Pathology from learning outcomes Flashcards
What are the signs and symptoms of COPD ?
Productive cough (every day, 3 consecutive months, 2 consecutive years) Steady decline Dyspnoea Severe weigh loss and muscle mass loss Acute exacerbations
Others Cyanosis fine tumour Flapping tumour expiratory wheeze chest infections pursed lip breathing Peripheral oedema Raised JVP
Describe the complications of emphysema
Emphysema causes a reduced in gas exchange and so there is vasoconstriction.
Fibrosis can then occur on these vasoconstricted capillaries and reduce blood flow further.
If emphysema affects a large area then pressure builds up in the heart, this can cause cor pulmonale, this causes build up in the veins, leading to peripheral oedema and raised JVP.
Decrease in the flow of the blood increases its thickness of the blood also increased in all of this making it even harder to pump the blood around the body.
All of this results in hypoxia.
What happens to the body in COPD ?
There is loss of the surface area in the lungs (emphysema).
Effects on the large and small airways hyperplasia etc
What are the symptoms of asthma?
Variation of symptoms
Night disturbances
Wheeze
Feeling like you cant breath
How does Asthma affects alveolar oxygen levels ?
It is an obstructive condition so there are problems getting air out of the lungs. There is air in the lungs but there is a reduced in alveolar ventilation and alveolar dead space.
What is a shunt ?
When blood moves from the right side of the heart to the left side of the heart without participating in sufficient gas exchange.
What is cor pulmonale ?
right side heart failure
What is anatomical dead space ?
The air which sits in the conducting region of the lungs around 150 ml
What is alveolar dead space ?
Air which sits in the alveoli and doesn’t participate in gas exchange
What is physiological dead space ?
Total dead space found in the lungs
What is the defining features of COPD ?
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What is the epidemiology of COPD ?
1.2 million living with a diagnosis of COPD
2% population
At least 50% undiagnosed
What is the aetiological (causes) factors of COPD ?
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What is the main causes of a wheezing illness ?
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What should you ask for in the clinical history of COPD
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What investigations are done to find out if a person have COPD ?
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How is the severity of COPD assessed ?
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What are the differences in COPD and Asthma ?
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What are the similarities in COPD and Asthma ?
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What is the natural history of COPD (What will happen if COPD was untreated) ?
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How does the natural history of COPD tie into realistic medicine ?
Realistic medicine is about having open and honest conversations about what the treatment and prognosis is for a patient and allowing the patient to be involved in that process
What is the aim of COPD management ?
Highest quality of life for as long as is possible i.e. preventing exacerbations,
What investigations are done when assessing a patient with a COPD exacerbation ?
ABG WBC + Hb U&Es Sputum culture CXR
What are the classes of drugs and there mode of delivery which are used to treat COPD and asthma ?
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What are the non-pharmacological management methods for COPD ?
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Why is patient education important in the management of COPD ?
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How is the management of asthma and COPD different ?
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What other treatments are important in the palliative care of a COPD patient ?
Oxygen therapy
Treatment of symptoms (Making as comfortable as possible)
What are the defining features of Asthma ?
Variation in symptoms
Wheeze
Exacerbations
What is the epidemiology of asthma ?
Affects 10-15% of children
Affects 5-10% of adults
Largest pulmonary disease in the UK
What are the aetiological factors of asthma ?
Atopic gene
Occupation
Smoking (maternal smoking)
What are the pathological features of asthma ?
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Why does the prevalence of respiratory disease change to rapidly in children as they grow?
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What should be included in the history of an asthma patient ?
Family history - Atopic gene and smoking in family
Social history - Triggers and occupation
What investigations should be carried out to help diagnose asthma ?
Spirometry Bronchodilator reversibility test FeNO test Allergen test PEFR
How should the severity of asthma be assessed ?
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How is the severity of acute asthma assessed ?
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How is acute asthma managed ?
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How is chronic asthma managed using the step up step down approach ?
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Name some of the common organisms which cause upper respiratory tract infections
Bacteria (Strep.)
Viruses (rhinoviruses, adenoviruses, parainfluenza, influence, EB virus)
What are some defence mechanisms of the body against infection ?
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What is the pathogenesis of pneumonia ?
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What are the complications of pneumonia and other LRTIs
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What are the clinical features of acute bronchitis ?
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What are the clinical features of pneumonia ?
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What is recurrent pneumonia ?
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What is bronchiectasis ?
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What is lung abscess ?
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What is empyema ?
