Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Respiratory > Rep I > Flashcards

Rep I Flashcards

(59 cards)

Start Studying
1
Q

Define asthma

A

Episodic, reversible airway obstruction due to bronchial hyper-reactivity to a variety of stimuli

  • Hyper- responsiveness
  • Air flow obstruction
  • Inflammation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Outline the pathophysiology associated with asthma

A

ACUTE

  • Mast cell Ag interaction
  • Histamine release
  • Bronchoconstriction, mucus plugs and mucosal swelling

CHRONIC

  • Th2 cells release IL 3,4,5
  • Mast cell, eosinophil and B cell recruitment
  • Airway modelling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

List the causes of asthma

A
  1. Atopy
    - T1 hypersensitivity
    - Dust mites, pollen, food, animals and fungus
  2. Stress
    - Cold air
    - Viral UTI
    - Exercise
    - Emotion
  3. Toxins
    - Smoking
    - Pollution
    - Drugs ( NSAIDs, B-blockers)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Signs of asthma

A 
Increased RR
Increased HR 
Widespread polyphonic wheeze 
Hyper inflated chest 
Decreased air entry 
Signs of steroid use
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Key features in an asthmatic hx

A 
Precipitants 
Diurnal variation 
Exercise tolerance 
Life effect (sleep, work) 
Home and job environment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Outline the findings that would be seen on lung function tests

A

Spirometry

  • Obstructive pattern c FEV1:FVC = <0/75
  • > 15% improvement in FEV1 with B agonist
  • PEFR monitoring diurnal variation and morning dipping
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Management of asthma

A
  1. SABA as required
  2. low dose ICS
  3. Add LABA to ICS asa combined treatment
  4. Consider increasing the dose of ICS
  5. Add on therapies
    - LTRA (Montelukast)
    - Theophylline
    - LAMA
  6. Oral steriods at the lowest dose possible
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Signs of life threatening asthma

A
  • PEFR <33%
  • SpO2 <92%, PaO2 <8kpa
  • Cyanosis
  • Hypotension
  • Exhaustion, confusion
  • Silent chest with poor resp effort
  • Tachy/Brady/ arrhythmias
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Define COPd

A 
Chronic bronchitis (cough and sputum production on most days) 
Emphysema 
Airway obstruction FEV1<80%, FEV1:FVC<0.72
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Signs of COPD

A
  • Increase RR
  • Hyperinflation
  • Wheeze
  • Cor pulmonale ( increase JVP, loud p2 )

PINK PUFFERs
Normal Po2, normal or low PaCO2
Type I resp failure

BLUE BLOATERs
Retainers, high Co2
Type II resp failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Investigations for COPD

A

CXR

  • Hyperinflation
  • Prominent pulmonary arteries
  • Peripheral oligaemia

ECG
- R atrial hypertrophy, p pulmonale

Spirometry

  • FEV1 < 80%
  • FEV:FVC 0.70
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Management of COPD

A
  1. Stop smoking
  2. Offer pneumococcal and influenza vaccines
  3. Offer pulmonary rehabilitation if indicated

PHARMA

  • Offer either a SABA ( salbutamol) or a SAMA ( ipratorpium)
  • Offer either a LABA (salmeterol) or a LAMA (tiotorpium)
  • Combine LABA and LAMA and ICS
  • If the patients has asthma symptoms that respond to steroid add a ICS prior to adding in a LAMA
  • If the steroid has no improvement revert to LAMA and LABA
  • Also consider mucolyitics like carbocisteine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Guidelines with regards to LTOT in people with COPD

A
  • Serious outflow obstruction FEV1 <30%
  • Cyanosis
  • Polycythemia
  • Peripheral oedema
  • Increased JVP
  • O2 sats <92%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Classify pneumonia

A
  1. Community acquired pneumonia
    - S.aureus, Moraxella, Chlamydia
  2. Hospital Acquired pneumonia
    - >48hrs post admission
    - S aureus
    - grm -ve enterobacteria
  3. Aspiration
    - Anaerobes
  4. Immunocompromised
    - PCP
    - TB
    - CMV/HSV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Sings of pneumonia on CXR

A 
Consolidation 
Decreased expansion 
Dull percussion 
Bronchial breathing 
Decreased air entry 
Crackles 
Pleural rub
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Name and discuss the scoring system for pneumonia

A

CURB-65

  • Confusion
  • Urea > 7mM
  • Resp rate >30
  • BP <90/60
  • > 65 yres
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Abx management of pneumonia

