intro

Question 1

what things are key to ask about in resp history (11)

Answer 1

age; gender; occupation; smoking history; asbestos exposure; pets (esp. birds/cats); Hx of childhood resp illness; SOB; cough (productive/dry); chest pain; fever

Question 2

what is stridor

Answer 2

a high-pitched extra-thoracic breath sound resulting from turbulent air flow in the larynx or lower in the bronchial tree

Question 3

red flag symptoms for resp (5)

Answer 3

night sweats; weight loss; voice change; shoulder tip pain; haemoptysis

Question 4

classifications of resp disease + examples (6)

Answer 4

1. airway diseases - asthma, allergic rhinitis
2. lung parenchymal disease - emphysema, Interstitial lung disease
3. pleural disease - infection, neoplasia
4. pulmonary - vascular disease
5. lung infection - pneumonia, TB, CF, Bronchectasis
6. lung cancer

Question 5

why is the angulation of the bronchi clinically significant

Answer 5

R is less angulated => more things are likely to be aspirated into it/ travel down it

Question 6

how many lobes does each side of the lungs have

Answer 6

R - 3 (upper, middle, lower); L - 2 (upper, lower)

Question 7

lung anatomy pathway

Answer 7

trachea -> bronchi -> bronchioles -> terminal bronchioles -> transitional -> transitional bronchioles -> alveolar ducts -> alveolar sacs

Question 8

what are the roles of the 2 types of alveolar epithelial cells found in the lugs

Answer 8

type 1 - structural;
type 2 - functional, they secrete surfactant

Question 9

why might premature babies need artificial surfactant?

Answer 9

type 2 epithelial cells develop later and so may not have developed by the time some premature babies are born => artificial surfactant is needed to stop the lungs collapsing in on themselves

Question 10

what receptor plays a big role in cough

Answer 10

TRPV1

Question 11

what to look for in general inspection of a resp pt

Answer 11

pallor (skin and eyes); jaundice (sclera); clubbing (related to chronic low O2 levels); cyanosis; oedema; lymphadenopathy; pule + resp rate

Question 12

what are the lung defence mechanisms

Answer 12

anatomical: muco-cilliary aparatus;
immunological: alveolar macrophages, ctyotoxic T cells; natural killer cells

Question 13

common investigations to order for resp pts

Answer 13

bloods - FBC, CRP, cultures, serology
urine - pneumococcal antgen, legionella antigen
sputum - MCS, AAFB
radiology

Question 14

what score is used to decide whether a pt should be hospitalised

Answer 14

C - confusion
U - urine
R - resp rate (<25/30)
B - BP (<90/60)
65 - age
if >=2 then consider keeping in hopsital