Other Pathologies Flashcards by Jasmine Aikman

Virchow’s triad

vessel wall damage
turbulent/stasis of blood flow
increased blood viscosity or hypercoagulability

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____ cascade works against ____ cascade to breakdown clots

fibrinolytic ; coagulation

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Hypoxaemia w/o hypercapnia

Type 1 respiratory failure

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Hypoxaemia with hypercapnia

Type 2 respiratory failure - sensitive to high FiO2 - give Venturi

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Why not high flow O2 to type 2 respiratory failure patients?

Haldane effect- O2 pushes CO2 off of Hb where it was in high concn => lots of CO2 in blood free = acidotic
Hypoxic drive - O2 drives breathing - so if high then stop

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Death occurs at ___kPa O2

2.7

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hyperventilation occurs at ____kPa O2

5.3 and below

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loss of consciousness occurs at ___ kPa O2

4.3 and below

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not enough Hb = ____ hypoxia

anaemia

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cardiac reduction or local reduction in O2 = ___ hypoxia

circulatory

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Caused by CO, alcohol, cyanide = _____ hypoxia

toxic - O2 cant bind with Hb

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Alveolar hypoventilation, altitude, ILD, shunting, dead space and V:Q mismatch are examples of ____ hypoxia

hypoxaemic - lungs don’t work

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CXR of pleural effusion shows

opacification of lung bases

curved meniscus - may track into oblique and horizontal fissures

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Non-tension pneumothorax CXR shows

draw crescent w/o lung markings at peripheries

subtle

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Tension pneumothorax CXR shows

Large and black on one side
Mediastinum pushed away from pneuumothorax
pneumothorax depresses its hemidiaphragm

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____ DVT most likely to embolise

ileo-femoral

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ECG changes seen in PE:

S1Q3T3

T inversion in V1-3

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Prevention of PE/DVT

compression stockings, exercises, S/C LMWH

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Treatment of PE =

heparin and warfarin - stop heparin afte short time and keep on warfarin for 3-6 months
thrombolysis if life threatening

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Multiple PEs suspect ____

CTEPH - chronic thromboembolic pulmonary hypertension)

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PE is a ____ infarct

due to ____

red

dual blood supply to lungs - bronchial arteries blood is drawn into alveoli

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Treatment for CTEPH

rioiguat - pulmonary arterial vasodilator
OR
pulmonary endartectomy

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haemothorax may be ___

trauma, malignancy, infection, infarction

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Milky/turbid pleural effusion may be ___

empyema, chylothorax

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Purulent pleural effusion may be ___

anaerobic effusion

straw coloured pleural effusion may be ____

HF, hypoalbuminaemia

viscous pleural effusion may be ___

mesothelioma

food in pleural effusion may be ___

oesophageal rupture

Parietal pleura nerve supply

intercostal and phrenic - sense pain

Visceral pleura nerve supply

CNX - sensory and vasomotor fibres - stretch sensed

Parietal and visceral pleurae combine at ____ to form ____. Attaches ___ to ____

root of lung ; pulmonary ligament; root to diaphragm

transudate = ____ protein | causes =

exudate = ___ protein | causes =

>30g/l | malignancy, parapneumonic, PE, rheumatoid, mesothelioma, drugs, connective tissue disease

pH of pleural effusion | 7.6=

7.6 normal

neutrophils in pleural effusion =

parapneumonic or PE

monocytes in pleural effusion =

chronic infection

lymphocytes in pleural effusion =

TB, lymphoma, rheumatoid

decreased mesothelial cells in pleural effusions -

inflammatory process eg. tb

decreased glucose in pleural effusion -

infection, tb, malignancy, rheumatoid, oesophageal rupture, lupus

Drain pleural effusion if -

tension/sytmptomatic pneumothorax, empyema, complicated parapneumonic effusion, malignancy, traumatic haemothorax

Pulmonary oedema cause a ___ PFT pattern

restrictive

ARDS development

injury to lung> inflamcells infiltrate>cytokines>WBCs release O2 radicals>cell membrane injury>hyaline membranes form, cell regeneration, inflammation

Saddle emboli is:

at bifurcation of pulmonary artery into L and R

CO2 retention headache characteristic

"thick head" in morning on waking, no change with posture | more likely in obese

Large tumour at apex of lung can compress ___ leading to facial swelling

SVC

Normal PCO2 in asthma attack denotes

severe as they are fatiguing, should be low due to hyperventilation

fungus clump mistaken for tumour ___

aspergilloma

Markers of severe asthma

can't finish sentences in 1 breath | silent chest, increased RR, tachypnoea, bradycardia, loss of consciousness, reduced FEV1

Frothy haemoptysis

pulmonary oedema

Rusty haemoptysis

Pneumococcal pneumonia

Massive haemoptysis is ___

>600ml in 24hrs

Pleural cavity usually holds ___ serous fluid

4ml

Stridor =

inspiratory wheeze due to large airway obstruction

Causes of stridor in kids

epiglottitis, croup, retropharyngeal abscess, diptheria, foreign body, anaphylaxis

Extrathoracic causes of stridor:

laryngeal tumours and vocal cord paralysis

adult causes of stridor:

neoplasm, goitre, Wegener's, trauma, bilateral vocal cord palsy, cricoarytenoid arthritis, tracheomalacia

tracheomalacia =

degradation of tracheal cartilages - softened and collapses on inspiration causing stridor

Risk factors for obstructive sleep apnoea

enlarged tonsils, obesity, retrognathia, hypothyroidism, acromegaly, oropharyngeal deformity, post-op after anaesthesia

______ score, _____ and ____ used to diagnose obstructive sleep apnoea

Epworth Sleepiness Scale, snoring and overnight sleep study

Symptoms of obstructive sleep apnoea

somnolence, daytime sleepiness, cognitive impairment, personality change

Most effective treatment for obstructive sleep apnoea

CPAP

Pathophysiology of obstructive sleep apnoea

Relaxation of pharyngeal dilator muscles during sleep esp. REM => UA collapse