A

CAP

  1. Mild: Amoxicillin 500mg TDS 5 days
  2. Severe: Co-amoxiclav 1.2g TDS

HAP
1. Tazocin (+/- vanco +/- gent)

Aspiration
1. Co-amoxiclav 625mg PO TDS

PCP: Co-trimoxale
Legionella: Clarithromycin + rifampacin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

List the complications of pneumonia

A 
Respiratory failure 
Hypotension 
AF 
Pleural effusion 
Empyema 
Lung abscess (get swinging fevers with a lung abscess)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Describe the pathophysiology of bronchiectasis

A 
Chronic infection of the bronchi or bronchioles leads to permanent dilatation 
Airway damage and recurrent infection 
- H influenza 
- Pneumococcus 
- S aureus 
- Pseudomonas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Causes of bronchiectasis

A 
Congenital 
Post infections (measles, TB)
Immunodeficiency (hypogammaglobulinaemia)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Signs of bronchiectasis

A

Clubbing
Coarse inspiratory crackles
Wheeze
Purulent sputum (pneumococcus) (pseudomonas)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Investigations for bronchiectasis

A 
Sputum MCS 
Blood 
- Se Ig, Aspergillus, RF 
CXR
- Thickened bronchial walls (tramlines and rings) 
Spirometery 
- Obstructive pattern
HRCT 
- Dilated thickened airways
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Management of bronchiectasis

A

Chest physio
Abx for exacerbations (ciprofloxacin 7-10days)
Bronchodilators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Outline the pathophysiology associated with CF

