Common Respiratory Conditions Flashcards
What is respiratory failure?
A condition where your blood doesn’t have enough oxygen or too much carbon dioxide
What are the two types of respiratory failure?
Type 1- pO2 <8kPa, pCO2 <6kPa
Type 2- pO2 <8kPa, pCO2 >6kPa
What is a pulmonary embolism?
Formation of a clot in a blood vessel that breaks loose and is carried by the blood stream to plug another vessel
What are the risk factors for a pulmonary embolism?
Surgery Obstetrics Lower limb problems Malignancy Reduced mobility Thrombotic disorders Previous venous thromboembolism
What is the treatment for pulmonary embolism?
Thrombosis is Heparin Warfarin Direct oral anticoagulants e.g. rivaroxaban Embolectomy
What is COPD?
An air flow obstruction- usually progressive, not fully reversible
Usually caused by smoking
Defined as forced expiratory volume in one second (FEV1)= FEV1<80% and forced vital capacity (FVC)= FVC<0.7
How is COPD diagnosed?
Chest x-ray
Blood test
Spirometer
How is COPD managed?
Pharmacotherapy for COPD is used to decrease symptoms and/or complications Smoking cessation Exercise Diet Vaccinations Pulmonary rehabilitation
What is the treatment for COPD?
Short/long acting bronchodilators- beta-agonists, anti-cholinergics Inhaled steroids/combined preparations Theophyllines Oral steroids Oxygen
What are some short-acting bronchodilators?
Salbutamol
Terbutaline
Ipratropium bromide
What do short-acting bronchodilators do?
Increase airway diameter by action on smooth muscles
Fast action- last 4 hours
Ipratrpium bromide- onset 15 mins, lasts up to 5 hours
What are some side effects of bronchodilators?
Tachycardia
Tremor
Dry mouth
What is an example of a long-acting bronchodilator?
Tiotropium bromide/spiriva
- long acting ani-cholinergic
- improves lung function, dyspnoea
- reduced exacerbations and rescue medications
What are some examples of inhaled steroids?
Generally use combined preparations:
- seretide (Fluticasone/Salmeterol)
- symbicort (Budesonise/Formoterol)
What are the components of pulmonary rehabilitation?
Physical exercise
Dietetics assessment
Disease education
Psychological and social interventions
What is asthma?
A chronic inflammatory disorder of the lungs characterised by the variability in symptoms and lung function
What are the symptoms of asthma?
Wheeze
Cough
SOB
Chest tightness
How is asthma diagnosed?
> 20% diurnal variation on at least 3 days in one week on PEFR chart
15% increase in FEV1 after short acting bronchodilator or 30mg/day prednisolone for 2 weeks
What is the treatment of asthma?
Allergen avoidance Environmental- smoking, air pollution Avoid NSAIDs in some patients Give anti-smoking advice Low dose inhaled corticosteroid Long acting bronchodilator Short acting beta-agonist as required
What are the symptoms of severe acute asthma?
Severe dyspnoea, unable to form complete sentences
Tachypnoeic>25/min
Tachycardia>110/min
PEFR 33-50% best or predicted
Call an ambulance
Oxygen >60% if available
Nebulised bronchodilator- 5mg salbutamol with spacing device if available- less drug lost to atmosphere, extra volume so allows the dose to be inhaled over more breaths
What is pulmonary fibrosis?
Gradual replacement of normal lung parenchyma with fibrotic tissue
How do you assess interstitial lung diseases?
History -symptoms -other illnesses -drugs -occupation -hobbies -functional capacity Bloods -FBP/U&E/LFTs Examination -finger clubbing -inspiratory crackles -location of crackles Pulmonary function -spiro/transfer factor -spO2 Radiology -chest X-ray/CT
What is extrinsic allergic alveolitis?
Hypersensitivity pneumonitis= inflammation of the alveoli caused by the hypersensitivity to inhaled organic dusts
What are the symptoms of EAA?
Acute- cough, fever, malaise
Chronic- productive cough, weight loss, anorexia, dyspnoea, fatigue, pleurisy
What is the treatment of EAA?
Absolute cessation of exposure
Steroids can be used to settle EAA
