MED200 > Resp - Lecture > Flashcards

Resp - Lecture Flashcards

(51 cards)

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1
Q

What vaccines useful in preventing CAP

A

Influenza and Pneumococcal Vaccine

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2
Q

List some risk factors for CAP

A 
Age >50
Alcoholism
Asthma
COPD
Dementia
CHF
Immunosuppression 
Indigenous
Smoking 
Stroke
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3
Q

What do peripheral chemoreceptors respond to

A
  1. Oxygen (critical response PaO2 <60mmHg)
  2. Carbon Dioxide
  3. H+
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4
Q

What do central chemoreceptors respond to

A
  1. CO2

2. H+

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5
Q

Where are peripheral chemoreceptors located

A

Type 1 Glomus Cell In Carotid Bodies (CN9) and Aortic Bodies (CN10)

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6
Q

Where are central chemoreceptors located

A

Ventral Medulla

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7
Q

Give an example of a Schedule 2 (Pharmacy Medicine)

A

Aspirin, Paracetamol, Ibuprofen

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8
Q

Give an example of a Schedule 3 (Pharmacist Only)

A

Ventolin, Pseudoephedrine

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9
Q

Give an example of a Schedule 4 (Prescription Only)

A

BZD, SSRI, Retenoids

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10
Q

Give an example of a Schedule 5 (Caution)

A

Phenergan, Lomotil

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11
Q

Give an example of a Schedule 8 (Controlled Drug)

A

Morphine

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12
Q

List some key features of mucosal immunity

A 
Mucus
IgA
MALT
Microbiota
Tolerance
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13
Q

What is the difference in Ig between Mucosal vs Systemic Immunoglobulins

A 
Mucosal = 80% IgA
Systemic = 52 % IgG, 30% IgA
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14
Q

Where is IgA1 Predominantly

A
  1. Nasal Mucosa
  2. Respiratory Tract
  3. Lacrimal Gland
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15
Q

What Interleukins are important for differentiating B cells to Plasma Cells

A

IL-5 and IL-6 (From Th2)

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16
Q

What are important mediators of immune regulation

A

IL-10 and TGF-beta

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17
Q

The mucosal immune system is made up of EPITHELIUM and LAMINA PROPRIA, give examples of the cell types of each

A 
E = M cells, Goblet Cells
LP = IgA, CD4/8, Macrophage, Mast, Plasma Cells
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18
Q

What components are important in an occupational history

A
  1. Age
  2. Occupation - title and role
  3. Exposure - FUMES/DUST/CHEMICALS
  4. Years
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19
Q

List 3 complications of Asbestosis

A
  1. Pleural Plaque
  2. Lung Cancer
  3. Mesothelioma
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20
Q

List come complications of Crystalline Silica (SiO2) Inhalation

A
  1. Acute/Chronic Silicosis
  2. Lung Cancer
  3. Industrial Bronchitis
  4. TB
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21
Q

List complications of Coal Inhalation

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A
  1. Coal Worker Pneumoconiosis
  2. Bronchitis
  3. Airflow Obstruction
22
Q

List some bacterial causes of CAP

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A 
Streptococcus pneumoniae
Haemophilus influenzae 
Staphylococcus aureus (post influenza)
Moraxella catarrhalis 
Anaerobes (aspiration)
Mycoplasma pneumoniae 
Legionella
23
Q

List some viral causes of CAP

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A

Influenza A and B
RSV
Rhinovirus
Adenovirus Type 4 and 7

24
Q

List some fungal causes of CAP

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A

Aspergillus

Pneumocystis jirovecii

25
How can you differentiate bronchitis vs pneumonia on a CXR
Pneumonia = consolidation on CXR (not in bronchitis)
26
What contextual features are important in a ?pneumonia history
1. CAP vs Nosocomial 2. Immunocompromised vs competent 3. Travel +/- Endemics
27
Patient query CAP has recently travelled to the tropics. What microbiology are of interest
Meliodosis | Acinetobacter
28
Patient query CAP who owns an aviary (birds). What microbiology are of interest
Chlamydia psittaci
29
Patient query CAP works in an abbatoir. What microbiology are of interest
Coxiella burnetti
30
Patient query CAP works as a gardner. What microbiology are of interest
Legionella
31
Patient query CAP is an alcoholic. What microbiology are of interest
S.pneumoniae Klebsiella Anaerobes Acinetobacter
32
What is the antibiotic treatment for pneumococcus pneumonia
Beta-Lactam (AMOXYCILLIN)
33
What is the antibiotic treatment for atypical pneumonia (legionella, mycoplasma, chlamydia)
Macrolide (ROXITHROMYCIN)
34
What is the antiobiotic treatment for nosocomial pneumonia
Extended Spectrum Beta-Lactamase | 3rd Gen Cephalosporin
35
What are some DDx for pneumonia that has poor treatment response
``` Obstruction Abscess Parapneumonic Effusion Empyema Drug Fever Not Pneumonia ```
36
What are important investigations in Pneumonia
``` Sputum Culture and PCR Oropharyngeal Swab Blood Culture Sets Serology CXR ```
37
What microbiology are of interest in immunocompromised CAP
S.pneumoniae Mycoplasma Legionella
38
What microbiology are of interest in decreased lymphocyte CAP
Pneumocystis jirovecci TB CMV
39
What does a failure of oxygenation cause
Hypoxia
40
What does a failure of ventilation cause
Hypercapnia
41
What level of PaO2 defines respiratory failure
<55 | <60 in organ failure/damage
42
What defines Type 2 Respiratory Failure
PaO2 <55 mmHg | PaCO2 >45 mmHg
43
What pH and bi-carb would suggest ACUTE T2RF
pH <7.35 (acidosis) | Normal HCO3- (no compensation)
44
What bi-carb would suggest ACUTE on CHRONIC T2RF
HCO3- >28 (renal alkalosis compensation - with acidosis)
45
What pH and bi-carb would suggest CHRONIC T2RF
Normal pH | Bi-Carb >28 (fully compensated)
46
What is oxygenation
Uptake of oxygen by Hb
47
What is ventilation
Removal of CO2 from blood
48
What are 5 mechanisms of HYPOXAEMIA
1. Impair diffusion (ILD, Pulm edema) 2. V/Q Mismatch 3. Hypoventilation 4. R to L Shunt 5. Reduced FiO2 (High Altitude)
49
What are 2 mechanisms of HYPERCAPNIA
1. Hypoventilation | 2. V/Q Mismatch
50
What is a DDx for the ACUTE SOB patient
RESP (PE, pneumothorax, obstruction, effusion) CARDIO (AMI, Tamponade, ACPO, CHF, Arrhythmia) INF (Sepsis/Bacteraemia) SHOCK (haemorrhage, anaphylaxis, obstructive)
51
What are important acute investigations in the SOB patient
CXR ABG ECG BLOOD (FBP. Glucose)
MED200
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