Week 9 Flashcards by Ethan Wong

What traps dust and smoke

hair and mucus

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What prevents food and liquid from entering lower respiratory tract

epiglottis

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Where does conducting zone start and end

trachea to bronchus

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where does respiratory zone begin

bronchioles with alveoli

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where does gas exchange occur at

respiratory zone (bronchioles with alveoli)

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What prevents alveoli walls from collapsing and sticking together

slightly oily surfactant

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What monitors PaCO2

Central chemoreceptors in medulla oblongata

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what monitors PaO2 and blood pH

Peripheral chemoreceptors in carotid and aortic arch

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What is respiratory failure

when lungs fail to oxygenate arterial blood adequately to prevent carbon dioxide retention

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hypoxemia

partial pressure of oxygen <60mmHg

Reduced PaO2 in arterial blood

Leads to tissue hypoxia

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hypoxemia AKA

type I respiratory failure

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hypocapnia

partial pressure of carbon dioxide > 50 mmHg

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hypocapnia AKA

type II respiratory failure

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Mild symptoms of hypoxemia

Decreased mental power, visual, tachypnea

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profound symptoms of hypoxemia

CNS, CVS, Respiratory

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Tissue hypoxia

inadequate cellular oxygenation

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tissue hypoxia effects

CNS, Myocardium, Renal, Vascular

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CNS effect of tissue hypoxia

hypoxic ischemic encephalopathy

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How to identify respiratory failure

Vital signs, GCS, Respiratory findings

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How to stabilize patients with respiratory failure

airway, breathing, circulation

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what needs to be investigated for respiratory failure

arterial blood gas, CXR, CT scans

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ABG is taken from ___

radial, brachial, femoral arteries

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lung cancer symptoms related to __

primary lesion, intrathoracic spread, distant metastasis, paraneoplastic (unusual hormone expression)

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ways to diagnose lung cancer

CXR, CT scan, PET scan, biopsy

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what is the most common screening test for lung cancer

CXR

radiological findings for lung cancer

- coin lesions - large irregular masses - alveolar consolidation

stage 1 of lung cancer signs

tumor is 1-4cm

stage 2 of lung cancer signs

tumor is 3-7cm, may be in lymph nodes / surrounding tissues

stage 3 of lung cancer signs

tumor is 3-7cm, disease in more than 1 lymph node / surrounding tissues

stage 4 of lung cancer signs

metasized cancer

NSCLC stage I

local disease

NSCLC stage II

resectable

NSCLC stage IIIa

locally advanced resectable

NSCLC stage IIIb

locally advanced unresectable

NSCLC stage IV

far advanced

diff types of NSCLC

- adenocarcinoma - squamous cell carcinoma - large cell carcinoma

diff types of small cell lung carcinoma

- combined small cell carcinoma - oat cell carcinoma

what is the lung test function to diagnose asthma

spirometry

factors of asthma

wheezing dyspnea cough chest tightness

increased probability of asthma

- > 1 symptom - worsens at night - varying intensities - multiple triggers

decreased probability of asthma

- isolated cough - chronic sputum - dyspnea with giddiness & paresthesia - chest pain / stridor

goals of asthma treatment

- control symptoms - maintaining lung function - prevent exacerbations, asthma death - minimize side effects

main determinants of oxygen delivery are __

cardiac output, hemoglobin & arterial oxygen saturation

most common cause of hypoxemia

mismatch between ventilation & perfusion

causes of hypercapnia are __

neurological, lungs & blood flow

ABG measures

amount of O2 & CO2 dissolved in arterial blood

NCS

nerve conduction study

EMG

electromyography

surgical evaluation of lung cancer done via __

VATS & thoracotomy

asthma involves inflammation of ___

airways

allergic asthma onset caused by __

childhood, atopy, eczema, food/drugs

non allergic asthma onset caused by __

obesity, adult, smoking

adult onset caused by __

late onset, female, no allergies

persistent airflow limited asthma onset caused by __

persistent chronic asthma

cellular involvement of allergic asthma

eosinophils & inflammation

cellular involvement of non allergic asthma

neutrophils, inflammation

cellular involvement of adult onset asthma

paucigranulocytic

cellular involvement of chronic asthma

airway wall remodelling

cellular involvement of asthma with obesity

less eosinophilic

AIR

anti-inflammatory reliever

MART

maintenance & reliever therapy

SABA

short acting beta agonists

triage escalation for asthma only occurs if __ are present

drowsiness, confusion, silent chest

genetically determined COPD / COPD-G

alpha-1 antitrypsin deficiency

COPD from infections / COPD-I

childhood, tuberculosis, WHIV

COPD-A

childhood asthma

COPD-D

COPD from abnormal development

COPD-P

biomass and pollution exposure COPD

COPD-C

cigarette smoking COPD

COPD-U

COPD of unknown causes

chronic bronchitis causes

inflammation & excess mucus

emphysema causes

alveolar membrane breakdown

biomarkers involved in systemic inflammation of COPD

IL-6, IL-1beta, TNF-alpha

dyspnea signs before considering COPD

progressively worse over time esp with exercise

follow up assessments after spirometry

pharmacology, alternative diagnosis, interventional procedures

spirometry assesses for __

airflow obstruction severity

COPD classification workflow

1. spirometry confirmation 2. airflow obstruction assessment 3. exacerbation / symptom assessment

ABE assessment involves ___

exacerbations, mMRC, CAT

mMRC

modified medical research council

COPD medication categories

short acting bronchodilators long acting bronchodilators combination inhalers

LAMA

long acting muscarinic antagonist

ICS

inhaled corticosteroid

LABA

long acting beta2-agonist

Group E treated using

LABA + LAMA (+ICS if blood eos > 300)

Group A treated using

A bronchodilator

Group B treated using

LABA + LAMA

what factors strongly favor ICS initiation

>2 exacerbations annually blood eosinophils > 300 microlitre concurrent asthma

what factors strongly prohibit ICS initiation

repeated pneumonia blood eosinophils < 100 microliter mycobacterial infections

5A's to quite tabacco

ask, advice, assess, assist, arrange

if patient is not viable for bullectomy, ELVR, LVRS, what can they consider?

lung transplant

interventions of bronchodilators

LABA, LAMA

interventions of corticosteroid containing regimens

LABA, LAMA, ICS

interventions of anti-inflammatory non-steroids

roflumilast

interventions of mucoregulators

N-acetylcysteine, carbocysteine, erdosteine

breakdown of alveoli wall is due to __

loss of surface area for gas exchange, pulmonary capillaries, elastic fibers altered ventilation-perfusion ratio decreased support for small bronchi

a post-bronchodilator FEV1/FVC ___ confirms the presence of persistent airflow limitation

< 0.70

COPD surgery includes ___

bullectomy, lung volume reduction strategy

Week 9 Flashcards

(97 cards)