Resp Flashcards
What Sx should NOT appear in COPD?
Clubbing
Haemoptysis
Chest pain
If patient presents with these, think lung cancer, pulmonary fibrosis or HF
Describe Type 1 Resp failure
Give an example
↓pO2
+
↓ / normal CO2
e.g. Pulmonary embolism!
Describe Type 2 Resp failure
Give an example
↓pO2
+
↑pCO2
e.g. Hypoventilation
Restrictive Resp Disease failure figures
FEV1/FVC > 0.7
FEV1 & FVC both below 80% of predicted value
Example of restrictive resp failure
Sarcoidosis
Pulmonary fibrosis
Goodpasture’s
Obstructive resp disease figures
FEV1/FVC < 0.7
FEV1 < 0.8
Example of Obstructive resp failure
Asthma
COPD (but copd can be both)
CF
Bronchiectasis
Why is restrictive FEV1/FVC > 0.7 ?
SMALL lung vol
∴ most of breath exhaled in first second of expiration (FEV1)
Pathophysiology Restrictive resp failure
V/Q mismatch
Pathophysiology Obstructive Failure
More mucus
∴ Lumen blockage
∴ Air can’t get out
What is Chronic Obstructive Pulmonary disorder?
Disease state of airflow limitation that is NOT fully reversible
Quick!
Haemoptysis + Haematuria simultaneously!
What is it?
Goodpasture’s disease
Type 1 Resp failure - which is it?
Restrictive
Type 2 Resp failure - which is it?
Obstructive
Typical patient of COPD and how they present
What would instantly make you think of another obstructive disease instead?
Older man
Long pack history
Chronic productive cough
Constantly for 2+ years
Often get chest infections
NO DIURNAL VARIATION
Resp failure =?
HYPOXAEMIA w/ systemic effects
+/- hypercapnea
3 types of COPD
Chronic Bronchitis
Emphysema
Alpha-1 antitrypsin deficiency
Pathophysiology Chronic Bronchitis
- Hypertrophy and hyperplasia of mucous glands (happens in response against cigarette smoke)
- Chronic inflamm cells in bronchial walls causes luminal narrowing
∴ MORE mucus + inflamed bronchi + narrow lumen
Pathophysiology Ephysema
Destruction of elastin layer of the bronchioles/alveoli etc
Causes distal air trapping - (can form Bullae)
Types of emphysema
acinar thing idk what it is look it up
Can be centricinar (resp bronchioles only) - Smokers, v common!
OR panacinar - (resp bronchioles, alveoli, alveoli sacs), AAAT def, severe
COPD in a < 40 year old with no/little smoking history
What is the cause?
COPD - Alpha-1 antitrypsin deficiency
Describe the MRC Dysnpnoea score
1 - SOB on marked exertion
2 - SOB on hills
3 - slows down or stop on flat
4 - exercise tolerance is 100-200 yards on flat
5 - housebound, can’t get dressed without SOB
Chronic Bronchitis is associated with what?
BLUE BLOATER
Chronic purulent cough
Dyspnoea
Cyanosis - BLUE
Obesity
Emphysema is associated with what?
PINK PUFFER
Weight loss
Breathless, pursed lips
Muscle wasting
Pursed lips
Emphysematous - PINK
Maintained pO2