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Respiratory JC > Week 2 > Flashcards

Week 2 Flashcards

(48 cards)

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1
Q

What is DPLD? What part of the lung does it effect?

A

Diffuse parenchymal lung disease, it is an umbrella term for conditions that affect the interstitium of lungs causing fibrosis, lack of compliance,

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2
Q

Give an example of a condition that could cause dpld?

A

Extrinsic allergic alveolitis

Infection

Amiodarone (antiarrythmic drug)

Sarcoidosis
Heart failure

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3
Q

How can DPLD present?

A 
With finger clubbing, cough but no wheeze 
Breathless on exertion
Inspiratory lung crackles
Central cyanosis if hypoxic
Pulmonary fibrosis
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4
Q

How do you treat DPLD?

A

Avoidance of trigger
Treat underlying cause
Corticoid steroids to suppress immune system
Drugs to prevent further deposition of collaen like pirfenidone and nintedanib

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5
Q

What are the locations of the respiratory centres?

A

Ventral and dorsal neurones in the botzinger complex within the medulla

Pneumotaxic centre in pons

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6
Q

What do the ventral neurones control?

A

Upon excessive stimulation of the dorsal neurones they cause the activation of the internal intercostal muscle and abdominal muscle to carry out active expiration

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7
Q

What do the dorsal neurones control?

A

Firing of these neurones cause the contraction of the inspiratory muscles, diaphragm and the external intercostal muscles.

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8
Q

What occurs when the dorsal neurones stop firing?

A

Passive expiration

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9
Q

What is the term for brief expiration

A

Apneusis

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10
Q

How can the pneumotaxic centre modify the rate of inspiration

A

By inhibiting the dorsal neurones firing

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11
Q

What is the main function of the peripheral chemoreceptors

A

To sense oxygen saturations and H+ ion concentrations. If metabolic acidosis will undergo hyperventilation

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12
Q

What is the main function of the central chemoreceptors?

A

Sense arterial Co2 and Hydrogen ions in the brain

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13
Q

Why is there increased respiratory rate during exercise?

A

Joint receptors activated causing increase in resp

Accumulation of CO2 and H+

Adrenaline acting on beta 2 adrenoceptors

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14
Q

What is the term for increased RBC production?

A

Polycthaemia

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15
Q

What is the function of 2,3 BPG production in RBC’s

A

O2 easier offloaded to tissues

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16
Q

What is the negative predictive value for a test?

A

The % of people who have a negative test who actually dont have the disease. True negative vs false negative

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17
Q

What is the positive predictive value?

A

% of people who have a positive test for a disease who actually have the disease

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18
Q

What is the normal proportion for a lung volume test of FEV1/FVC

A

75%

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19
Q

What happens to the FEV1/FVC ratio is asthma and Copd

A

Is reduced

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20
Q

What happens to the FVC in asthma and COPD

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A

Athma fvc the same

Copd fvc reduced

21
Q

Describe the inflammatory cascade in asthma

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A

Eosinophillic inflammation

Th2 activation
Cytokines

Twitchy smooth muscle

22
Q

What are the two main classes of drugs for airflow obstruction diseases?

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A

Preventers; antiinflammatory

Relievers; bronchodilators

23
Q

Name some anti-inflammatory drug classes

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A 
Steroids
Cromones
Leukotriene receptor antagonists
Anti-ige
Anti-IL5
PDE4 inhibitors
24
Q

Name some bronchodilator drug classes

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A

Beta agonists

Muscarinic receptor antagonists

25
What are the two drugs in the corticosteroid antiinflammatory class?
Inhaled; beclomethasone | Oral; predinisalone
26
What is the main drug used in the cromones anti-inflammatory class? What is its function
Sodium cromoglycate- a mast cell stabiliser
27
Name the drug in Leukotriene receptor antagonists, how does this work? What drug is it used in conjuction with?
Monteleukast orally taken Inhibits receptor on eosinophils that leukotrienes bind ICS
28
Name an anti-ige medication and an anti-il5 and their modes of action
Anti ige- inhibits TH2 response that attracts eosinophils. OmaliZUMAB Anti-il5- inhibits the IL-5 that acts on eosinophils. mepoliZUMAB or resliZUMAB
29
What is a PDE4 drug, what condition does it treat, what is it prescribed with?
Roflumilast, COPD, prescribed with a LABA or LAMA
30
Name muscarinic receptor antagonists long and short acting
Short acting- ipratropium | Long acting - tiatropium
31
What do methylxanthines treat? What is prescribed for an acute attack Vs management
COPD and asthma Theophylline for maintenance Aminophylline for acute attacks (A for A)
32
Describe how activation of muscarinic M3 receptors cause bronchial smooth muscle contraction
Acetylcholine acts on M3 receptors to activate a G protein that activates the phospholipase C pathway causing an influx in calcium ions that allow contraction of the smooth muscle
33
Name some causes of respiratory acidosis
Choking Bronchopneumonia COAD (chronic obstructive airway disease)
34
Name some causes for respiratory alkalosis
Mechanical Hyperventilation Hysterical hyperventilation Raised intracranial pressure (stimulating respiratory centres driving ventilation)
35
What are some causes for metabolic acidosis
Impaired H+ excretion (renal failure) Increased H+ production from ingestion Loss of HCO3-
36
What are some causes for metabolic alkalosis
Vomiting (loosing H+ ions) Alkali ingestion Potassium deficiency
37
What is involved in respiratory alkalosis
Loss of CO2
38
What is involved in metabolic acidosis
Increased presence of H+ ions
39
In healthy individuals what is the range of SaO2 saturations?
94-98%
40
What is type 1 resp failure?
Where there is lack of oxygen
41
What is type 2 resp failure?
When lack of oxygen and too muchco2
42
What is VQ mismatching
When ventilation and perfusion are not the same due to infarct, poor diffusion
43
What is the haldane effect?
That when haemoglobin is empty from o2, co2 will bind to it
44
What is the bohr effect
As acidity and co2 concentration increases, haemoglobins affinity for oxygen decreases
45
What two vitamins are required for the maturation of RBCs
B12 and folate
46
What is the maximum volume of air that can be expired in a single breath following maximum inspiration ?
Vital capacity
47
What is equivalent to inspiratory reserve volume plus tidal volume, plus expiratory reserve volume?
Vital capacity
48
What is the volume of air in the lungs following passive normal expiration?
The functional residual capacity

Respiratory JC (11 decks)

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