Disorders of Breathing, Respiration or Circulation Flashcards
Superficial venous thrombosis
palpable as linear, indurated cord
variable pain, tenderness, erythema, warmth
Why would we do a chest x-ray?
- Disorders of: Heart, Lungs, Pleural and pericardial cavities, Great vessels, Skeletal structures, Lymph nodes in mediastinum
- Usually done PA (postero-anterior) and lateral
- Maybe followed by CT, MRI
Describe a sputum test?
- by expectoration, bronchoscopy, endotracheal, transtracheal aspirations
- Sputum Culture and Sensitivity: microscope, culture of preparation, antibiotic sensitivity test
- Sputum Cytology: microscope, for malignancy
What causes White sputum?
allergies or viral
or non-pus forming bacterium
What causes Yellow-green sputum?
pus-forming bacterium
What causes scattered expiratory wheezes?
narrowing of LRT in both lungs and all over
What are the reasons for a change in chronic cough?
1) Worsening of previous condition
2) Superimposed infection
3) New pathology (malignancy)
What is the pathophysiology of wheeze and sputum in smokers?
smoking -> metaplasia (- ciliary cells, + goblet cells, + mucus) -> narrows lumen
What investigations would you use to confirm a suspected pneumonia?
- Microscopy, Culture, Sensitivity test
- Chest x-ray
What causes night coughing in kids?
- asthma
- post-nasal drip
- GORD
What questions do you ask when you suspect asthma?
- what months is it during?
- family history of allergies?
- any changes in home recently? (new detergent, new pet, new room with carpet)
- other allergies?
What is the pathophysiology of wheeze in asthma?
-stimulus (eg. pollen) -> inflammation of epithelium -> thickens + smooth muscle contraction + inflammatory exudate
What causes runny eyes?
likely allergies
What does a dry cough mean?
- URT issue
- inhaled irritants
Define coryza
stuffy nose
What is the likely cause of acute rhinorrhea, sore throat, runny eyes, dry cough?
Allergic pharyngitis
What other disorders is “acute rhinorrhea, sore throat, runny eyes, dry cough” a prodrome to?
-Influenza
-LRT infection
-glandular fever
-HIV becoming positive AIDS
-meningitis
Hodgkins lymphoma
What are the 3 top causes of dyspnoea?
- respiratory tract pathology
- L side heart failure with pulmonary oedema
- anaemia
What colour sputum would croup make?
white (it is viral, not bacterial)
What questions do you ask for a 3yr old with cough with sputum?
- immunization history?
- daycare? other sick kids?
What investigations do can you do for asthma?
- allergy patch test
- blood test for eosinophils (high), IGE (high)
- spirometry
What causes crackles at both lung bases?
pulmonary oedema
What causes crackles at one lung base?
TB
lobar pneumonia
What causes scattered crackles on both lungs?
bronchopneumonia
What do you ask a 26 year old female with occasional palpitations and fatigue?
- last period?
- diet?
- family history of anaemia?
What is the DDx for palpitations and fatigue in a 26 yr old woman?
- anaemia
- pregnancy
What could be the cause of a 14 year old’s mild dyspnoea and wheeze with dry cough, precipitated by strong emotions and exercise?
Asthma
Allergies
What is the DDx of 42yr old heavy smoker male with 10yr history of increasing dyspnoea, morning cough with white sputum, increasing fatigues ?
- emphysema
- chronic bronchitis
- bronchus carcinoma
What investigations can confirm emphysema?
- chest X-ray
- lung function test
What causes a pink frothy sputum?
pulmonary oedema
What are the causes of pleuritic pain?
- pulmonary embolism with infarction
- pericarditis
- pneumonia
- myocardial infarction
- pneumothorax
Which is the only disorder of impulse conduction?
Heart block
What are some causes of arrhythmias?
- electrolyte imbalance (hypercalcaemia)
- high catecholamines (hyperthyroid)
- drugs (B-blockers, antidepressants)
- hypoxia (MI)
- vagal hyperactivity
- acidosis
- ischaemia
- aging
- fever
What is the definition of a cough?
- forceful expiratory action, preceded by preliminary inspiration
- protects lung from accumulation of secretions and entry of irritating destructive substances
What are the categories for the common causes of a cough?
inflammatory stimuli (laryngitis) mechanical stimuli (choking) chemical stimuli (noxious gas) thermal stimuli (cold air)
What are the common causes of haemoptysis?
- lung oedema
- bleeding tendency
- trauma
- TB
- pneumonia
- bronchus carcinoma
- pulmonary embolus with infarction
What causes a blood-streaked sputum?
- bleeding tendency
- lung carcinoma
- pulmonary embolism + infarction
- trauma
- TB
- bronchiectasis
What causes a rusty sputum?
-pneumococcal pneumonia
What causes morning cough?
- chronic bronchitis
- bronchiectasis
- postnasal drip
- chronic sinusitis
What causes night cough?
- asthma
- postnasal drip
- CROUP
What causes cough worse lying down, better with sitting up ?
left hear failure
What causes cough worse with exercise ?
- asthma
- chronic bronchitis
- many
What causes cough with fever and sweats ?
- respiratory infections
- Lymphoma
What causes cough plus sore throat and rhinorrhoea ?
URT infection
What are the top 3 things to ask a patient which hypertension?
- dyspnoea (L H failure)
- ishcaemic heart disease
- signs of stroke / brain bleed / cerebellar lesions
What are the causes of hypertension?
90% primary idiopathic
10% secondary to:
- endocrine (hyperthyroid)
- renal (glomerulonephritis)
- pregnancy
- neurogenic (cranial, lesions)
- medications
What are causes of systolic pressure increase?
- exercise
- stress
- pain
- cafeine
- recent smoke
What causes increase of diastolic blood pressure?
increase in total peripheral resistance
What are the causes of bilateral ankle oedema?
- R heart failure
- renal failure
- metabolic (starvation, malabsorption)
- pregnancy, PMS
- bilateral venous congestion
What are the causes of unilateral ankle oedema?
- venous congestion
* lymphatic obstruction -> filariasis, irradiation
What is CROUP?
- acute laryngotracheobronchitis
- follows URT
- parainfluenza type 1
- bark like cough
- hoarseness, dyspnoea, cyanosis
- inspiratory stridor, accessory insp. muscles
What is pernicious anaemia?
- macrocytic
- low intrinsic factor -> B12 deficiency
- presents with GIT discomfort and sensory changes
What is aplastic anaemia?
- low all blood formed elements due to bone marrow failure
* presents with features of anaemia plus bleeding tendency and low immunity
What is thalassaemia?
- haemolytic anaemia
* abnormal structure and function of RBC
What is mesothelioma?
- pleural carcinoma
* from exposure to asbestos
