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BDS2 BAMS Respiratory > 2. Obstructive Airway Disease > Flashcards

2. Obstructive Airway Disease Flashcards

1
Q

General respiratory disease symptoms (5)

A 
Cough
Wheeze (expiration)
Stridor (inspiration)
SoB (distress on effort)
Pain (general/inspiration)
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2
Q

General respiratory disease signs (5)

A 
Chest movement with respiration
Rate of respiration
Air entry (symmetrical, reduced)
Vocal resonance
Percussion notes (resonant, dull)
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3
Q

Normal rate of respiration

A

12-15 breaths/min

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4
Q

General respiratory disease investigations (5)

A 
Sputum exam
CXR
Pulmonary function
Bronchoscopy
VQ scan
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5
Q

Pulmonary function tests (3)

A

PEFR - max. flow rate
FEV1 - forced expiratory volume/one second
FEV1/VC - measurement of respiratory function

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6
Q

Types of respiratory diseases (4)

A

Infections
Airflow obstructions
Gas exchange failure
Tumours

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7
Q

Types of respiratory infections

A

Pneumonia

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8
Q

Types of respiratory airflow obstructions (3)

A

Asthma
COPD
Restrictive pulmonary change

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9
Q

Types of respiratory gas exchange failure (3)

A

Reduced surface area
Fibrosis
Fluid

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10
Q

Chronic airflow obstruction definition and examples (2)

A

Reversible airway obstructions
Asthma
COPD

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11
Q

Chronic airflow obstruction exacerbations (3)

A

Infections
Exercise
Cold air

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12
Q

Asthma mechanism (3)

A

Airway smooth muscle constriction
Inflammation of mucosa
Increased mucus secretion

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13
Q

Asthma symptoms (3)

A

Cough
Wheeze
SoB

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14
Q

Asthma triggers (5)

A 
Infections
Environmental stimuli (dust, smoke, chemicals, asbestos)
Cold air
Exercise
Atopy
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15
Q

First stage of asthma treatment

A

Occasional B-agonist only

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16
Q

Second stage of asthma treatment

A

Low-dose inhaled steroid (or Na chromoglycate)

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17
Q

Third stage of asthma treatment

A

High-dose inhaled steroid

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18
Q

Fourth stage of asthma treatment (3)

A

Long-acting B-agonist, theophylline, anti-muscarinic drugs

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19
Q

Fifth stage of asthma treatment

A

Oral steroid

20
Q

Types of respiratory drugs (6)

A 
B-adrenergic agonists
Anticholinergic drugs
Corticosteriods
Leukotrine inhibitors
Chromones
Theophylline
21
Q

Action of B-agonists

A

Relax smooth muscle by reducing bronchoconstriction and reducing resting bronchial tone

22
Q

Action of anticholinergic drugs

A

Reduce basal tone

23
Q

Action of theophylline (3)

A

Cause adenosine inhibition

May cause CNS stimulation, diuretics and arrhythmias

24
Q

When are corticosteroids used

A

If B2-agonists are used >3 times each week

25
Q

Corticosteroid side effects (2)

A

Adrenal suppression

Osteoporosis (potentially)

26
Q

COPD is a combination of (3)

A

Chronic obstructive airway disease (asthma and emphysema)
Chronic bronchitis
Emphysema

27
Q

What is COPD (2)

A

Mixed airway reversible obstruction

Destructive lung disease

28
Q

Definition and outcome of emphysema (2)

A

Destruction of alveoli

Causes dilatation of others to fill the space

29
Q

How can COPD progress to respiratory failure (2)

A

Reduced surface area for gas exchange

Thickening of alveolar mucosal barrier

30
Q

COPD results in poor ventilation due to (2)

A 
Airway narrowing (potentially reversible)
Restrictive lung disease
31
Q

Causes of COPD (3)

A

Smoking
Environmental lung damage
Hereditary (emphysema)

32
Q

Occupational lung disease can lead to respiratory failure from (2)

A

Fibrosis (dust related) - coal, silicon, beryllium, asbestos, silica
Tumours - asbestos (mesothelioma)

33
Q

COPD management (6)

A 
Smoking cessation
Long-acting bronchodilator
Inhaled steroids (if FEV < 50%)
Systemic steroids
Oxygen support
Pulmonary rehabilitation therapy
34
Q

Types of respiratory failure (2)

A

Type 1

Type 2

35
Q

What is type 1 respiratory failure

A

Hypoxaemia (low oxygen)

36
Q

What is type 2 respiratory failure

A

Hypercapnia (ventilation failure)

37
Q

Why does type 2 respiratory failure occur

A

Due to airway blockage or narrowing

38
Q

What is respiratory failure due to (2)

A

Failure of oxygenation

Failure of ventilation

39
Q

When does failure of oxygenation occur (2)

A

When PaO2 < 8kPa or

When SaO2 < 90%

40
Q

What does failure of oxygenation result in (3)

A

Poor alveolar ventilation
Diffusion abnormality
VQ (ventilation perfusion) mismatch

41
Q

When does failure of ventilation occur (2)

A

When PaCO2 > 6.7kPa
Only in acute respiratory failure
(20% reduction in ventilation required)

42
Q

What does chronic ventilation failure result in

A

Renal compensation from acidosis

43
Q

Chronic ventilation failure involves contributions from (3)

A

Reduced compliance
Airway obstruction
Muscle dysfunction

44
Q

Normal breathing control (2)

A

CO2 drive controls ventilation

SaO2 usually fine

45
Q

COPD breathing control (2)

A

Hypoxia drives ventilation

CO2 tolerance

BDS2 BAMS Respiratory (5 decks)

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