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Mucosal Surfaces > B5- Examining Resp Disease > Flashcards

B5- Examining Resp Disease Flashcards

1
Q

What % do resp diseases account for deaths in eu

A

15%

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2
Q

Jow many die w year in eu

A

600k

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3
Q

1 in how many deaths caused by reap diseases worldwide

A

1 in 5 deaths

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4
Q

What are rhe 3 steps of examination

A

1- clinical examination eg signs/sounds

2- lung functioning tests

3- radiology eg ct,pet scans, xray

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5
Q

What sorts of checks would you do on notmal bresthng

A

Nose flaring, check pace of breathing, mouth breathing, when they have difficulty eg lying down

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6
Q

What is tachypnoea and when is it ok

A

Tachypnoea is fast bresthing. Ok if acute eg sfger exercuse but hyperventilating chronically is worrying

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7
Q

What is it called when people have difficulty breathing lying down due to blood going to heart

A

Orthopnoea

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8
Q

What is dyspnoea

A

Breathlessness

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9
Q

Dyspnoea is common and not restricted to lung diseases. What other things

A

Allergens, hesrt failure, anxiety

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10
Q

What extea info you need to look at dyspnoea

A

Onset of it, where its worsened or wlleviated eg around cats could be allergy

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11
Q

How is it graded

A

1-5 1 being dyspnoea during vigorous exercise vs 5 too breathless to leave house

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12
Q

What 4 physical signs eg of digits should eb looked at

A

Cyanosis
Clubbing
Tar stains from smoking
Co2 retention

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13
Q

What is cyanosis and give the 2 types

A

Where artial po2 saturation is below 80% and causes blur discolouration

Central cyanosis is the worsened type at mcuosal surfsces eg tongue

Peripheral cyanosis is on skin eg of hands and ears

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14
Q

Whag is an issue with chdcking cuanosis as a sign of reap disease

A

Most likely mever hit below 80% oxygen saturation due to the body response

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15
Q

What causes clubbing of digits ie curvature of nail and refcued angle of nail bed

A

Chronic hypoxia eg in ipf and carcinoma most likely.

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16
Q

How does chronic hypoxia wg in ipf cause clubbing

A

Increqsed angiogenesis response

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17
Q

Which artticle discusses how both clubbing and cyanosis of lower limbs not accurate in only reap disease

A

Mocetti 2014

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18
Q

What did mocetti find cyanosis and clubbing asdociated with

A

Eisenmenger syndrome which is a heart condition

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19
Q

What is co2 retwntion signa in hands

A

Warm and perfused jands due to blood flow

Co2 retention tremor

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20
Q

What is the co2 retention flap aeen with in reap disease (wei et al 2018)

A

Copd when hypercapnia occurs

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21
Q

What is auscultation when listening to lung sounds

A

Intensity and cheracter of sounds

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22
Q

What is wheezing

A

Air passing through narrow tubes

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23
Q

What is difference between monophonic and polyphonic and give examples

A

Monophonic is blockage one of major airway eg carcinoma

Polyphonic is obstruction of many airways eg cb/copd, asthma

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24
Q

What other auscultation sound is there

A

Crackling where air passes across fluid ef mucus/oedema

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25
Q

Which article discusses crackling auscultstion

A

Howell 2006

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26
Q

What did howell say early inspiratory and expiratory crackling was sign if

A

Severe airway obstruction diseases

eg copd, chronic bronchitis, asthma

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27
Q

What could late inspiratirt crackles be from (howell 2006)

A

Restrictive lung diseases

Pneumonia, ipf and oedema

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28
Q

If lack of disappearance in crackling when changing position whay does this indicate (howell 2006)

A

Worsening lung disease

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29
Q

Why would pneumonia cause restrictive/late inspirstiry crackling

A

Causes Late openining of small airways

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30
Q

What is percussion of lung sounds

A

How muffled/resonant they are eg dull or hyper resonance

31
Q

What are dull sounds from

A

More material eg fluid, mucus, fibrosis material

32
Q

What would hyper reaonant sound be indicstion of

A

Destruction of airways, eg emphysema with large air spaces

33
Q

What are coughs/forced expiratory blasts stimulated by

A

Sensory neurones/irritant receotrs down the vagal neeve (damaged on allograft)

34
Q

What is sputum

A

What is coughed up ie saliva and mucus mixture

35
Q

What would green/ yellow sputum indicate

A

Bacterial infection

Yellow is incrrased neutrophils

36
Q

What would white sputumnindicate

A

Viral sputum

37
Q

Which sputum cells were increwsed in asthma

A

Eosinophils (prominent in asthma)

