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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