• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/114

Click to flip

114 Cards in this Set

  • Front
  • Back
what is the dominant frequency of wheezing?
400 Hz
what generation is the trachea?
0
where does wheezing originate?
trachea or major bronchi
what produces the high-pitched sound of wheezing?
oscillation of airway walls produced by gas flowing through a narrowed airway
what is the commonest cause of stridor?
laryngeal obstruction or muscle weakness
what is the relationship between the intesity of wheeze and pulmonary function?
there is no relationship
which viruses are common precipitants of wheeze in asthmatic children?
coronavirus, rhinovirus, RSV
what is atopy?
predisposition to produce IgE antibodies in response to the ordinary exposure to allergens in the environment
what causes a Type I allergic reaction?
IgE and possible IgG
what are antigens causing a Type I reaction called?
allergens
which chemical mediators are released by mast cells in Type ! reactions?
histamine, SRS-A, ECF, PAF
which cells possess IgE receptors?
mast cells, eosinophils and macrophages
which subset of T helper cells support IgE synthesis?
Th2 cells
which cytokine suppresses IL-4 dependent IgE synthesis?
IFN-gamma
which T helper cells do not produce IL-4?
Th1 cells
which features of atopic disease are more prominent in infancy?
atopic dermatitis and immediate food hypersensitivity
are asthma and allergic rhinitis more prominent in infancy or pre-school/school years?
pre-school/school
what is the most important participant int the late-phase reaction in Type I hypersensitivity?
eosinophil
what promotes B cell switching from IgG to IgE production?
Th2 cells via IL-4
which cytokine released by Th2 cells stimulate eosinophils?
IL-5
which cytokines are released by Th1 cells?
IL-2, IL-3, IFN-gamma, TFN-beta
which cytokines are released by Th2 cells?
IL-4, 5, 6, 9, 10, 13
what is the commonest viral precipitant of asthma attacks in school aged children?
rhinovirus
t/f... bacterial infections can cause wheezing
false
t/f... asthmatic individuals develop eosinophilic inflitration of the airways secondary to GM-CSF following a viral infection
true
what do rhinoviruses use as a cell receptor for attachment and entry into epithelium?
ICAM-1
which cytokine is markedly stimulated by rhinoviruses?
IL-8
what is the risk of development of asthma in babies admitted to hospital for bronchilitis?
50%
what is the most common trigger for episodes of wheezing in children?
viral respiratory tract infections
what is the most common trigger of asthma symptoms in older children and adults?
exercise
t/f... wheezing may be absent in severe airway obstruction
true
what percentage of Australians have asthma?
11%
what fraction of adolescents are affected by asthma?
1/7
what fraction of primary school children have asthma?
1/4
what fraction of adults have asthma?
1/10
what does cromoglycate do?
blocks antigen induced bronchoconstriction and exercise induced asthma
t/f... nedocromil has anti-inflammatory activity?
true
which cromone blocks antigen induced bronchoconstriction and bronchoconstrictor response to neural stimulation such as inhalation of sulphur dioxide?
nedocromil
t/f... nedocromil has a similar effect on airway hyperresponsiveness as low dose beclomethasone
true
which inhaled corticosteroids are available in Australia?
beclomethasone, budesonide and fluticasone
what does regular treatment with ICS do?
reduce airway hyperresponsiveness
which of the ICS is twice as potent as the other two?
fluticasone
why doesn't the ICS deposited in the oropharynx during inhalation gain access to the systemic circulation in significant amounts?
high first-pass metabolism
list some upper airway side effects of ICS
sore throat, oral candidiasis, dysphonia
which anti-leukotriene drugs inhibit the synthesis of leukotrienes?
5-LO inhibitors
what do the cysteinyl LT receptor antagonists do?
block the actions of LTC4, LTD4 and LTE4 at receptor sites (particularly on airway smooth muscle)
name the long acting beta agonists
salmeterol and eformoterol
what is atropine?
non-selective cholinergic muscarinic receptor antagonist
t/f... atropine causes bronchodilation
true
how does atropine cause dryness of the mouth?
by antagonising cholinergic receptors in the salivary glands
what are the only agents that will reduce airway hyperresponsiveness?
ICS
what is the duration of action of salmeterol?
12 hours
what percentage of the population is affected by atopic eczema?
10%
when does atopic eczema usually start?
in the first year of life
what is the main characteristic of atopic eczema?
itch
what are the chronic changes causing airways obstruction in asthma?
epithelial hyperplasia, inflammatory swelling and oedema, granulation tissue, hypertrophy/hyperplasia of smooth muscle and submucosal glands
what is responsible for acute airways obstruction in asthma?
mucous, epithelial sloughing, inflammatory swelling and oedema
