breathlessness (W3) Flashcards
common causes of breathlessness
asthma
COPD
heart failure
anaemia
bronchiectasis
idiopathic pulmonary fibrosis
bronchiectasis features?
chronic airway thickening, dilation, mucus collection in lungs (that may become infected)
idiopathic pulmonary fibrosis features?
type of interstitial lung disease
thickened alveolar walls and problems with gas exchange
classic asthma symptoms?
cough at night
chest tightness in exercise (worse in cold weather)
sometimes eczema and hay fever
what is looked for in spirometry in asthma and how
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
test for asthma other than spirometry and peak flow
fractional exhaled nitric oxide - nitric oxide produced in response to inflammation, therefore acts as a signalling molecule
when is a fractional exhaled nitric oxide test useful to use?
to see if patients are compliant with asthma medication (would expect it to go down)
asthma treatment
smoking cessation (including parents etc)
allergen avoidance
weight loss
beta2-agonist (reliever)
inhaled corticosteroid (preventer)
what is lisinopril
ACE-inhibitor
what is atorvastatin
lipid lowering therapy for hypertension
heart failure and breathlessness at night?
lying on back = fluid overload so sleeping more upright.
cause of ankle oedema
heart failure
what is heart failure
impaired ability to fill with or eject blood
signs of left ventricular failure
pulmonary oedema
signs of right ventricular failure
ankle oedema
name for both left and right ventricular failure? signs?
congestive cardiac failure
combination of pulmonary and peripheral oedema
test for heart failure?
atrial natriuretic peptide (ANP)
brain-type natriuretic peptide (BNP)
when and where is atrial natriuretic peptide released
from atria in response to stretch (eg in fluid overload)
what marker protein is related to left ventricular dysfunction
BNP
what confirms diagnosis of heart failure after finding elevated BNP results
echocardiography
what does echocardiography inform you about (in terms of heart failure)
ejection fraction - gives you a measurement of how well the left ventricle is working
what is ejection fraction
compares amount of blood in the left ventricle before and after each contraction
finger clubbing is a sign of what?
chronic bronchial infection
interstitial lung diseases
lung cancer
name for bluish discolouration of the skin or mucous membranes? what is this caused by?
cyanosis
caused by increased concentration of deoxyhaemoglobin
what does central cyanosis indicate
problems with oxygenation
what peripheral cyanosis indicate
if not with central cyanosis then you can have it without a lung problem if you’re anaemic
characteristics of idiopathic pulmonary fibrosis
late inspiratory crackles, finger clubbing, cyanosis
pulmonary fibrosis investigations
chest x-ray
CT scan chest
pulmonary function tests
what type of lung disease is pulmonary fibrosis
restrictive
pulmonary fibrosis features on x-ray
ill defined borders around peripheries of lungs
idiopathic meaning?
dunno what causes it
pulmonary fibrosis features on CT
honeycomb pattern (late stage)
restrictive lung diseases FVC and FEV1? ratio?
FVC & FEV1 both reduced
ratio normal/high
obstructive/restrictive lung diseases?
obstructive - loss of ability to conduct air
restrictive - loss of lung volume
