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phase2a medicine > more respiratory diseases > Flashcards

more respiratory diseases Flashcards

Non-infectious respiratory diseases excluding malignancies, COPD, and asthma.

1
Q

risk factors for pulmonary embolism

A

thrombosis
malignancy
surgery
immobility

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2
Q

definition of embolism

A

a mass of material in the vascular system lodged in a vessel blocking its lumen

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3
Q

most common cause of pulmonary embolism

A

DVT

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4
Q

signs of first class pulmonary embolism

A

idiopathic pulmonary hypertension

small level pulmonary deficiency

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5
Q

signs of second class pulmonary embolism

A

acute respiratory and cardiac problems
chest pain
shortness of breath
right heart strain

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6
Q

ECG signs of second class pulmonary embolism

A

deep S waves in lead I

presence of Q waves and inverted T waves in lead 3

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7
Q

sign of third class pulmonary embolism

A

sudden death

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8
Q

treatment of pulmonary embolism

A

anticoagulants (heparin and warfarin)

thrombolysis

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9
Q

risk factors for sarcoidosis

A

age 20-29
women >40
coeliac disease
Black people (increased genetic tendency)

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10
Q

pathology of sarcoidosis

A

non-caseating granulomas

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11
Q

signs of sarcoidosis

A

wheezing
coughing
chest pain

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12
Q

diagnostic tests for sarcoidosis

A 
CT
PET
biopsy
test tissues to rule out other causes
bloods - increased ESR
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13
Q

treatment of sarcoidosis

A

anti-inflammatories

give corticosteroids if patient has parenchymal lung disease, uveitis, hypercalcaemia, or neurological or cardiac involvement

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14
Q

pathology of idiopathic pulmonary fibrosis

A

active lung epithelium produces mediators –> differentiation in myofibroblasts –> produce excess extracellular matrix –> remodelling of lung architecture and deposition of collagen

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15
Q

signs of idiopathic pulmonary fibrosis

A 
dry cough
malaise
weight loss
cyanosis
finger clubbing
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16
Q

complications of idiopathic pulmonary fibrosis

A

respiratory failure

increased risk of lung cancer

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17
Q

diagnostic tests for idiopathic pulmonary fibrosis

A

ABG - decreased Pao2 and increased PaCO2
CXR/CT - decreased lung volume and honeycomb lung (essential for diagnosis)
spirometry - restrictive
biopsy

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18
Q

treatment for idiopathic pulmonary fibrosis

A

corticosteroids
antifibrinitic drugs (pirfenidone)
tyrosine kinase inhibitors (nintedanib)
transplant

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19
Q

how do tyrosine kinase inhibitors work against idiopathic pulmonary fibrosis?

A

reduce fibroblast proliferation
reduce production of collagen and fibrogenic mediators
inhibit other growth factor receptors

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20
Q

risk factors for pleural effusion

A

heart failure
TB
cirrhosis

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21
Q

pathology of pleural effusion

A

damage to pleura leads to secretion of fluid which is in greater volume than can be absorbed by the lymphatic system

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22
Q

signs of pleural effusion

A

bronchial breathing
decreased expansion
decreased percussion (stony dull)
decreased vocal resonance

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23
Q

complications of pleural effusion

A

constricts breathing

constricts cardiac contractions

24
Q

diagnosis of pleural effusion

A

CXR

fluid biopsy

25
Q

treatment of pleural effusion

A

treat underlying cause
pleural tap if large effusion
pleuroperitoneal shunt if chronic

26
Q

treatment of pneumothorax

A

treat primary condition

chest drain

27
Q

signs of tension pneumothorax

A

respiratory distress
hypotension
tachycardia
tracheal deviation from side with pneumothorax

28
Q

what is a pneumothorax?

A

gas in the cavity between the lung and the chest wall, causing the lung to collapse

29
Q

pathology of pulmonary hypertension

A

high pulmonary artery blood pressure due to arterial swelling

30
Q

risk factors for pulmonary hypertension

A 
family history
prior clots in the lungs
HIV
mitral valve disease
sickle cell 
LV dysfunction
31
Q

signs of pulmonary hypertension

A

syncope

tachycardia

32
Q

symptoms of pulmonary hypertension

A 
shortness of breath 
feeling faint or dizzy
chest pain 
palpitations
oedema
33
Q

diagnosis of pulmonary hypertension

A

echocardiogram
ECG
pulmonary function tests
exclude other causes

34
Q

treatment of pulmonary hypertension

A

oxygen therapy
diuretics
prostaglandins
clotting inhibitors

35
Q

risk factors for hypersensitivity pneumonitis

A

exposure to an inhaled allergen

e.g. Farmer’s lung, Pigeon fancier’s lung

36
Q

pathology of hypersensitivity pneumonitis

A

either type 3 or type 4 hypersensitivity

37
Q

treatment of hypersensitivity pneumonitis

A

depends on causes - e.g. antibiotics or corticosteroids

38
Q

blood test results for hypersensitivity pneumonitis

A 
raised neutrophilia
lymphocytosis
eosinophilia
raised ESR and CRP
blood gases - hyperaemia
serum antibodies
39
Q

signs on CT scan of hypersensitivity pneumonitis

A

patchy ground glass attenuation
small, poorly defined centrilobular nodules
patchy areas of air trapping

evidence of pulmonary fibrosis and honeycombing if advanced

40
Q

what percentage of adult asthma is occupational?

A

15%

41
Q

what is pneumoconiosis caused by?

A

inhalation of mineral dust - e.g. asbestos, silicates, coal dust

42
Q

how many people with occupational asthma end up unemployed?

A

1/3

43
Q

what does asbestos exposure cause?

A

pleural plaques
diffuse pleural thickening
asbestosis
mesothelioma

44
Q

diagnosis of occupational asthma

A

OASYS peak flow diary - measure every few hours - a positive work effect index is suggestive of occupational asthma

45
Q

causes of Goodpasture’s syndrome

A

viral respiratory infection

breathing in hydrocarbon solvents

46
Q

how much more likely are men to develop Goodpasture’s syndrome than women?

A

8x

47
Q

pathology of Goodpasture’s syndrome

A

anti-glomerular basement membrane antibodies attack collagen

48
Q

signs of Goodpasture’s syndrome

A 
coughing up blood
dry cough
shortness of breath
bloody urine
burning sensation when urinating
nausea and vomiting
pale skin 
oedema
49
Q

treatment of Goodpasture’s syndrome

A

plasmapheresis
corticosteroids
bp correcting medication
kidney transplant

50
Q

risk factors for Wegener’s granulomatosis (granulomatosis with polyangiitis)

A

genetic

51
Q

which blood vessels are inflamed in Wegener’s granulomatosis

A

sinuses
lungs
kidneys

52
Q

pathology of Wegener’s granulomatosis

A

a form of vasculitis

widespread anti-neutrophil cytoplasmic antibodies

53
Q

first sign of Wegener’s granulomatosis

A

rhinitis

then goes on to cause many other problems

54
Q

diagnosis of Wegener’s granulomatosis

A

test for cytoplasmic c-ANCA autoantibodies (90% cases)

55
Q

treatment of Wegener’s granulomatosis

A

corticosteroids
cyclophosphamide
rituximab

phase2a medicine (53 decks)

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