302 The case of the breathless teenager and pathophysiology of asthma Flashcards
What is dyspnoea?
An unpleasant awareness of increased respiratory effort
What is tachypnoea?
An increased respiratory rate
What is orthopnoea?
Breathlessness when laying flat
What is bradypnoea?
Inappropriately reduced respiratory rate
What are cheyne stokes?
Abnormal breathing pattern characterised by progressively deeper or faster breather
-Caused by an issue in the respiratory centres of the brainstem
What are some pulmonary causes of breathlessness?
-Airway obstruction
-Anaphylaxis
-PE
-Asthma
-COPD
-Pneumonia
-Pleural effusion
-Neoplasm
-Fibrosis
What are some cardiovascular causes of breathlessness?
-Pulmonary oedema
-ACS
-Arrhythmia
-Cardiac tamponade
-DCM
-Valvular heart disease
-Pneumothorax
What is ACS?
Acute coronary syndrome
-A range of conditions associated with sudden, reduced blood flow to the heart
What is a tamponade?
When the pericardium fills with fluid like blood
What is DCM?
Dilated cardiomyopathy
-The heart chambers enlarge and lose their ability to contract
What are some infection causes of breathlessness?
-Pneumonia
-Epiglottitis
What are some traumatic causes of breathlessness?
-Pneumothorax
-Haemothorax
-Flail chest
-Pulmonary contusion
What is a flail chest?
Two or more contiguous rib fractures with two or more breaks per rib
What is a pulmonary contusion?
An injury to the lung parenchyma in the absence of laceration to lung tissue or any vascular structures
What are some abdominal causes of breathlessness?
-Ascites
-Obesity
-Pregnancy
What are some psychological causes of breathlessness?
-Anxiety
-hyperventilation
What are some metabolic causes of breathlessness?
-Metabolic acidosis
-Renal failure
-Toxins
What are some neuromuscular causes of breathlessness?
-Cerebral vascular accident (CVA)
-Motor neurone disease
-Guillain-Barré syndrome
What is a cerebral vascular accident (CVA)?
An interruption of blood flow to the brain
What is Guillain-Barré syndrome?
Autoimmune destruction of nerves
-This harm causes muscle weakness and sometimes paralysis
Which cells indicate airway inflammtion?
Eosinophils
What are some tests for airway inflammation?
-Eosinophil count
-FeNO
What is a FeNO test?
A fractional exhaled nitric oxide test
-When you breathe out, your breath can show if you have inflamed airways by testing how much FeNO there is in your breath
Why won’t bronchodilation work in COPD?
Because it’s a fixed airflow limitation
What are some disease that mimic asthma?
-Airway obstruction
-Inducible laryngeal obstruction (ILO)
-Exercise-induced laryngeal obstruction (ELIO)
-Sinusitis
-Cough hypersensitivity
-GORD
What is Inducible laryngeal obstruction (ILO)?
An inappropriate, transient, reversible narrowing in the larynx in response to external triggers
How does sinusitis mimic asthma?
Both are caused by inflammation caused by an allergen or irritation
How does magnesium sulphate act as a bronchodilator?
It’s a mast cell stabiliser that prevents further inflammation and it relaxes bronchial muscles
