What asthma drug has a narrow therapeutic index for cardio and neurotoxicity?
What asthma drug inhibits phosphodiesterase to ↓cAMP?
What drug to treat pulmonary hypertension?
Bosentan Antagonizes endothelin-1 receptors
What pulmonary drug antagonizes endothelin-1 receptors?
Bosentan Pulmonary hypertension
What drug antogonizes NMDA glutamate receptors?
Dextromethorphan cough suppressant that also blocks serotonin uptake and opiod agonist
Where is airways resistance the greatest in lung?
Larger airways: series Smaller: parallel
Compare compliance work for obstructive vs restrictive lung disease?
Compliance work ↓ obstructive ↑ restrictive
Why does breathing at an elevated residual capacity in obstructive disease result in less effecient breathing?
Lungs are most compliant at midportion...breathing at partially inflated lungs results in more work against less compliant lungs
Compare elasticity of lungs between obstructive and restrictive disease?
↓elasticity obstructive ↑elasticity restrictive
What is the mech of respiratory depression of benzos, barbituates, opiods and general anesthetics?
Medullary respiratory center less responsive to increases in PaCO2.
What immunoglobulin is elevated in a person with asthma?
What is the main pathogenesis of asthma?
Hyperactivity of tracheobronchial tree to inflammatory mediators (leukotrienes with asprin for example)
Why does RV increase with asthma attack compared to emphysemsa?
Asthma: bronchial constriction Emphysema: gas trapping
Compare wheezing in asthma vs COPD?
Asthma: inspiration and expiratory wheezes due to bronchiol constriction
COPD: expiraory only due to ↑ collapse of intrathoracic pressures causing airway collapse
Why are cromolyn sodium and medocromil useful for prevention but not trreatment of symptoms?
They inhibit mast cell degranulation and histamine release... too late one symptoms have started
What is a main side effect of theophylline?
Lowers the seizure threshold
Compare asthma and hypersensitivity pneumonitis?
Hypersensitivy: Type III/IV mediated Does not involve IgE. Does not involves bronchioles Does not respond to albuterol
Dyspnea, fever, pulmonary infiltrates in an asthma patient that doesn't respond to inhaler is what?
Hypersensitivity to Aspergillus Eosinophilic pneumonas
Giving O2 to a chronic COPD patient might respond how?
Hypoventilation because their respiratory center has "reset" and the higher O2 level makes them breath less
What changes in the heart might you see in a COPD patient?
RVH because the hypoxic lung vessels have been constricting, leading to increased pulmonery pressure
What cell produces elastase?
How does ipratropium work with COPD?
Anticholinergic to prevent smooth muscle constriction
What acid-base abnormality is seen in COPD?
Respiratory acidosis (via depressed ventilation) with metabolic compensation
What can a mechanical ventilator do to a patient with COPD?
Cause them to increase their tidal volume too much, causing respiratory alkalosis that their kidneys can't compensate for
What is risk for asbestos and smoking?
↑bronchogenic risk NO mesothelioma risk
How do ferruginous bodies stain?
+ Prussian blue CHF will not stain blue **Both have hemosiderin
How does anemia contribute to dypsnea?
Low O2 delivery causes increase lactic acid produciton which are sensed by the peripheral chemoreceptors. **The peripheral chemoreceptors don't sense the total O2 content, only the PaO2 which is unaffected in anemia.
When do you see cyanosis?
Inadequate amount of oxygen in the ARTERIAL blood when Hgb is <5 g/dL
How does CO poisoning affect PaO2?
It does not change the amount of dissolved O2 in the blood **It does decrease Hgb saturation but this may not show up on pulse ox
Common damage in ARDS?
widespread pulmonary capillary endothelial damage
What can happen by delivering pure O2 to a ARDS patient?
damage by free radicals that exacerbates the condition
Why should you be careful in giving fluids to an ARDS patient?
Could exacerbate the pulmonary edema
Where are the Ca++ channels affected in Lambert-Eaton?
Presynaptic voltage-gated Ca++ channels
What produces the 1,25 D3 in sarcoidosis?
macrophages of the noncaseating granulomas
What does acidosis do to calcium levels?
Increases Ca++ levels via displacement from albumin
How is TB atacked into a latent infection resulting in a small calcified lesion?
Th1 (CD4+ cells) and macrophages
What must be known to do a PCR of a targeted gene sequence?
The flanking nucleotide sequences for primer placement
Deficiency of what vitamen could cause squamous metaplasia of epithelial cells?
Vit A maintains differentiation of specialized epithelium like conjunctiva, respiratory, urinary tracts and other exocrine tracts (pancreas).
What drug must be processed by mycobacterial catalase-peroxidase for the drug to be active?
MHC I cells present with antigen to cell surface with what attached?
B-microglobulins (aids in transport to cell surface)
Where is antigen loaded on MHC I?
Where is MHC II antigen loaded?
Loaded following release of invariant chain
What is the antigen bound to on MHC I?
Peptide-binding groove of alpha chain
What is the antigen bound to on MHC II?
Peptide-bonding groove on both alpha AND beta chain
What enzyme is specific to mast cell activation and often measured?
What is always the same between pulmonary and systemic circulation?
Blood flow per minute
What are Peptpstreptococcus and Fusobacterium species?
Normal oral flora. **May be aspirated in a seizure patient
What is the histological finding in ARDS?
Alveolar hyaline membrane formation
Want to see the other 113 Flashcards in To Remember 6/7?JOIN TODAY FOR FREE!