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What happens to gas exchange during a respiratory tract infections ?
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What is the clinical presentation of tonsillitis / pharyngitis ?
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What are the clinical presentations of the common cold ?
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What are the clinical presentations of the EB virus glandular fever ?
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What are the clinical presentations of otitis media ?
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What are the clinical presentations of sinusitis ?
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What is supportive therapy in respiratory tract infections ?
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What is the difference between community and hospital acquired pneumonia ?
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What is another name for hospital acquired pneumonia ?
nosocomial
How is pneumonia treated ?
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How is bronchiectasis treated ?
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How is a lung abscess treated ?
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How is empyema treated ?
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How is secondary and primary care different in how they treat reparatory tract infections ?
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Describe the global distribution of tuberculosis ?
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What is the pathogenicity of primary TB ?
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What is the pathogenicity of post-primary TB ?
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What is the pathogenicity of fibrocaseous TB ?
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What is the histopathology of TB ?
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What is the typical presentation of TB ?
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How is TB treated ?
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What are the public health duties of a doctor when managing a TB case ?
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What is the typical clinical presentation of lung cancer ?
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What causes localised opacity on the chest X-ray ?
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What are the different types of lung cancer ?
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What is the epidemiology of lung cancer ?
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What is the pathogenesis of lung cancer ?
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How does lung cancer spread?
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What investigations are carried out into lung cancer?
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How is lung cancer staged ?
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How is inoperable non-small cell lung cancer managed ? what are the side effects and the likely outcomes ?
Radiotherapy
Chemotherapy
What is the epidemiology of smoking ?
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What is the economics of smoking ?
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What is the politics of smoking ?
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What are some strategies used to reduce smoking ?
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What are the causes of pleural effusion ?
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What are the clinical features of pleural effusion ?
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How are the differential diagnosis of pleural effusion ?
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What is the pathology of malignant mesothelioma ?
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How do you manage pleural effusion ?
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What are pleural plaques ?
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Names and describe some congenital respiratory conditions
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What is ‘tracking’ of pulmonary function from early life to adulthood ?
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What is the term remodelling in relation to the developmental aspects of lung disease ?
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How does sleep apnoea present ?
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What conditions are associated with sleep apnoea ?
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What is the natural history of sleep apnoea?
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How is sleep apnoea managed ?
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What is another condition which causes excessive daytime sleepiness ?
Narcolepsy
What are some conditions which cause congenital respiratory muscle weakness ?
muscular dystrophy,
motor neurone disease
What are the clinical symptoms of restrictive lung disease ?
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What are the major classes of restrictive lung disease?
occupational,
granulomatous lung disease (sarcoidosis), idiopathic pulmonary fibrosis
What is the natural history of restrictive lung disease?
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What are the functional effects of interstitial lung disease?
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What is the aetiology of diffuse alveolar damage syndrome
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What is the pathogenesis of diffuse alveolar damage syndrome
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What is the aetiology of sarcoidosis syndrome
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What is the pathogenesis of sarcoidosis syndrome
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What is the pathogenesis of hypersensitivity pneumonitis syndrome
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What is the aetiology of hypersensitivity pneumonitis syndrome
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What is the aetiology of idiopathic pulmonary fibrosis syndrome
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What is the pathogenesis of idiopathic pulmonary fibrosis syndrome
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What is the end stage effects of idiopathic pulmonary fibrosis ?
lung fibrosis/honeycomb lung.
How is restrictive lung disease investigated ?
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How is restrictive lung disease managed ?
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What is the pathogenesis of deep vein thrombosis
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What is the pathogenesis of pulmonary embolism ?
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What is the pathogenesis of pulmonary infarction?
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What is pulmonary hypertension ?
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What causes pulmonary hypertension ?
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How is pulmonary vascular disease investigated ? (I.e. Hypertension, embolism)
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How is pulmonary vascular disease Managed ? (I.e. Hypertension, embolism)
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Describe the genetics of cystic fibrosis
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Describe the presenting features of cystic fibrosis
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Define the possible complications of cystic fibrosis
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Outline the management of pancreatic insufficiency (Cystic fibrosis)
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Outline the management of chest infections (Cystic fibrosis)
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Explain the options available for antenatal and post natal screening for cystic fibrosis
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What are the differing issues associated with the management of adult and
paediatric patients with CF?
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What are the social, educational and economic impact of cystic fibrosis on the child
and the family
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What is the the role of transplantation in CF?
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What are emerging CFTR modulator therapies ?
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