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1st/2nd Year Revision > Resp Conditions > Flashcards

Resp Conditions Flashcards

1
Q

What is the pathology of asthma?

A

Reversible airway narrowing:
Bronchial muscle contraction
Mucosal swelling
Increased mucous production

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2
Q

What are the symptoms of asthma?

A 
Dyspnoea
Wheeze
Cough
Diurnal variation – typically worse at night
Episodic
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3
Q

What investigations would be done if asthma was suspected?

A

Spirometry

Peak flow

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4
Q

How is asthma treated?

A 
SABA (short acting beta agonist) – salbutamol
ICS low dose
Add LTRA (leukotriene receptor antagonist) – Montelukast
Add LABA
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5
Q

What are the two types of COPD?

A

Emphysema

Chronic bronchitis

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6
Q

What is the pathology of COPD?

A

Emphysema - pink puffers, increased alveolar ventilation, breathless but not cyanosed
Bronchitis - blue bloaters, decreased alveolar ventilation, cyanosed, not breathless

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7
Q

What causes COPD?

A

Smoking

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8
Q

What are the symptoms of COPD?

A 
Cough
Sputum
Dyspnoea
Wheeze
Chest – wheeze, reduced expansion and air entry
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9
Q

What investigations would be done if COPD was suspected?

A 
Spirometry – FEV1/FVC ratio <0.7
CXR – lung hyperinflation 
Sputum culture
ABG – high CO2
ECG
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10
Q

How is COPD managed?

A 
Stop smoking
1 – SABA/SAMA
2 – LABA + LAMA if no asthmatic / steroid response, if they are responsive then LABA + ICS
3 – LABA + LAMA + ICS
4 – nebulisers, oral theophylline
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11
Q

What are the complications of COPD?

A

Acute exacerbations of condition
Respiratory failure
Lung cancer

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12
Q

What is the pathology of pneumonia?

A

Inflammation of lung parenchyma caused by LRTI

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13
Q

What are the different types of pneumonia?

A

Community acquired
Hospital acquired – develops >48hrs after hospital admission
Aspiration

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14
Q

What are the causes of pneumonia?

A

Community – strep pneumoniae, haemophilus influenzae, morexalla catarrhalis
Hospital – staph aureus

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15
Q

What are the symptoms of pneumonia?

A 
Fever
SOB
Cough
Sputum
Haemoptysis
Pleuritic pain
Chest – reduced expansion, consolidation, dull percussion
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16
Q

What investigations would be done if pneumonia was suspected?

A

Sputum culture
CXR – consolidation
Bloods – FBC, U&Es, LFT, CRP

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17
Q

How is pneumonia treated?

A

Antibiotics
Oxygenation
Hydration

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18
Q

What are the complications of pneumonia?

A 
Pleural effusion
Empyema
Lung abscess
Respiratory failure 
Septicaemia
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19
Q

How is the severity of pneumonia assessed?

A 
CURB 65 - 1 point for each
Confusion
Urea >7mmol/l
Respiratory rate >30/min
BP <90/60 mmHg
Age > 65
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20
Q

Type 1 respiratory failure

A

Low PO2, normal PCO2

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21
Q

Type 2 respiratory failure

A

Low PO2, raised PCO2

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22
Q

What are the histological subtypes of lung cancer?

A 
Small cell – 25%
Non-small cell:
Squamous – 35%
Adenocarcinoma – 25%
Large cell – 10%
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23
Q

What are the symptoms of lung cancer?

A 
Cough
Haemoptysis
Dyspnoea
Chest pain
Lethargy
Weight loss
Clubbing
Hoarse voice
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24
Q

What investigations would be done if lung cancer was suspected?

A

CXR – hilar enlargement, peripheral opacity, pleural effusion (unilateral), collapse
Contrast enhanced CT
Biopsy
PET

25
Q

How is lung cancer treated?

A

Non-small cell – surgery (typically lobectomy), radiotherapy if early enough, chemotherapy if later
Small cell – combination radiotherapy and chemotherapy

26
Q

What are the complications of lung cancer?

A 
Recurrent laryngeal nerve palsy
Phrenic nerve palsy
SVC obstruction
Horner’s syndrome (Pancoast tumour)
Syndrome of inappropriate ADH
27
Q

How is lung cancer staged?

A

TNM staging

28
Q

Where does lung cancer commonly metastasise to?

A

Bone
Brain
Liver
Adrenal glands

29
Q

What is the pathology of pulmonary embolism?

A

Thrombus in the pulmonary arteries

30
Q

What typically causes a pulmonary embolism?

A 
Deep vein thrombosis
Risk factors:
Pregnancy
Recent flight
Immobility
Recent surgery
Thrombophilia
31
Q

What are the symptoms of pulmonary embolism?

