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Y2 - Resp > Lecture 18 - Signs And Symptoms Of Lung Disease > Flashcards

Lecture 18 - Signs And Symptoms Of Lung Disease Flashcards

1
Q

What are some diseases involving the airways?

A

Asthma
COPD
Bronchiectasis
Cystic fibrosis

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2
Q

What is the pathophysiology of Bronchiectasis?

A

Permanent dilation of the airways leading to mucus production in the airways

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3
Q

What are some diseases affecting the lung parenchyma?

A

Pulmonary fibrosis
Pneumonia
TB

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4
Q

What is the general issues with pulmonary fibrosis?

A

Reduced lung compliance due to increased elastic tissue deposits

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5
Q

How does pneumonia cause respiratory issues?

A

Infection of the lower respiratory tract leads to build up of inflammatory exudative fluid in the alveoli inhibiting gas exchange

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6
Q

What is a respiratory condition the affects pulmonary circulation?

A

Pulmonary embolism

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7
Q

What are some diseases of the pleura?

A

Pneumothorax
Pleural effusion

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8
Q

What are some diseases of the chest wall and Neuromuscular junctions affecting the respiratory system?

A

Kyphoscolisosis
Myasthenia gravis

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9
Q

What are some key signs and symptoms of respiratory disease?

A

Breathlessness
Chest pain
Sputum
Breath sounds
Haemoptysis

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10
Q

Is dyspnoea a sign or symptom?

A

Symptom but there may be evidence like raised RR and accessory muscle use

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11
Q

What are the main things we need to explore when it comes to breathlessness?

A

Onset, timing and duration
Exacerbating factors
Progression
Severity

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12
Q

What are some questions we can ask in terms of onset, time and duration of breathlessness?

A

How quickly did it come about
Intermittent/reversible?

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13
Q

What are some respiratory causes that would cause sudden onset breathlessness?

A

Massive PE
Massive pneumothorax
Anaphylaxis (air way seals)

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14
Q

what are some respiratory disease that cause breathlessness that takes hours or days to start?

A

Mild to moderate asthma
LRTI

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15
Q

What are some respiratory diseases that cause chronic breathlessness?

A

COPD
Pulmonary fibrosis I

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16
Q

Wht are some common exacerbating factors worsening breathlessness?

A

Cold (asthma)
Pets or pollen
Lying down (cardiac failure)

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17
Q

What is the medical term for breathlessness worsened by lying down that’s seen in cardiac failure?

A

Orthopnea

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18
Q

What is meant by progression in breathlessness?

A

Has it worsened, stayed the same?

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19
Q

What are some ways to describe severity of breathlessness?

A

Housebound
Struggling to communicate
Can’t walk mroe than 100yds
Cant climb stairs

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20
Q

What is an empyema?

A

Collection of pus in the pleural space

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21
Q

What type of breathlessness would an empyema cause?

A

Likely felt ill before, then never fully got better then gets worse as empyem forms

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22
Q

What are some diseases of mediastinal strucutres that can cause chest pain?

A

Acute coronary syndromes
Pericarditis
Oesophagitis/GORD
Aortic dissection

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23
Q

What are some diseases of the pleura causing chest pain?

A

Infection
Pneumothorax
PE (infarction of pleura)

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24
Q

What are some conditions of the chest wall and skin that can cause chest pain?

A

Rib fracture
Costochondritits
Shingles

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25
Q

What causes pleuritic chest pain?

A

When the parietal pleura is irritated

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26
Q

What type of pain is pleuritic chest pain?

What worsens it?

A

Sharp and well localised
Worse with coughing and breathing in since pleura sliding over each other

27
Q

Why can pain be experienced at the thoracic wall or shoulder tip with pleuritic pain?

A

Referred pain via intercostal and phrenic nerve

28
Q

What stimulates the cough response?

A

Triggering mechanoreceptors/chemoreceoptors within the airways

Larynx, trachea and bronchial receptors

29
Q

What is the afferent sensory limb in the cough reflex?

