Lecture 10.5: Physiology of breathlessness

Question 1

What is the difference between type 1 and 2 respiratory failure?

Answer 1

Type 1 is low O2 and normal/low Co2.

Type 2 is Low O2, high CO2.

Question 2

What are the 5 major causes of dyspnoea (think anatomically)

Answer 2

Airways
Alveolar
Pulmonary vascular
Pleural/chest wall disease
Respiratory muscle disease

Question 3

What are prominent airway diseases? What can we notice?

Answer 3

Upper: Tumour, Croup
Lower: Asthma, COPD, bronchiolitis

Cough, sputum, wheeze, stridor. If obstructive, we see marked decrease in FEV.

Question 4

What are prominent alveolar diseases? What can we notice?

Answer 4

Pneumonia, lung collapse, pulmonary oedema/fibrosis.

Crepitations may suggest terminal lung units being involved as air bubbles through fluid. Can get cough, orthopnea. Restrictive ventilatory defect: no marked change in FEV1 but decrease in FVC.

Question 5

What are prominent pulmonary vascular diseases?

Answer 5

PE, vasculitis, pulmonary hypertension

Question 6

Where is the likely point of pathology if we have chest pain?

Answer 6

Most likely pleura. Can present with haemoptysis sometimes.

Question 7

True or false? Deconditioned bodies may present with hypoxia upon exertion. This hypoxia will not be alleviated if body re-conditions.

Answer 7

False. Athletes that get fat, and then fit again, can fix their hypoxia (so to speak).

Question 8

True or false? Atopic asthmatics respond to asthma treatment.

Answer 8

True.