Study These Flashcards
A 
Autosommal recessive condition 
Mutation in the CFTR gene on Chr7 
Defective CFTR protein is unresponsive to cAMP 
Transported of chloride ions is impaired
Decrease in luminal Cl- secretion 
Increase in NA reabsortion 
Results in viscous secretions 
Salty sweat
25
CF is a multi system disease. Outline which systems are involved and how they are affected
Nasal: polyps Resp: wheeze, cough, infections, pneumothorax GI: Pancreatic insufficiency, gallstones, cirrohosis Infertility Low BMI
26
Key organisms that affect CF patients
Early disease - s.aureus - h.influenza Late - P.aeruginosa - b.cepacia
27
Diagnosis of CF
1. Sweat test NA and Cl > 600mM 2. Genetic screening 3. Faecal elastase 4. Immunoreactive trypsinogen
28
Management of CF patients
CHEST - physio - abx for infections - mucolytics (dnase) GI - Creon - ADEK supplements - Insulin - Ursodeoxycholic acid, stimulate biles secretion Gene therapy
29
List the types of lung cancers
1. SCC 2. Adeno 3. Large cells 4. Small cell
30
Discuss the pathology and behaviour of the following lunch cancers 1. SCC 2. Adeno 3. Large cells 4. Small cell
SSC - Centrally located - Keratinisation - Locally invasive - Metastasise late - Secrete PTHrP Adeno - Peripherally located - Glandular differentiation - Mucin production - More common in females - Present with mets Large cell - Large poorly differentiated cells - Poor prognosis Small cell - Central located - Near bronchi - V chemosensitive but v poor prognosis - ectopic hormone secretion
31
Test in the investigations of lung cancer
``` Bloods (BC UEs Ca LFTs0 CXR - Coin lesion - Hilar enlargement - Consolidation - Effusion Contrast enhanced Volumetric CT PET CT Radio nucleotide bone scan Biopsy ```
32
CXR coin lesion differentials
``` Foreign body Abscess Neoplasia Granuloma Structural (AVM) ```
33
Management of lung ca
``` MDT NSCLA - Surgical resection - Curative radiotherapy - Chemo ``` SCLA - Palliative radio - Rx obstruction - Analgesia
34
Complications associated with lung cancer
1. Local - recurrent laryngeal N.palsy - SVC obstruction - Horner's syndrome 2. Paraneoplastic - Endo SIADH Cushings Carcinoid PTHrP - Rheum Polymyositis -Neuro Peripheral neuropathy - Derm Acanthosis nigricans - Metastatic Path # Hepatic failure Addisons
35
Classify pleural effusion and name the classy the criteria used to differentiate between the groups
1. Transudates: effusion protein <25g/L 2. Exudate: effusion protein > 35g/L Between apply Lights Exudate must have one of - serum protein ratio > 0.5 - serum LDH ration > 0/6 - LDH os 0.6 x ULN
36
List the causes of exudates pleural effusion
``` Increased capillary permeability Infection; pneumonia, Tb Neoplasm: bronchial, lymphoma Inflammation: RA, SLE Infarction ```
37
List the causes of transudates
``` Increase capillary hydrostatic or decrease oncotic pressure CCF Renal failure Decrease albumin Hypothyroidism Meig's syndrome - Right pleural effusion - Ascites - Ovarian fibroma ```
38
Presentation of pleural effusion
``` Can be asymptomatic or can present with dyspnoea and pleuritic pain Tracheal deviation Decreased expansion Stony dullness Decrease air entry ``` ``` Beaware of associated disease CA Liver disease RA SLE Hypothyroidism ```
39
Define pulmonary hypertension
PA pressure > 25mmHg
40
List the causes of pHTN
1. Left heart disease - mitral stenosis - mitral regurgitation - l - r shunt 2. Lung parenchymal disease - COPD - Asthma - Interstitial lung disease - CF 3. Pulmonary Vascular disease - Scleroderma - SLE - Wegners - Sickle cell - Portal hypertension
41
Investigations of pHTN
ECG - P Pulmonale - RVH - RAD Echo - Tricuspid regurgitation Right heart catheterisation - Gold standard
42
Define Cor pulmonale
RHF due to pHTN
43
List the signs of cor pulmonate on examination
``` Increased JVP with a wave Left parasternal heave Loud P2 Murmur Pulsatile hepatomegaly ```
44
List the management of pHTN
Decrease pulmonary resistance - LTOT - CCB (nifedipine) - Sildenafil (PDE-5 inhibitors) Cardiac failure - ACEi - Diuretics
45
Classify the different types of pneumothorax
1. Closed Intact chest wall, air leak from the lung to the pleural cavity 2. Open Defect in the chest wall allows communication between the PTX and the exterior 3. Tension Air enters pleural cavity through a one way valve and can't escape
46
List the causes of a pneumothorax
Spontaneous - No underlying disease, seen in young men and smokes - Underlying lung disease such as COPD, marinas, EDS, Trauma Iatrogenic - Central line insertion - PP ventilation - Biopsy
47
Cause of mesothioloma
Asbestos exposure Note prognosis is very poor, presents in a similar way to lung cancer. It is important to notify patients of the compensation scheme that is available to them.
48
Define Goodpastures disease
Acute glomerulonephritis and alveolar haemorrhage Type II antigen-antibody reaction Presence of antiglomerular basement membrane antibodies (Anti-GBM abs) Bind to the kidney basement membrane and the alveolar membrane. Complement cascade is activated Attackes type IV collagen of basement membranes
49
Key investigations for Goodpastures
Bloods - ESR - ANCA-ve - Anti- GBM antibodies (ELISA) CXR - infiltrates pulmonary haemorrhage - patchy consolidation Kidney biopsy - crescentric glomerulonephritis
50
Treatment for Goodpastures
1. Remove circulating abs via plasmapheresis 2. Place on high dose corticosteroids 3. IV methylprednisolone + cyclophosphamide
51
List the potential causes of hypersensitivity pneumonitis
1. Bird's fanciers lung 2. Farmer's and mushroom workers lung 3. Malt workers lung 4. Sugar workers lung
52
Outline the CXR findings in hypersensitivity pneumonitis
Upper zone mottling Hilar lymphadenopathy Honey comb lung in acute cases
53
Classify the different types of lung disease
1. Associated with systemic disease 2. Enviromental triggers 3. Granulomatous disease 4. Idiopathic 5. Other
54
Define sarcoidosis
Multi system granulomatous disorder of unknown cause Mass of macrophages forming giant cells Non caesating
55
Outline the systems affect by sarcoidosis
Pulmonary - Bilateral hilar lymphadenopathy - Cough - Dyspnoea Non pulmonary - Hepatomegaly - Splenomegaly - Conjunctivitis - Cardiomyopathy - Nephrocalcinosis - Enlargement of the paratoid glands - Bell's palsy
56
Outline the radiological staging of sarcoidosis
``` Stage 0: Normal Stage 1: BHL Stage 2: BHL + pulmonary inflitrates Stage 3: as above Stage 4: Progressive pulmonary fibrosis ``` Biopsy will reveal non casting granulomatous
57
Treatment for patients with sarcoidosis
Acute 1. Bed rest 2. NSAIDs Chronic 1. Steroids (prednisalone)
58
Clinical features of pulmonary fibrosis
``` Dry cough Excertional dyspnoea Weight loss Cyanosis Finger Clubbing Fine end inspiratory crackles ```
59
How does rheumatoid arthritis affect the lungs
Pleural adhesions Fibrosing alveolitis Rheumatoid nodules Obliterative disease of the small bronchioles

Respiratory (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions