Other, OSA, Cancer Flashcards

1
Q

What is obstructive sleep apnoea?

A

Intermittent closure/collapse of pharyngeal airway during sleep - causing apnoeic episodes (cessation of air flow >10s during sleep) - terminated by partial arousal

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2
Q

Typical OSA patient

A

Obese, middle aged man

Presents with snoring or daytime somnolence

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3
Q

Features of OSA

A
Loud snoring
Daytime somnolence
Poor sleep quality 
Morning headache 
Decreased libido 
Cognitive performance decrease
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4
Q

Complications of OSA

A

Pulmonary hypertension, type 2 respiratory failure and hypertension

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5
Q

DX of OSA

A

Polysomnography - O2 sat at nose and mouth, ECG, EMG chest, abdominal wall movements
15 of more episodes of apnoea or hypopnoea during 1 hour of sleep indicates OSA

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6
Q

Management of OSA

A

Lose weight
Avoid smoking and alcohol
CPAP via nasal mask during sleep
Surgery to relieve obstruction is occasionally needed

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7
Q

Presentation of cor pulmonale

A

Dyspnoea fatigue and syncope
Cynaosis, tachycardia, raised JVP, ECG signs
Hepatomegaly and oedema

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8
Q

Management of cor pulmonale

A

Treat cause
Treat resp failure
Treat cardiac failure

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9
Q

What is pleural effusion - two types

A

Fluid in pleural space

Transudates 35g/l of protein

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10
Q

Causes of a transudative pleural effusion

A

Increased venous pressure

  • Cardiac failure
  • Fluid overload
  • Constrictive pericariditis

Hypoproteinaemia

  • Cirrhosis
  • Nephrotic syndrome
  • Malabsorption

Hypothyroidism

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11
Q

Causes of an exudative pleural effusion

A

Increased leakiness due to infection, inflammation or malignancy

Eg. pneumonia, TB, pulmonary infarction, RA

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12
Q

Symptoms of pleural effusion

A

Dyspnoea

Pleuritic chest pain

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13
Q

Signs of pleural effusion

A

Decreased expansion
Stony dull percussion
Diminished breath sounds
Vocal fremitus decreased

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14
Q

CXR in pleural effusion

A

Small effusions blunt costophrenic angle

Larger ones seen as water-dense shadows, concave upper borders

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15
Q

Other diagnostic measures in Pleural effusion

A

USS

Diagnostic aspiration

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16
Q

Management of pleural effusion

A

Drain - remove slowly

Pleurodesis (tetracycline, talc or bleomycin) if recurrent