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Questions and Answers
What are the consequences of immunodeficiency diseases?
What are the consequences of immunodeficiency diseases?
- Minimal effect on disease severity
- Increased susceptibility to infections (correct)
- Shortened duration and severity of disease
- Decreased susceptibility to infections
Which drug group is known to cause cortico-suprarenal gland suppression?
Which drug group is known to cause cortico-suprarenal gland suppression?
- Cytotoxic drugs
- Glucocorticoids (correct)
- Calcineurin inhibitors
- Antibodies
What is a side effect associated with Calcineurin inhibitors?
What is a side effect associated with Calcineurin inhibitors?
- Hyperglycemia (correct)
- Psoriasis
- Uveitis
- Autoimmune disease
Which drug class includes Azathioprine and Mycophenolate mofetil?
Which drug class includes Azathioprine and Mycophenolate mofetil?
What do Antilymphocyte and Antithymocyte Antibodies target in the body?
What do Antilymphocyte and Antithymocyte Antibodies target in the body?
What is a characteristic of monoclonal antibodies used as oncological agents?
What is a characteristic of monoclonal antibodies used as oncological agents?
Which drug group is known to cause autoimmune diseases such as Uveitis?
Which drug group is known to cause autoimmune diseases such as Uveitis?
What is the term used to describe the volume of all the space of the respiratory system other than the alveoli and their other closely related gas exchange areas?
What is the term used to describe the volume of all the space of the respiratory system other than the alveoli and their other closely related gas exchange areas?
Which type of alveoli must also be considered dead space due to absent or poor blood flow through adjacent pulmonary capillaries?
Which type of alveoli must also be considered dead space due to absent or poor blood flow through adjacent pulmonary capillaries?
Which term refers to the volume of air in the respiratory passages that does not participate in gas exchange and is expired first on expiration?
Which term refers to the volume of air in the respiratory passages that does not participate in gas exchange and is expired first on expiration?
In healthy lungs, why are anatomical and physiological dead spaces nearly equal?
In healthy lungs, why are anatomical and physiological dead spaces nearly equal?
What is the term for the volume of air remaining in the lungs after a forced expiration?
What is the term for the volume of air remaining in the lungs after a forced expiration?
Which factor causes physiological dead space to be as much as 10 times the volume of anatomical dead space in some parts of the lungs?
Which factor causes physiological dead space to be as much as 10 times the volume of anatomical dead space in some parts of the lungs?
Which lung capacity represents the maximum amount of air that can be inhaled into and exhaled out of the lungs?
Which lung capacity represents the maximum amount of air that can be inhaled into and exhaled out of the lungs?
Why is dead space air considered disadvantageous for removing expiratory gases from the lungs?
Why is dead space air considered disadvantageous for removing expiratory gases from the lungs?
What is the term for including the alveolar dead space in the measurement of total dead space?
What is the term for including the alveolar dead space in the measurement of total dead space?
How does dead space air behave in comparison to alveolar air during expiration?
How does dead space air behave in comparison to alveolar air during expiration?
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Study Notes
Asthma
- Definition: a chronic inflammatory disorder characterized by inflammation of the airways, reversible airway obstruction, and spastic contraction of airway smooth muscle, leading to coughing, wheezing, and dyspnea.
- Pathomechanism of asthma:
- Immune response to allergen → Increased expression of TH2 → Activation of B cells → Release of IgE → Binding to high-affinity IgE receptor
- Acute allergic inflammation of the airways
- Consequences of untreated asthma: Reversible airways obstruction with possible chronicism and progressive inflammation
Glucocorticoids (GCS)
- Definition: Steroids used to suppress the immune response and inflammation
- Mechanism of action:
- Suppression of the immune response
- Inhibition of the release of IL1, IL2, TNF
- Decreased release of HIS
- Decreased antibody production
- Indications:
- Rheumatoid arthritis
- Systemic lupus erythematosus (SLE)
- Polyarteritis nodosa (PAN)
- Dermatological disorders (psoriasis, dermatitis)
- Acute cerebral edema
- Doses:
- Rheumatoid arthritis: 7.5-10 mg/daily of prednisone or methylprednisolone oral
- SLE, PAN: 1-2 mg/kg/daily oral or pulses therapy
- Side effects:
- Gastritis
- Pancreatitis
- Visceral perforation
- PUD
- Hypokalemia
- Infertility
- Myopathy
- Euphoria
- Depression
- Psychosis
- Bone loss and avascular necrosis
- Posterior subcapsular cataracts
- Glaucoma
- Exophthalmos
- PUD
Inhaled Corticosteroids
- Definition: Steroids administered directly to the airways to reduce inflammation and prevent bronchospasm
- Examples:
- Fluticasone (Flovent) MDI
- Flunisolide (Aerobid) MDI
- Budesonide (Pulmicort Turbohaler) DPI, nebulizer
- Beclomethasone (QVAR) MDI
- Triamcinolone (Azmacort) MDI
- Indications:
- Asthma
- Chronic obstructive pulmonary disease (COPD)
Cromolyn and Nedocromil
- Definition: Medications used to prevent mast cell degranulation and release of histamine and other inflammatory mediators
- Mechanism of action:
- Inhibition of ClChannels
- Blockage of release of inflammatory mediators
- Indications:
- Mild to moderate allergic asthma
- Allergic rhinitis
- Exercise-induced asthma
- Side effects:
- Increased coughing
- Wheezing
Leukotriene Modifiers
- Definition: Medications that inhibit the production or action of leukotrienes, thereby reducing inflammation
- Examples:
- Zileuton (inhibits leukotriene synthesis)
- Montelukast, zafirlukast (leukotriene receptor antagonists)
- Indications:
- Mild to moderate allergic asthma
- Allergic rhinitis
Chronic Obstructive Pulmonary Disease (COPD)
- Definition: A progressive lung disease characterized by chronic inflammation and irreversible airflow obstruction
- Stages:
- Stage 0: At risk
- Stage 1: Mild
- Stage 2: Moderate
- Stage 3: Severe
- Stage 4: Very severe
- Characteristics:
- Chronic symptoms
- Exposure to risk factors
- Normal spirometry
- FEV1/FVC < 70%
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
- Definition: Medications used to reduce pain, inflammation, and fever
- Mechanism of action:
- Inhibition of prostaglandin synthesis
- Indications:
- Pain
- Inflammation
- Fever
- Side effects:
- Gastrointestinal toxicity
- Renal toxicity
- Cardiovascular toxicity
- Anti-aggregant effects
Immunosuppressive Therapy
- Definition: Medications used to suppress the immune system to prevent rejection of transplanted organs or to treat autoimmune diseases
- Examples:
- Glucocorticoids
- Calcineurin inhibitors (cyclosporine, tacrolimus)
- Cytotoxic drugs (azathioprine, mercaptopurine)
- Antibodies (anti-lymphocyte, anti-thymocyte)
Pulmonary Ventilation
- Definition: The process of breathing, including inspiration and expiration
- Muscles involved:
- Diaphragm
- External intercostal muscles
- Internal intercostal muscles
- Regulation of ventilation:
- Brainstem
- Chemoreceptors
- Stretch receptors
Alveolar Ventilation
- Definition: The process of gas exchange between the alveoli and the blood
- Factors affecting alveolar ventilation:
- Respiratory rate
- Tidal volume
- Dead space
- Alveolar volume
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