resp stuff to memorise Flashcards
define bronchiolitis and extra info
inflam of bronchioles, RSV, common in winter, infants under 1
coryzal symptoms ? (bronchiolitis)
runny/snotty nose
sneezing
mucus in throat
watery eyes
how to monitor resp distress
capill blood gas (arterial to look at blood gas)
manage bronchiolitis
supportive
adequate intake - nasogastric tube, orally, IV fluids
saline nasal drops to clear way for feeding
suppl oxygen
ventilation if severe
what you’d hear from chest in bronchiolitis
whistling due to airway narrowing
wheeze, crackles, harsh breath sounds
what causes grunting and stridor
grunting - exhaling with glottis closed
stridor - high pitch inspiration due to upper airway obstruction
prophylaxis for bronchiolitis
monthly injection of palivizumab - monoclonal antib targets RSV - passive protection (doesnt stim immune sys like a vaccine would)
3 brackets of causes of bronchiectasis - 2 causes of each
chronic inflam: - CF auto recess - mucus too sticky/hard to move - prim ciliary dyskinesia auto recess - cilia move abnormally airway obstruct: - tumour - lodged foreign object infection: - TB - haemophilius influenzae - staph aureus
define bronchiectasis
chronic inflam and dilation of bronchioles = destruction of airways
damage to mucocilliary ‘elevator’ = mucus and bacteria accumulate - excessive mucus production
how is mucus normally cleared
mucocilliary ‘elevator’ moves it up and out of resp tract via cilia
cl- channels pump out ions which attracts water = keeps them lubricated/moving
sign of long term hypoxia
finger clubbing
signs/symptoms of bronchiectasis
wheeze prod cough fouls smelling mucus haemoptysis dyspnea recurrent pneumonia basilar crackles
diag bronchiectasis
CT scan - will show dilation
CXR
sputum culture
spirometry - reduced ratio aka obstruction
treat bronchiectasis
bronchodilator eg. beta 2 agonist
inhaled corticosteroid
atib for pneumonia
percussion/postural drainage
pleural effusion?
collection of fluid in pleural cavity (between lung and chest wall)
exudative?
high protein count above 3g
protein moves out of tiss into pleural space
transudative?
low protein count below 3g
fluid moving across pleural space
pres of pleural effusion
SOB, dullness to percussion (no air), reduced breath sounds, tracheal deviation - fluid has pushed mediastinum
investigate pleural effusion
CXR - blunting of costophrenic angle, mediastinal and tracheal deviation
pleural fluid aspiration/chest drain - can check protein
small vs large pleural effusions managements
conservative if small
if large: aspirate (needle thru chest wall which may need to be repeated) or drain (prevent reoccurence)
empyema - what is it, investig, treat?
infected pleural effusion eg patient has improving pneumonia but ongoing fever
aspirate would show pus, low ph, low gluc, high LDH
treat w chest drain and beta lactam with beta lactamase inhib eg. amoxicillin and Clavulanic acid
3 key conseq of CF
thick pancreatic and biliary secretions - lack of digestive enzymes eg. pancreatic lipase due to blockage of ducts
low volume thick airway secretions - reduced airway clearance, bacteria colonisation, susceptible to airway infections
congenital bilateral absence of vas deferens in men - sperm cannot get into ejaculate so infertility
lack of pancreatic lipase presence in CF leads to…
malabsorption = weight loss, short AKA FTT, loose greasy stool
