PRELIMS > PHCP - Module 1 > Flashcards

PHCP - Module 1 Flashcards

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1
Q

Voicebox

A

laryngopharynx

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2
Q

Windpipe

A

Trachea

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3
Q

Contains upper, middle, lower lobe

A

Right Lung

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4
Q

Contains upper and lower lobe

A

Left Lung

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5
Q

Final destination of inhaled cells
No smooth muscles

A

Alveoli

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6
Q

Thin epithelial cell

A

Pneumonocytes

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7
Q

AKA Hay Fever

A

Allergic Rhinitis

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8
Q

It involves inflammation of nasal mucous
membranes in sensitized individuals when
inhaled allergenic particles contact mucous
membranes and elicit a response mediated by
immunoglobulin E (IgE).

A

Allergic Rhinitis

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9
Q

Mediators of immediate
hypersensitivity include :

A

histamine, leukotrienes,
prostaglandin, tryptase, and
kinins.

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10
Q

Dark circles under the
eyes

A

allergic shiners

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11
Q

Determines whether rhinitis is caused by immune response to allergens.

A

Allergy testing

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12
Q

Commonly used Allergy testing

A

Immediate-type hypersensitivity skin tests

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13
Q

safer and more generally
accepted than intradermal testing, which is usually
reserved for patients requiring confirmation.

A

Percutaneous testing

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14
Q

can detect IgE antibodies in the blood that are specific for a given antigen, but it is less sensitive than percutaneous tests.

A

radioallergosorbent test (RAST)

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15
Q

most effective first-line drug treatments for Rhinitis

A

– Nasal corticosteroids with or without oral or nasal antihistamines
-Oral antihistamines plus oral decongestants (eg, a
sympathomimetic such as pseudoephedrine)

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16
Q

Less effective alternatives include

A
  • nasal mast cell stabilizers (eg, cromolyn) given 3 or 4 times a
    day,
  • nasal H1 blocker azelastine 1 to 2 puffs twice a day, and
  • nasal ipratropium 0.03% 2 puffs every 4 to 6 hours, which
    relieves rhinorrhea.
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17
Q

A chronic allergic disorder characterized by
episodes of severe breathing difficulty,
coughing, and wheezing using the air passage
to narrow & causes shortness of breath.
* These episodes are usually reversible, either
spontaneous or with treatment.
* The inflammation is due to bronchia hyper
responsiveness to a variety of stimuli

A

Asthma

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18
Q
  • Occurs 6-9 hours after allergen provocation
    – Involves the activation of eosinophils, T lymphocytes,
    basophils, neutrophils and macrophage
A

Late phase inflammatory reaction

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19
Q

Migrates to the airways and release inflammatory
mediators (leukotrienes and granule proteins) cytotoxic
mediators and cytokines

A

EOSINOPHILS

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20
Q
  • Release cytokines from type 2 T-helper cells that mediate
    allergic inflammation.( IL-4, IL-5 and IL-13)
    – Type 1- T- helper produces IL-2 and Interferon gama that
    are essential for cellular defense mechanism
A

T- lymphocytes

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21
Q

Release of histamine, eosinophil and neutrophil chemotactic factors, leukotriene C4, D4 and E4,
prostaglandin and platelet activating factors.

A

Mast Cell degranulation

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22
Q

capable of inducing smooth muscle
constriction and bronchospasm and may play a role in
mucosal edema and mucus secretion.

A

Histamine

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23
Q
  • release a number of inflammatory mediators including
    PAF and leukotrienes B4, C4 and D4
    – 5 lipoxygenase pathway of arachidonic acid metabolism
    – Produce Cysteinyl leukotrienes C4, D4 and E4
  • Released during the inflammatory process in the lungs and causes
    bronchospasm, mucus secretion and airway edema
A

