Resp Clinical Seminar

Question 1

Acute (4), chronic (2) and both (1) diseases of lung and bronchial tree?

Answer 1

Acute - atelectasis, ALI, pulm vascular disease, pulmonary infection
Chronic - ILD, tumor
Both - obstructive airway disease

Question 2

Causes (7) and signs (6) of upper airway dyspnoea?

Answer 2

Causes - infection, tumor, anaphylaxis, tracheal stenosis, tracheomalacia, goiter, vocal cord dysfunction
Signs - stridor, cyanosis, loss of consciousness, resp. arrest, difficulty swallowing and speaking, dehydration

Question 3

Obstructive airway diseases? (2)

Answer 3

Asthma - hyper responsive airways to irritation causing inflammation and bronchoconstriction
COPD - chronic, persistent and progressive
- bronchitis - inflammation and mucus
- obstructive asthma - hyper responsive
- emphysema - alveolar duct destruction and fibrosis

Question 4

What are the three mechanisms of parenchymal disease?

Answer 4

1. reduce elastic recoil
2. reduce alveolar ventilation
3. reduce diffusion capacity

Question 5

Causes of chest pain (6) and associated features (8)

Answer 5

Causes - pleuritis, croup, foreign body, pneumothorax, pneumonia, cancer, foreign body
Associated features - dyspnoea, cough, hemoptysis, fever, presyncope, weight loss, smoking symptoms, DVT

Question 6

What is ILD?

Answer 6

tissue injury with aberrant healing leading to collagenous fibrosis. Lungs become stiffer with reduced elastic recoil and structural remodelling of alveolilead to reduced alveolar volume and impaired diffusion
Associated with dry cough

Question 7

What are the 4 types of pulmonary vascular disease?

Answer 7

1. Pulmonary infarct
2. Pulmonary hypertension
3. Diffuse pulmonary haemorrhage
4. Pulmonary embolism - reduced perfusion so increased V/Q leading to dead space

Question 8

Causes of irregular breathing? (8)

Answer 8

damage to respiratory centers in brain, mood disorders, illness, infection, fever, hyperthermia, drugs, apnoea

Question 9

List 12 causes for a cough and the associated character of the cough?

Answer 9

1. barking, painful - laryngitis
2. acute, painful - tracheitis
3. intermittent, worse at night - asthma
4. worse in morning - COPD
5. with blood - malignancy
6. dry then productive - pneumonia
7. chronic, very productive - bronchiectasis
8. productive with blood - tuberculosis
9. irritating, dry, persistant - ILD
10. worse lying down, frothy - pulmonary oedema
11. dry, scratchy, persistant - medication induced

Question 10

What are two types of risk assessments for pneumonia?

Answer 10

C - confusion of new onset
U - urea > 7
R - resp rate >30
B - bp
65 - older than 65

S- systolic pressure
M - multilobe involvement
A - albumin
R - resp rate
T - tachycardia
C - confusion
O - oxygen
P - pH