A 
Sudden onset:
Breathlessness
Pleuritic chest pain
Haemoptysis
Dizziness
Syncope
32
Q

What investigations would be done if a pulmonary embolism was suspected?

A

CT pulmonary angiogram
V/Q scan
D-dimer

33
Q

How is a pulmonary embolism treated?

A

LMWH – dalteparin
Long-term anticoagulation – warfarin, NOAC (apixaban)
Massive PE – thrombolysis

34
Q

What score is used to assess someones risk of a pulmonary embolism?

A

Wells score

35
Q

What is the pathology of a pneumothorax?

A

Air in the pleural space separating the lung from the chest wall

36
Q

What are the causes of a pneumothorax?

A 
Spontaneous
Chronic lung disease
Infection
Traumatic
Carcinoma
Connective tissue disorders
37
Q

What are the symptoms of a pneumothorax?

A

Sudden onset:
Breathlessness
Pleuritic chest pain
Chest – hyper-resonant percussion, reduced expansion

38
Q

How is a pneumothorax investigated?

A

CXR - not if a tension pneumothorax is suspected

39
Q

How is a pneumothorax treated?

A

If no SOB and <2cm rim air then will resolve spontaneously
If SOB and/or >2cm rim air then aspirate
If aspiration fails twice – chest drain
Tension – insert large bore hole cannula into 2nd intercostal space, mid-clavic line then chest drain

40
Q

What is a common finding of a tension pneumothorax?

A

Tracheal deviation

41
Q

What is the pathology of a pleural effusion?

A

Fluid in the pleural space
Transudates <25g/L
Exudates >25g/L

42
Q

What causes a pleural effusion?

A

Transudate (fluid moving across into pleural space) – congestive heart failure, hypothyroidism, hypo-albuminaemia
Exudate (inflammation, protein leaks into space from tissue) – lung cancer, pneumonia, RA, TB

43
Q

What are the symptoms of a pleural effusion?

A

SOB
Pleuritic chest pain
Chest – reduced air entry, dull percussion, diminished breath sounds
Tracheal deviation if massive

44
Q

What investigations would be done if a pleural effusion was suspected?

A

CXR – blunting of costophrenic angle
Ultrasound
Diagnostic aspiration
Pleural biopsy

45
Q

How is a pleural effusion treated?

A

Conservative if small effusion
Drainage – aspiration, drain
Pleurodesis – recurrent effusions

46
Q

Haemothorax

A

Blood in the pleural space

47
Q

Empyema

A

Pus in the pleural space

48
Q

What are the risk factors for contracting tuberculosis?

A

Known contact with active TB
Immigrants from areas of high TB prevalence
Immuno-suppressed

49
Q

What is the causative agent of tuberculosis and how is it stained?

A

Mycobacterium tuberculosis (rod shaped) – Zeihl-Neelsen stain, turns bacteria red on blue background

50
Q

What are the symptoms of tuberculosis?

A 
Asymptomatic
Fever
Weight loss
Night sweats
Clubbing
Cough
Pleurisy
Haemoptysis
51
Q

How is tuberculosis investigated?

A 
Mantoux test – intradermal injection
Interferon-gamma release assays 
CXR
Sputum culture
Nucleic acid amplification test (NAAT)
Biopsy
52
Q

How is tuberculosis treated?

A 
(RIPE)
4 for 2 months:
Rifampicin
Isoniazid
Pyrazinamide
Ethambutol
2 for 4 months:
Rifampicin
Isoniazid
53
Q

What are the complications of tuberculosis?

A

R – irn bru urine, tears, hepatitis, oral contraceptive pill ineffective
I – hepatitis, peripheral neuropathy
P – gout
E – optic neuropathy

54
Q

How is cystic fibrosis inherited?

A

Autosomal recessive

55
Q

What is the pathology of cystic fibrosis?

A

Mutation in CF transmembrane conductance regulator (CFTR) gene on chromosome 7 leading to defective Cl secretion and increased Na absorption across the epithelium

56
Q

What are the symptoms of cystic fibrosis?

A

Neonate – failure to thrive, meconium ileus, rectal prolapse
Children – cough, wheeze, thick sputum production, recurrent infections, pancreatic insufficiency, male infertility, clubbing

57
Q

How is cystic fibrosis investigated?

A

Screened at birth – newborn blood spot test
Sweat test – sweat Na and Cl >60mmol/L
Genetic testing during pregnancy – amniocentesis
Faecal elastase – pancreatic enzyme deficiency

58
Q

How is cystic fibrosis treated?

A 
Chest physiotherapy
Treat infections where they arise
Prophylactic flucloxacillin
Bronchodilators 
CREON tablets if pancreatic insufficiency
59
Q

What are common colonisers of cystic fibrosis?

A

Staph aureus

Pseudomonas aeruginosa

1st/2nd Year Revision (15 decks)

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