Conditions

Question 1

Which anatomical structures are affected by asthma?

Answer 1

Small and large airways

Question 2

Is asthma an obstructive or restrictive disease?

Answer 2

Obstructive

Question 3

In asthma is the greatest reduction in airflow on inhilation or expiration? What can this lead to?

Answer 3

Expiration. Can lead to dynamic hyperinflation as a little of the previous breath remains in the lungs.

Question 4

What are the physiological abnormalities of asthma and what affect do these have on gas exchange?

Answer 4

Bronchospasm and inflammed airways reduces rate of airflow to and from alveoli

Question 5

What five things can induce asthma?

Answer 5

Exposure to allergens
Exposure to irritants
Exercise or cold weather
Prior eczema or hay fever
Family history

Question 6

What are four symptoms experienced by asthmatic patients?

Answer 6

Wheezing
Coughing
Chest tightness
Shortness of breath

Question 7

What four clinical signs are observed in people with asthma?

Answer 7

Wheeze heard (on expiration and/or through stethoscope)
Use of accessory muscles of respiration
May have a paradoxical pulse (weaker during inhalation)
Over-inflation of chest

Question 8

What would the FEV1/FVC ratio be like in an asthmatic patient?

Answer 8

Reduced FEV1 so ratio reduced, but this is reversible

Question 9

What might a chest x-ray show in an asthmatic patient?

Answer 9

Over-inflation of chest

Question 10

What 5 drugs could an asthmatic be prescribed?

Answer 10

1. Inhaled short acting beta-2 agonist (e.g. salbutamol)
2. Inhaled corticosteroid (e.g. beclametasone)
3. Long acting beta-2 agonist (e.g. salmetrol)
4. Oral prednisolone (cortcosteroid)
5. Leukotriene antagonists (reduce allergic response)

Question 11

Bronchiectasis affects which anatomical structures?

Answer 11

Small and large airways

Question 12

Bronchiectasis affects which functions of the lungs?

Answer 12

Transfer of air in and out
Efficient gas exchange
Protection of lungs from infection

Question 13

What structural abnormalitt is present in bronchiectasis?

Answer 13

Localised, irreversible dilation of part of the bronchial tree. Bronchi are inflamed, dilated and easily collapsible= airflow obstruction and impaired clearance of secretions.

Question 14

What are four possible causes of bronchiectasis?

Answer 14

1. Prior infection e.g. measles, pertussis, bacterial pneumonia
2. Immunodeficiencies
3. Other acquired causes e.g. tuberculosis, connective tissue disease, foreign body aspiration
4. Other congenital causes e.g. Kartagener syndrome, alpha-1 antotrypsin deficiency.

Question 15

What 4 symptoms might a patient with bronchiectasis experience?

Answer 15

1. Dyspnoea
2. Chronic green/yellow sputum production
3. Repeated chest infections
4. Halitosis

Question 16

What clinical signs might someone with bronchiectasis present with?

Answer 16

1. Coarse crepitations heard with stethoscope over affected area of the lung
2. Hypoxaemia (low blood O2)
3. Hypercapnia (high blood CO2)

Question 17

What might a CT scan of a person with bronchiectasis show?

Answer 17

Signet ring sign (ADD PICTURE)

Question 18

What would spirometry of a person with bronchiectasis show?

Answer 18

Obstructive pattern

Question 19

What would blood gases of someone with bronchiectasis show?

Answer 19

Low O2, high CO2

Question 20

Is bronchiectasis an obstructive or restrictive disease?

Answer 20

Obstructive

Question 21

How would you treat bronchiectasis? (5 ways)

Answer 21

1. Control infections and bronchial secretions (physiotherapy for drainage)
2. Relieve airway obstructions
3. Antibiotics (possibly nebulised)
4. If localised, surgery to affected lung.
5. Maintain body weight with nutritional support.

Question 22

What are some preventative measures to avoid bronchiectasis?

Answer 22

Immunisation against measles, pertussis and other acute respiratory infections and avoiding smoking

Question 23

How does COPD affect lung structure?

Answer 23

Narrowing of airways, enlarged air spaces distal to terminal bronchioles with destruction of their walls (emphysema) and expansion of the chest.

Question 24

In what way does COPD reduce lung function?

Answer 24

Reduces rate of airflow (especially on expiration) so reduced effectiveness of the lungs
Dynamic hyperinflation

Question 25

What are 4 risk factors for COPD?

Answer 25

1. Smoking 2. Repeated chest infections 3. Family history 4. Exposure to dust in workplace or air pollution

Question 26

What are 4 symptoms of COPD?

Answer 26

1. Dyspnoea 2. Wheeze 3. Phlegm 4. Cough

Question 27

What are 5 clinical signs of COPD?

Answer 27

1. Tachypnea 2. Hyper-inflated chest 3. Wheeze 4. Breath sounds decreased in intensity 5. Prolonged expiration

Question 28

What would a CXR of a COPD patient show?

Answer 28

Hyper-inflated lungs

Question 29

What is the effect of COPD on FEV1?

Answer 29

Reduces it as an obstructive disease

Question 30

What might blood gases of a COPD patient show?

Answer 30

Hypoxia (low O2) and hypercapnoea (raised CO2)

Question 31

What are 7 treatment options for COPD?

Answer 31

1. antibiotics for chest infections 2. beta-2 receptor agonists (bronchodilator therapy) 3. anticholinergic bronchodilator therapy 4. long acting beta 2 agonists 5. inhaled steroids 6. oral steroid anti-inflammatory therapy 7. O2 therapy

Question 32

Which four parts of the body are affected by cystic fibrosis?

Answer 32

1. Epithelial cells of the lungs 2. Sweat glands 3. Pancreas 4. Bowel

Question 33

What is the genetic and biochemical basis for cystic fibrosis?

Answer 33

Mutation in CFTR (cystic fibrosis transmembrane conductance regulator) gene which codes for chloride channels which regulate passage of chloride ions and water across cell membranes. Mucous is therefore thick and sticky, clogging the airways and various ducts.

Question 34

What type of inheritance is cystic fibrosis?

Answer 34

Autosomal recessive