M103 T4 L16

Question 1

What is the difference between a sign and a symptom?

Answer 1

sign - is observed by a health worker

symptom - is experienced by the patient

Question 2

What is the mechanism behind a ptussive reflex?

Answer 2

irritation in the upper airway
stimulates the medulla - co-ordinates inspiration
the glottis closes and contracts
cough - expulsion

Question 3

Why do patients with a chronic cough get a hoarse voice?

Answer 3

bc it causes a recurrent build of applied pressure behind the closed glottis
causes oedema of the vocal folds

Question 4

Which two conditions are common in older patients that could cause extra effects from a chronic cough?

Answer 4

osteopenia

osteoperosis

Question 5

How could an older patient with osteopenia or osteoperosis be affected by a recurrent cough?

Answer 5

fractured ribs

very painful and difficult to manage

Question 6

What are the three categories of cough?

Answer 6

acute
sub acute
chronic

Question 7

What are the types of identifiable coughs?

Answer 7

smokers cough, productive cough, fruity or dry cough
whooping cough, barking cough
nocturnal cough

Question 8

How does smoking cause a cough?

Answer 8

the body’s reaction to cigarette smoke is a build-up of mucus in the lungs
leads to a recurrent cough in the morning

Question 9

Why are barking / whooping coughs seen much more commonly in children?

Answer 9

bc younger children have smaller airways

Question 10

What causes a croup?

Answer 10

a virus that causes respiratory tract infections

Question 11

What generates the sound associated with Croup?

Answer 11

the greater effort made trying to maintain normal respiratory rate respiration due to the smaller opening in the airway in a smaller child

Question 12

How can a croup sound be identified?

Answer 12

makes a different sound

can be associated with respiratory distress

Question 13

How is an oedema in the airway of a child treated?

Answer 13

dexamethasone (high dose)

prednisolone (in the community)

Question 14

What are things to look out for in productive coughs?

Answer 14

coloured sputum (green / yellow)
viscosity
blood

Question 15

What might a bovine cough be a warning side of?

Answer 15

a tumour in the upper bronchial tree that could be compressing on the recurrent laryngeal nerve

Question 16

What are the causes of an acute cough?

Answer 16

Irritation

Infection

Question 17

What are the causes of a chronic cough? (COrMAR)

Answer 17

Cancer, Oesophageal reflux

Medications, Asthma, Rhinitis

Question 18

Which medications could be responsible for a chronic cough?

Answer 18

ACE inhibitors

blood pressure tablets

Question 19

How is gastro-oesophageal reflux disease treated?

Answer 19

proton pump inhibitor

Question 20

What might cause nocturnal coughing?

Answer 20

when the patient lies down at night, the physical levelling out of the body means that more acid is going to be sloshing around up at the top of their oesophagus and airway
causes irritation and so coughing

Question 21

What four aspects of sputum is assessed?

Answer 21

Quantity
Colour
Smell
Blood

Question 22

What are the three different colours of blood in haemoptysis?

Answer 22

Frothy & pink
Bright red
Dark (altered)

Question 23

Why might blood from a haemoptysis be bright red or dark?

Answer 23

bc the blood would be from the upper respiratory tract or the oropharynx where it’s not had a chance to oxidise or become altered

Question 24

Why might blood from a haemoptysis be frothy and pink?

Answer 24

associated with heart failure

Question 25

What might dyspnoea be caused by?

Answer 25

an acute obstruction to the airway

a restriction to the expansion of the lungs

Question 26

What might acute dyspnoea be caused by? (3Ps + OTI)

Answer 26

Obstruction, Trauma, Infection

PE, Panic, Pneumothorax

Question 27

What might chronic dyspnoea be caused by? (CCAHM-AF) -calm af

Answer 27

Cancer, COPD, Anaemia, HF, Metabolism

asthma, fibrosis

Question 28

What is the physiological lifespan of a panic attack?

Answer 28

20 - 40 mins

Question 29

What does ABCD stand for?

Answer 29

airways
breathing
circulation of the cardiac shadow
diaphragm

Question 30

How can coughing be avoided? (ABCDs, QASAI)

Answer 30

ABCDs
Quarantine
Avoidance
Syrups & linctus
Antibiotics
Inhalers

Question 31

Why can’t children below the age of approx 7 be diagnosed for asthma?

Answer 31

they’re not really able to do things like spirometry or peak flow in a way that is going to give you a reliable enough result to test or diagnose asthma

Question 32

Which two coughs are common in children?

Answer 32

whooping and barking

Question 33

g What muscles are innervated by the recurrent laryngeal nerve?

Answer 33

the posterior cricoarytenoid muscles

Question 34

g What are the only muscles that can open the vocal folds?

Answer 34

the posterior cricoarytenoid muscles

Question 35

g What are the lateral cricoarytenoid muscles responsible for?

Answer 35

adducting the vocal folds so that the rima glottidis is narrowed
AAR tone and volume of speech is modulated

Question 36

g What are the origins of the lateral cricoarytenoid muscles?

Answer 36

the arch of the cricoid cartilage

Question 37

g What is the purpose of the lower oesophageal sphincter closing?

Answer 37

to prevent the backward movement of acid and stomach contents

Question 38

g What are the symptoms of gastro-oesophageal reflux disease?

Answer 38

heartburn, an unpleasant taste in the back of the mouth