Other Respiratory Diseases

Question 1

what happens during obstructive sleep apnoea

Answer 1

airways close during sleep causing partial occlusion - snoring or temporary complete occlusion - breathing stops
typically occurs in obese people with COPD

Question 2

symptoms of obstructive sleep apnoea

Answer 2

daytime sleepiness
snoring
headaches
restless sleep

Question 3

obstructive sleep apnoea is defined as

Answer 3

more than 10 apnoeas during one hour of sleep

Question 4

what are the investigations for obstructive sleep apnoea

Answer 4

Epworth sleepiness scale

Overnight oxygen analysis

Question 5

what is the treatment of

Answer 5

continuous positive airway pressure mask to wear at night

Question 6

what is bronchiectasis and who typically develops it

Answer 6

abnormal permanent dilatation of the airways due to inflammation and thick walls
most common in CF patients because mucociliary transport impaired

Question 7

symptoms of bronchiectasis

Answer 7

productive cough with yellow sputum 
recurrent infections 
halitosis 
clubbing 
crackles on auscultation

Question 8

what is cystic fibrosis

Answer 8

autosomal recessive condition with defect in CFTR gene
multisystem disorder where chloride channel cannot open leading to raised cAMP and increased viscosity of airways - overproduction of mucus

Question 9

how does cystic fibrosis present

Answer 9

abnormal teenage milestones 
recurrent infections 
breathlessness 
steatorrhoea - malabsorption 
family history !

Question 10

what are the tests for cystic fibrosis

Answer 10

family history
gene testing
sweat test - measures concentration of Cl- in sweat (raised)

Question 11

what is the treatment for cystic fibrosis

Answer 11

lifestyle - smoking etc
antibiotics when required
SABAs and inhaled corticosteroids for symptoms

Question 12

what is a pulmonary embolism

Answer 12

acute respiratory condition where a thrombus typically from the lower systemic veins travels and becomes lodged within the pulmonary arteries

Question 13

what three components are there to Virchow’s Triad and give examples of them

Answer 13

endothelial injury - smoking, trauma
hypercoaguable blood - pregnancy, HRT, clotting disorders
circulatory status - varicose veins, immobility

Question 14

what are the risk factors for developing pulmonary embolism

Answer 14

major surgery 
inactivity 
oral contraceptives 
pregnancy 
genetic blood clotting disorders 
hypertension 
age 
varicose veins 
stroke

Question 15

what are the symptoms of pulmonary embolism

Answer 15

sudden onset of breathlessness, chest pain, haemoptysis, tachypnoea, fever, hypoxia

Question 16

what are the symptoms associated with DVT

Answer 16

hot, red, swollen legs, tender to touch

Question 17

what investigations should be carried out if someone has suspected pulmonary embolism

Answer 17

D-dimer blood test
V/Q scan
CTPA
(CXR)

Question 18

a positive D-dimer result diagnoses a PE, true or false

Answer 18

false, D-dimer is positive when fibrin clot is produced but is not always responsible for PE can be other causes - use history
negative D-dimer = no pulmonary embolism

Question 19

what does a V/Q scan show

Answer 19

ventilation against perfusion

measures airflow against blood flow to highlight underperfused areas from a clot

Question 20

which scan is best for suspected pulmonary embolism in pregnant women

Answer 20

V/Q - lower radiation risk

Question 21

which scoring system assesses risk for PE

Answer 21

PESI score

Question 22

what is the treatment for pulmonary embolism

Answer 22

oxygen if hypoxic
thrombolysis if severe
oral anticoagulants for several months - epixaban, rivaroxaban, warfarin
low molecular weight heparin injections