A

Vagus nerve (X)

30
Q

Describe what happens in the cough reflex:

A

Receptors in larynx, trachea and bronchi irritated
Vocal cords ADduct
Internal intercostals and abdominal muscles contract increasing intrathoracic pressure
Vocal cords ABduct

31
Q

What needs to be considered when it comes to a cough?

A

Productive?
Character
Timing

32
Q

What is meant by a productive cough?

A

Mucus or Haemoptysis

33
Q

What are some condtions tht produces lots of mucus?

A

Bronchiectasis or CF

34
Q

What are some causes of Haemoptysis?

A

TB
Lung cancer

35
Q

What is the most common cause of an acute cough?

A

URTI
Should resolve after 10days

36
Q

What type of sputum is produced when theres chronic bronchitis or COPD?

A

Clear sputum (no infection active)

37
Q

What colour sputum is produced when there’s an infection?

A

Yellow-green sputum

38
Q

What makes sputum yellow-green?

A

Neutrophils

39
Q

What condition is lots of yellow/green sputum produced?

A

Bronchiectasis

40
Q

What drugs can cause a dry cough?

A

ACEi like ramipril

41
Q

What type of sputum is produced in LV heart failure?

A

Pink frothy sputum

42
Q

What is a wheeze/what causes it?

A

Air flowing through a narrowed airway causing turbulent airflow

High pitched

43
Q

What part of breathing is a wheeze normally heard in?

A

Expiration

44
Q

What is stridor?

A

High pitch constant loud breath sound

45
Q

What stage of breathing is stridor heard in?

A

Inspiration

46
Q

What causes stridor?

A

Narrowing in EXTRAthoracic airways like supraglottis, glottis, infraglottis or trachea

47
Q

What conditions are wheezes often heard in?

A

COPD
Asthma

48
Q

What are the general things that are done on clinical examination for a respiratory disease?

A

Inspect
Palpate
Percuss
Auscultation

49
Q

What is examined on inspeticion for resp disease?

A

Breathlessness
RR
Hands, face and chest

50
Q

What is peripheral cyanosis?

A

Bluish discolouration of the hands, feet, nose and tips of ears

Due to cold exposure or decreased CO, vasoconstriction of the peripheries

51
Q

What is central cyanosis?

A

Much less oxygenated blood reaching the tissues
Cuasing the oral mucosa, lips and tongue to be blue

52
Q

What partial pressure and oxygen saturations does central cyanosis occur?

A

Sats <85%
Partial pressure <8kPa

53
Q

What are some accessory muscles to ventilation?

A

SCM
Trapezius
Scalene

54
Q

What condition is pursed lip breathing typically seen in?

A

COPD

55
Q

Why do COPD patients do pursed lips breathing?

A

To get postive expiratory pressure the extra pressure to allow for the airways to stay open for longer maximising gas exchange time

56
Q

What causes barrel shaped chest?

A

Lung hyper inflation

Seen in COPD especially emphysema (loss of elastin)

57
Q

What is examined in the ppalpation stage of resp exams?

A

Tracheal position
Chest expansionist

58
Q

What is suggested by a patient being hyper resonant on percussion?

A

Increased air

59
Q

What is suggested by a patient being dull to percussion?

A

Consolidation

60
Q

What is suggested by a patient being stony dull to percussion?

A

Fluid like pleural effusion

61
Q

What should a healthy patient sound like on auscultation?

A

Continous rustling leaf like breathing

62
Q

What is bronchial breathing?

A

Harsh breath sounds with a gap between inspiration adn expiration

63
Q

What is indicated by hearing crackles on auscultation?

A

Snapping open and closing of airways
Or
Air bubbling through secretion s

64
Q

What is indicative of pneumothorax on CXR?

A

Lungs markings/lung fields dont extend to the edge of the lung

Y2 - Resp (23 decks)

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