Alveolar macrophages

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24
Q

Releases eicosanoids, peptidases, matrix proteins, cytokines and nitric oxide

A

Bronchial epithelial cells

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25
– Expectorated mucus from patients with asthma are:
highly viscous
26
Characterized by episodic dyspnea with wheezing – Coughing particularly at night – These often occurs during exercise – Other signs: * Expiratory wheezing on auscultation * Dry hacking cough * Signs of atopy (Allergic rhinitis or eczema)
Chronic Asthma
27
During vigorous exercise, pulmonary functions (FEV1) in patients with asthma increase during the first few minutes but then begin to decrease after 6 to 8 minutes
EXERCISE-INDUCED BRONCHOSPASM
28
Type of asthma which may be worse when the air is cold and dry
Exercise-induced asthma
29
Type of asthma triggered by workplace irritants such as chemical fumes, gases or dust
Occupational asthma
30
Type of asthma triggered by particular allergens, such as pet dander, cockroaches or pollen
Allergy-induced asthma
31
is the volume of air that can forcibly be blown out after full inspiration, measured in liters. -most basic maneuver in spirometry tests
FVC: Forced vital capacity (FVC)
32
the volume of air that can forcibly be blown out in one second, after full inspiration. Values of between 80% and 120% of the average value are considered normal.
FEV1
33
the ratio of FEV1 to FVC. – In healthy adults this should be approximately 70–85% (declining with age)
FEV1/FVC (FEV1%)
34
B2RA w/ some B1 activity ADE: Tremors, Nervousness in 2-6yrs old
Albuterol sulfate (Proventil HFA, Ventolin HFA, ProAir HFA)
35
B2RA w/ some B1 activity Attractive choice in tx of acute symptoms in younger children
Pirbuterol (Maxair Autohaler)
36
B2RA w/ some B1 activity Effective in smaller doses. fewer ADE
Levalbuterol (Xopenex)
37
Anticholinergic INH secretions from serous and seromucous glass lining the nasal mucosa
Ipratropium (Atrovent)
38
Anticholinergic + B2 little effect on cardiac muscle contractility
Ipratropium + Albuterol (Combivent, DuoNeb)
39
Corticosteroid, Oral decreases inflammation bu reversing increased capillary permeability and suppressing polymorphonuclear leukocyte activity
Prednisone (Deltasone, Orasone) Methylprednisone (SoluMedrol, Medrol) Prednisolone (Pediapred, Prelone, Orapred)
40
Long-Acting B2 Bronchial Smooth muscle relaxation
Formoterol (Foradil, Performist) Salmeterol (Serevent)
41
Long-Acting B2 Increased intracellular cyclic AMP
Arformoterol (Brovana)
42
Corticosteroid. -Elicit local anti-inflammatory effects to respiratory effect
Mometasone
43
Corticosteroid. Potent anti-inflammatory activity
Fluticasone
44
Corticosteroid. INH multiple types of inflammatory cells
Budesonide
45
B2 Agonist elicit bronchial smooth muscle relaxation
Formoterol
46
Long-Acting B2 Agonist bronchial smooth muscle relaxation
Salmeterol
47
Symbicort
Budenoside/Formoterol
48
Dulera
Mometasone/Formoterol
49
Advair
Salmoterol/Fluticasone inhaled
50
INH 5-lipoxygenase INH Leukotriene formation
Zileuton
51
Methylxanthines Directly relaxes smooth muscle of resp tract
Theophylline (Theo-24, Theocron, Uniphyl)
52
Mast Cell Stabilizer INH release of histamine, leukotrienes, and other mediators
Cromolyn sodium (Intal)
53
Monoclonal Antibody Recombinant humanized monoclinal antibody
Omalizuyab (Xolair)
54
Corticosteroid, Inhalant aerosol inhaled indicated for maintenance treatment of asthma as prophylactic therapy
Ciclesonide (Alevasco)
55
Corticosteroid, Inhalant INH bronchoconstrictions mechanism
Beclomethasone (QVAR, Beclovent)
56
Corticosteroid, Inhalant Glucocorteroid, anti-inflam
Triamcinolone inhaled (Azmacort) Flunisolide (Aerobid, AeroSpan, Nasalide)
57
Leukotriene Receptor Antagonist selective competitive inh of LTD4 and LTE4 receptors
Zafirlukast (Accolate)
58
Leukotriene Receptor Antagonist blocks binding of leukotriene D4 to its receptor Advantage: chewable
Montelukast
59
* Airflow limitation that is NOT FULLY reversible with bronchodilators
COPD
60
As compared to asthma, ______ is associated with neutrophilic rather than eosinophilic inflammation.
COPD
61
is associated with chronic or recurrent excessive mucus secretion into the bronchial tree with cough that is present on most days for at least 3 months of the year for at least 2 consecutive years.
Chronic bronchitis
62
Permanent enlargement of the airspaces distal to the terminal bronchioles🡪 decreased alveolar spaces available for gas exchange🡪 1. loss of alveoli walls🡪 Decreased elastic recoil🡪 airway limitation.
Emphysema
63
Pink puffers
Emphysema
64
emphysema associated with smoking and typically most severe in the upper lobe
Centriancinar
65
involves central alveioli, distal and terminal bronchioles. Typically most severe in the lower lungs. Common in patients with HOMOZYGOUS ALPHA 1 ANTITRYPSIN
Panancinar
66
The most common etiologic factor is exposure to environmental
tobacco smoke
67
responsible for inhibiting several protease enzymes, including neutrophil elastase.
AAT
68
AAT is __________
α1-antitrypsin
69
MOST SIGNIFICANT SYMPTOM of COPD
Breathlessness
70
Blue Bloater
Chronic Bronchitis
71
Stage 0
at risk
72
Stage 1
Mild COPD
73
Stage 2:
Moderate COPD
74
Stage 3
Severe COPD
75
Stage 4:
Very Severe COPD
76
A drug used as an antidepressant. * Can markedly reduce nicotine cravings. * Though associated with an increased risk for seizures
Bupropion
77
a new agent became available to assist in tobacco cessation attempts. - a nicotine acetylcholine receptor partial agonist that has shown benefit in tobacco cessation. - Varenicline relieves physical withdrawal symptoms and reduces the rewarding properties of nicotine.
Varenicline
78
a new agent became available to assist in tobacco cessation attempts. - a nicotine acetylcholine receptor partial agonist that has shown benefit in tobacco cessation. - Varenicline relieves physical withdrawal symptoms and reduces the rewarding properties of nicotine.
Varenicline
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