38
Q

Which article discusses sputum analysis

A

Lacy et al 2005

39
Q

What is given tonpatient which infuces sputum production

A

Saline solution

40
Q

Eosinophils jigher in astham but what was higher in copd

A

Neutrophilia, elastases and proteases (consistent with emphysema and cb)

41
Q

What would be looked at in a physicsl examinstioj

A

Vibrations when speaking, asymmetry, shape, bruising, skeletal abnormality

42
Q

What is pigeon breast abnormality

A

Where breast sternum pushed out too far

43
Q

What is the word for coyghing up blood

A

Haemoptysis

44
Q

What can haemoptysis be caused by

A

Tumour, infections or oedema

45
Q

What can chest pain indicate

A

Non specific rib issues or muscle

Or can be infection , tumour or reflux in lungs

46
Q

Why are meds looked st in patinet history

A

Eg if theh take b blockers for bronchodilstion indicates asthma

47
Q

Which systemic illness has a 5% risk to lung fibrosis so is looked for in patient history

A

Ra

48
Q

What needs ti be taken into account when makint ntomal references in lft

A

Age, height, sex. All affect fev values

49
Q

What happens in spirometry

A

Spirometer which is a mouth piece is given and used to measure fev1 against fvc during expiration of patient

50
Q

What should be the fev1/fvc ratio ie what % of air should be breathed out in 1 sex

A

70% or more if nromal

51
Q

What is total lung capacity

A

Volume lung can hold at full inspiration (IRV + TV + ERV + Residual vol)

52
Q

What is the tlc of frmales vs males

A

4200 ml femaile

5800 ml in male

53
Q

What is tidal volume and what ml for both f and m

A

Volume of air breahted in and out without force (no irv or erv)

500ml

54
Q

What is vital capacity

A

Volume of air expelled out after max insp and exp

Tv+irv+erv

55
Q

What is the calues of vital capscity in female and male (tlc - rv)

A

3100 ml for female

4600 ml for male

56
Q

What is the viral capacjty in male and female (tlc - rv)

A

3100 ml in female

4600 ml in maleb

57
Q

Why cant residuak volume be measured by spirometer

A

Its rhe cokume which cannot be expired. Left in lung after even erv

58
Q

What is functional residual capacity

A

The volume left in lung after normal expiration (ERV +RV)

59
Q

Whag is it for female and male

A

1800 ml ve 2300 ml

60
Q

Which method is uaed to measure frv/rv alongside spirometry

A

Helium dilutjon merhod

61
Q

Explain

A

Helium ar known amount with oxygen fills spirometer and lungs when pateint breathes in. The amount of air left in lung is determined after expiration

62
Q

Wjy does this work

A

Because helium will stay constant as its a closed system. Doesnt diffuse actoss alveoli

63
Q

Give rxamples of obstructive

A

Copd (inc cb and emphysema) ,asthma, bos

64
Q

Give examples of restrictivr disease

A

Ards, ipf, pneumothorax (air fills csvity)

65
Q

How else can lung disease be classified

A

Cause

Pathopjysiology

Site of issue

66
Q

Why are obstrcutive and resitrcitive different

A

Obstructive can have same capacity ans therefore same fvc (can sometimes decrease) but slow rxpiration due to obstruction/narrowing

Restrictive have a lowered lung capscity wg due to lack of compliance in fibrosis, oedema filling

67
Q

What syndrome of muscles can cause lack of compliance therefore restrictive

A

Duchenne myscular dystrophy

68
Q

Fev1/fvc ration reduces in obstrucive due ti decrewsed fev1 below 70%. Is this seen with restrictive

A

No because both fvc and fev1 decrease st the same rate so no change in ratio

69
Q

What does peak flow metre measure eg in asthma/obstructive

A

The peak expirstort flow rate (ie where dlow is largest l/min. Its compared to the references eg normal at same age/height)

70
Q

If the pefr is the same or up to 80% same as normal what does it indicate

A

Normal lungs and lack of obstruction

71
Q

What does below eg at 50% mean

A

Need immediate care as obstruction is bad

72
Q

What is the airway hyperresponsive test

A

Where spirometry combined with giving bronchoconstricters to see responsiveness to histamine or methacholine

73
Q

Why would fall in 20% fev1 at lowrr conc of methacholine or histamine indicate issues

A

Shows hyper responsiveness to constrict eg asthmatic.

If mormal lunfs you need kuch greater conc to cause decrease in fev1 by 20%/ major constriction

74
Q

What are fibreoptic bronchoscopes going down nose paired eith

A

Bal or biopsies to indicate levels of inflammation, foreign objects, tumours

Mucosal Surfaces (33 decks)

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