t/f... thickening of the basement membrane epithelium is a feature of asthma
true
where does the trachea bifurcate?
sternal angle
where does the pleura extend to inferiorly?
8th rib in midclavicular line, 10th rib in midaxillary line, 12th rib in midscapular line
name the two recesses of the lung
costodiaphragmatic and costomediastinal
what is the blood supply to the conducting part of the airways?
bronchial arteries
what is the blood supply to the trachea?
inferior thyroid arteries and bronchial arteries
what innervates the parietal pleura?
intercostal nerves and phrenic nerves
t/f... alveolar size is related to height
false, alveolar size is independent of height
why do tall people have larger lungs?
they have more alveoli
what is the predominant predictor of lung volume?
height
t/f... tall people have larger alveoli
false, they have a greater number of alveoli of the same size
what is the effect of obesity on lung volume?
obesity reduces lung volume
t/f... prevalence of asthma is increasing worldwide
true
t/f... airway hyperresponsiveness correlates with severity of asthma
true
which leukotriene is a mediator of neutrophil chemotaxis?
LT B4
which leukotrienes mediate bronchoconstriction, vascular leak and mucous production?
LT C4, D4, E4
which are the only drugs that reduce airway hyperresponsiveness?
inhaled corticosteroids
name the two combination medications for asthma
seretide (salmeterol/fluticasone)
symbicort (eformeterol/budesonide)
how do M2 and M4 receptors act?
by inhibiting adenylate cyclase (decrease cAMP)
which muscarinic receptors act via inositol phosphate pathway (increase IP3 and then Ca2+ release)?
M1, M3, M5
which adrenoceptor inhibits adenylate cyclase?
alpha2
which adrenoceptors stimulate adenylate cyclase?
all beta adrenoceptors
how do alpha1 adrenoceptors act?
activate phospholipase C
what is isoprenaline?
non-selective beta adrenoceptor agonist
what is the half life of isoprenaline?
approx 2 hours
what is the effect of isoprenaline of blood pressure?
decreases blood pressure
what does dobutamine do?
stimulates alpha and beta1 adrenoceptors
what is phenylephrine?
directly acting sympathomimetic, alpha1 adrenoceptor agonist
of the following beta agonists, which are long acting? isoprenaline, salbutamol, salmeterol, eformoterol, terbutaline
salmeterol, eformoterol
which of the following anticholinergics are long acting? atropine, ipratropium, tiotropium
tiotropium
what is the effect of beta agonists on mast cells?
inhibits release of histamine and leukotriene
what is the effect of beta agonists on cAMP?
increase
what does phosphodiesterase do?
degrades cAMP
which type of hypersensitivity reaction is mediated by immune complexes?
type III
what is type I hypersensitivity mediated by?
IgE and mast cells
what is the mechanism of delayed type hypersensitivity?
T cell mediated
which hypersensitivity reaction is mediated by antibody and complement?
type II
what is atopy?
genetic predisposition to make IgE antibody responses to common otherwise harmless environmental antigens
which cytokine induces B cells to switch to IgE production?
IL-4
which cytokines promote IgM synthesis?
IL-2, IL4, IL5
which type of hypersensitivity reaction is mediated by antibody?
type II
t/f... urticaria is itchy
true
which cytokine recruits and activates eosinophils?
IL-5
what are the stored mediators released upon degranulation of mast cells?
amines (histamine, adenosine), chemotactic mediators, enzymes, proteoglycans
what are the secondary mediators in mast cell activation?
lipid mediators (prostaglandins, leukotrienes), cytokines (IL-1, 3, 4, 5, 6, GM-CSF, chemokines
t/f... prevalence of asthma is high in developing world
false, high in western world, low in developing world
how does the risk of atopy relate to number of siblings?
risk of atopy is inversely related to number of siblings
what is the strongest identifiable risk factor for asthma in Australia?
hose dust mite exposure
what percentage of asthma patients on preventors are compliant in the long term?
50%
t/f... atropine is a selective antagonist of M3 receptors in the lung
false, atropine is a non-selective cholinergic muscarinic receptor antagonist which is not selective for muscarinic M3 receptors on airway smooth muscle
why does atropine cause dryness of the mouth?
antagonises cholinergic receptors in the salivary glands
how does atropine cause bronchodilation?
blocks the bronchoconstrictor effect of acetylcholine and thereby causes bronchodilatation
why is inhaled nedocromil useful in the treatment of asthma?
it blocks allergen induced bronchoconstriction if inhaled prior to allergen challenge
t/f... nedocromil has bronchodilator properties
false
which class of T helper cells are associated with a macrophage response?
TH1 (via IFN gamma)
t/f... presence of allergic rhinitis is predictor of severity of asthma
false
what does viral induced GM-CSF cause?
eosinophilic infiltration in atopic airways