CXR?
Any areas of density just underneath the diaphragm
67
What is the meniscus sign?
Loss of the sharp costophrenic angle
68
What is Westermark sign?
Pulmonary embolism -> blood shunted from affected to opposite side -> opposite side hyperaemic
69
Upon examination of a patient's CXR, you observe multiple calcified nodules in both upper lobes. What is this indicative of?
Tuberculosis (until proven otherwise)
70
What are the most important symptoms associated with pulmonary oedema?
Orthopnia and ankle oedema (CHF)
71
What vascular changes are observed in a CXR of a patient with CHF?
Cephalisation -> vessels become engorged, upper lobe vessels more visible
72
What are air bronchograms?
Where the outline of smaller bronchi are observed on the background of fluid -> water density in the lungs but not in the airways
73
What is the primary clinical indication for spirometry?
To establish or confirm diagnosis of an obstructive ventilatory defect
74
Which clinical measurement is essential in diagnosing a restrictive lung disease?
Total Lung Capacity
75
Which test is used for evaluation and follow up for parenchymal lung disease?
DLCO (alveolar-capillary diffusion assessment)
76
Inhalation/exhalation in a flow volume diagram would be abnormal in a patient with COPD
Exhalation
77
Inhalation/exhalation in a flow volume diagram would be abnormal in a patient with goitre
Inhalation
78
Which long volume cannot be measured clinically?
Residual volume
79
Architectural destruction and extrinsic constriction can be measured by which lung function test?
DLCO
80
Which lung function test can distinguish between COPD and asthma?
DLCO

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