breathlessness (W3)

Question 1

common causes of breathlessness

Answer 1

asthma
COPD
heart failure
anaemia
bronchiectasis
idiopathic pulmonary fibrosis

Question 2

bronchiectasis features?

Answer 2

chronic airway thickening, dilation, mucus collection in lungs (that may become infected)

Question 3

idiopathic pulmonary fibrosis features?

Answer 3

type of interstitial lung disease
thickened alveolar walls and problems with gas exchange

Question 4

classic asthma symptoms?

Answer 4

cough at night
chest tightness in exercise (worse in cold weather)
sometimes eczema and hay fever

Question 5

what is looked for in spirometry in asthma and how

Answer 5

reversibility of spirometry - find results before and after given a beta-agonist.
Looking for percentage change greater than 12% and FEV1 increase of at least 200ml

Question 6

test for asthma other than spirometry and peak flow

Answer 6

fractional exhaled nitric oxide - nitric oxide produced in response to inflammation, therefore acts as a signalling molecule

Question 7

when is a fractional exhaled nitric oxide test useful to use?

Answer 7

to see if patients are compliant with asthma medication (would expect it to go down)

Question 8

asthma treatment

Answer 8

smoking cessation (including parents etc)
allergen avoidance
weight loss
beta2-agonist (reliever)
inhaled corticosteroid (preventer)

Question 9

what is lisinopril

Answer 9

ACE-inhibitor

Question 10

what is atorvastatin

Answer 10

lipid lowering therapy for hypertension

Question 11

heart failure and breathlessness at night?

Answer 11

lying on back = fluid overload so sleeping more upright.

Question 12

cause of ankle oedema

Answer 12

heart failure

Question 13

what is heart failure

Answer 13

impaired ability to fill with or eject blood

Question 14

signs of left ventricular failure

Answer 14

pulmonary oedema

Question 15

signs of right ventricular failure

Answer 15

ankle oedema

Question 16

name for both left and right ventricular failure? signs?

Answer 16

congestive cardiac failure
combination of pulmonary and peripheral oedema

Question 17

test for heart failure?

Answer 17

atrial natriuretic peptide (ANP)
brain-type natriuretic peptide (BNP)

Question 18

when and where is atrial natriuretic peptide released

Answer 18

from atria in response to stretch (eg in fluid overload)

Question 19

what marker protein is related to left ventricular dysfunction

Answer 19

BNP

Question 20

what confirms diagnosis of heart failure after finding elevated BNP results

Answer 20

echocardiography

Question 21

what does echocardiography inform you about (in terms of heart failure)

Answer 21

ejection fraction - gives you a measurement of how well the left ventricle is working

Question 22

what is ejection fraction

Answer 22

compares amount of blood in the left ventricle before and after each contraction

Question 23

finger clubbing is a sign of what?

Answer 23

chronic bronchial infection
interstitial lung diseases
lung cancer

Question 24

name for bluish discolouration of the skin or mucous membranes? what is this caused by?

Answer 24

cyanosis
caused by increased concentration of deoxyhaemoglobin

Question 25

what does central cyanosis indicate

Answer 25

problems with oxygenation

Question 26

what peripheral cyanosis indicate

Answer 26

if not with central cyanosis then you can have it without a lung problem if you’re anaemic

Question 27

characteristics of idiopathic pulmonary fibrosis

Answer 27

late inspiratory crackles, finger clubbing, cyanosis

Question 28

pulmonary fibrosis investigations

Answer 28

chest x-ray
CT scan chest
pulmonary function tests

Question 29

what type of lung disease is pulmonary fibrosis

Answer 29

restrictive

Question 30

pulmonary fibrosis features on x-ray

Answer 30

ill defined borders around peripheries of lungs

Question 31

idiopathic meaning?

Answer 31

dunno what causes it

Question 32

pulmonary fibrosis features on CT

Answer 32

honeycomb pattern (late stage)

Question 33

restrictive lung diseases FVC and FEV1? ratio?

Answer 33

FVC & FEV1 both reduced
ratio normal/high

Question 34

obstructive/restrictive lung diseases?

Answer 34

obstructive - loss of ability to conduct air
restrictive - loss of lung volume