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27 Cards in this Set
- Front
- Back
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What is the distribution of V & Q in the lungs due to gravity?
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* At apex: ↑ distension of alveoli & ↑ constriction of blood vessels, so Q and V both higher at the base of the lung
* But Q increases more rapidly down the lung * Therefore V/Q higher at apex (physiological dead space) and lower at base (physiological shunt) |
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How far along the airways do goblet cells and ciliated columnar cells extend?
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* Goblet cells stop at the terminal bronchioles
* Ciliated columnar cells extend to the respiratory bronchioles |
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What are the equations relating the pressure in the alveoli, pleura, chest wall, and lung recoil?
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Ppleura = - Pchest wall
Palveoli = Plung recoil + Ppleura |
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What are typical adult values for FRC, TV, TLC, and RV?
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FRC = 2.2 L
TV = 0.5 L RV = 1.2 L TLC = 6.0 L |
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What is the pleural pressure at the top and bottom of the lungs at FRC?
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Apex: -8.5 cm H2O
Base: -2.5 cm H2O |
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What are risk factors for asthma?
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* Atopy in infants
* Family history * Maternal smoking / parents smoking * Indoor allergen exposure |
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What are the main triggers of early phase and late phase response in asthma?
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* Early phase: antigen cross-links IgE on mast cells
* Late phase: recruitment of eosinophils from bone marrow (via IL-3, IL-5, GM-CSF) |
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What is the role of leukotrienes in asthma? (4)
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* Neutrophil chemotaxis
* Bronchoconstriction * ↑ vascular permeability * Mucus production |
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What is the mechanism of action of theophylline in asthma?
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* Theophylline = PDE inhibitor
* PDE converts cAMP to AMP * cAMP inactivates MLCK --> bronchodilation |
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Which organisms are principally responsible for precipitating asthma exacerbations in children?
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* Rhinoviruses and RSV
* Passive smoking |
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What is the role of cromones (e.g., cromoglycate) in asthma?
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* For long-term treatment
* Blocks antigen-induced bronchoconstriction and exercise-induced asthma |
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What spirometry results are diagnostic of COPD?
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* FEV1 < 80% pred
* FEV1 / FVC < 70% (after bronchodilators) |
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What are the clinical features of patients with predominant bronchitis (vs. patients with predominant emphysema)?
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Predominant bronchitis:
* Earlier in life * Cough, sputum ++ * Cor pulmonale common (hypoxia --> pulmonary vasoconstriction?) * "Blue Bloater" |
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What spirometry results are diagnostic of restrictive lung disease?
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TLC < 80% pred
FEV1 ↓, FVC ↓↓ FEV1 / FVC normal or ↑ DLCO ↓ |
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What are the primary immune effector cells in alveoli?
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Macrophages
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What sizes of particles deposit in the upper airways vs. bronchi vs. alveoli?
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* >10μm: upper airways
* 3-10μm: bronchi * 1-3μm: alveoli |
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What determines TLC and RV in a healthy young person?
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TLC: ↓ compliance of lung at high volumes
RV: ↓ compliance of chest wall at low volumes |
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What shifts the O2 dissociation curve to the right?
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* ↑ Temp
* ↑ [H+] * ↑ PCO2 * ↑ DPG |
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What happens to CO2 in red blood cells?
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* CO2 --> H+ + HCO3-
* HCO3- diffuses out of RBCs, Cl- moves in * H+ binds preferentially to reduced Hb * Therefore reduced Hb assists loading of CO2 (Haldane effect) |
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What is the role of CFTR channels in sweat glands, pancreas, and airway epithelium?
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* Sweat glands: reabsorb Cl- from lumen of sweat duct
* Pancreas: secrete HCO3- * Airways: secrete Cl- into lumen, also inhibit Na+ channels that reabsorb Na+ from lumen (Cl- & H2O follow through tight junctions --> dehydration) |
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What is bronchiectasis?
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Chronic obstruction + infection --> destruction of elastic and muscular tissue --> permanent dilation of bronchi & bronchioles
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What are positive and negative prognostic factors for CF?
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* Positive: male, primarily GI presentation, good exocrine pancreatic function
* Negative: primarily resp presentation, early colonization, pulmonary complications |
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* What antibiotics should be prescribed for acute bronchitis?
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Amoxycillin or Doxycyline
BUT There is almost no clinical role for antibiotics in acute bacterial bronchitis provided the patient does not have chronic lung disease |
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What are the four pathological stages of pneumonia?
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* Congestion
* Red hepatization * Grey hepatization * Resolution |
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What are the predominant organisms causing otitis media?
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* Haemophilus influenzae
* Streptococcus pneumonia * Moraxella (Branhamella) catarrhalis |
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Which two organisms account for the majority of community-acquired pneumonia?
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* Streptococcus pneumoniae
* Mycoplasma pneumoniae |
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The following pathogens most commonly cause ARTs in which age groups?
* RSV * Mycoplasma pneumoniae * Legionella * Chlamydia trachomatis * Chlamydia pneumoniae |
* RSV: young children (esp. bronchiolitis)
* Mycoplasma pneumoniae: school age to young adults * Legionella: > 50 yrs * C. trachomatis: infants (acquired from birth canal) * C. pneumoniae: young adults |
