Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Phase 2a Revision > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Asthma & Pathophysio

A

Episodic, chronic inflammatory disorder of the airways.

  • Narrowing of airway → Due to smooth muscle contraction, thickening of airway wall by cellular infiltration & inflammation & secretions in lumen.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Asthma Risks

A
  • Cold air
  • Emotion
  • Allergens
  • NSAIDs / Beta - Blockers
  • Smoking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Asthma Signs & Symptoms

A
  • Cough (worse at night & morning)
  • Dyspnoea
  • Wheeze/ Chest tightness
  • Spit clear sputum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Asthma Investigations

A

Spirometry:
→ Obstructive defect (decreased FEV1/ FVC, increased residual volume)
→ >1% improvement in FEV1 after Beta-2 agonists.

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

Acute Asthma Management

A
  • Short acting beta 2 agonist = Salbutamol
  • Inhaled corticosteroid = Beclometasone
  • Leukotriene receptor antagonist = Montelukast
  • Long acting beta 2 agonist =Salmeterol
  • Maintenance & Reliever Therapy
  • Long acting muscarinic antagonist = Tiotropium
  • Theophylline
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Asthma long- term management

A

Children & Adults:

SABA → SABA + ICS → SABA + ICS + LTRA → SABA + ICS + LABA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

COPD

A

Chronic bronchitis & emphysema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

COPD Symptoms & Signs

A

→ Productive cough (Smoker’s cough)
→ Dyspnoea
→ wheeze
→ Severe RHF → Peripheral Oedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

COPD Investigations

A
  • Obstructive Iung disease - FEV 1 / FVC < 0.7
  • CXR - hyperinflation, bullae, flat hemidiaphragm, exclude malignancy
  • Spirometry
  • FBC - exclude polycythaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Acute COPD management

A

Bronchodilation & Oxygen

Oral Prednisolone or IV Hydrocortisone (if severe)

CPAP before intubation & ventilation

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

When to give Long- term Oxygen COPD

A
  • FEV1< 30% Predicted
  • Cyanosis
  • Polycythaemia
  • Raised JVP
  • Peripheral oedema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Pneumothorax + Risks

A

Collapsed lung when air enters Pleural cavity.

Risks:

  • COPD
  • Smoking
  • Trauma
  • Genetics/ Fx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Pneumothorax Symptoms

A
  • Dyspnoea
  • Chest pain
  • Tachycardia
  • Tachypnoea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Pneumothorax Management

A

Primary

  • <2cm Discharge
  • Aspiration
  • Chest Drain

Secondary

  • <1cm O2 & admit
  • 1-2 cm Aspirate
  • > 2cm Chest drain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Tension Pneumothorax

Tx

A
  • Compression of lung
  • RHF

Tx = Chest drain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

TB

A

Disease caused by mycobacterium - small rod shaped acid fast bacilli
(Has waxy coating which makes gram staining ineffective)
- Caseating Granulomas

→ Active TB: Active infection
→ Latent TB: Immune system stops progression of disease - this reactivates to become 2° TB.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

TB
Sx

I×

Tx

A

Sx: Fever, Night sweats, Weightloss, cough with/out blood, Erythema nodosum

Ix:

  • Ziehl- Neelsen
  • Chest X-Ray= Ghon complex, hilar lymphadenopathy, Pleural effusion
  • Mantoux test

Tx: Rifampicin, Isoniazid, Pyrazinamide, Ethambutol

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

Cystic Fibrosis

A

Autosomal Recessive

Defect in CFTR gene (which regulates movement of salts across epithelial cell membranes - this means secretions are thicker & stickier)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Cystic Fibrosis Symptoms

A
  • Neonatal jaundice
  • Recurrent chest infections → cough, fever
  • Struggling to cough something up
  • thick greasy stools
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Cystic Fibrosis Investigations

A
  • Newborn = Heel prick

- Older = Sweat test → High chloride

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Cystic Fibrosis Management

A
  • Chest drainage
  • High calorie, high fat diet
  • Minimise contact with infective patients
  • Pancreatic supplementation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Bronchiectasis

A

Permanent dilation of airways.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Bronchiectasis Causes

A

→ Post-infection - after TB/ Pneumonia
→ Cystic Fibrosis
→ Immunodeficiency - AIDS
→ Airway obstruction

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

Bronchiectasis Symptoms

A

→ Dyspnoea
→ Cough
→ Hamoplysis
→ Recurrent chest infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Bronchiectasis Investigations

A
  • Chest X. Ray: Kerby B Lines
  • Coarse crackles in inspiration, wheezing
  • Sputum - H.influenzae (most common)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Bronchiectasis Management & Complications

A

→ Physiotherapy
→ Healthy diet
→ Prophylactic antibodies

Cx: Emphysema, Pneumothorax, Resp. failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Lung Cancer Risks

A
  • Cigarette smoking
  • Asbestos, Arsenic, Iron oxide
  • Pulmonary Fibrosis
  • Genetic factors
28
Q

Lung Cancer Types

A 
Non-Small cell:
→ Adenocarcinoma
→ Squamous Cell carcinoma
→ Large cell & differentiated carcinoma
→ Carcinoid tumours

Small Cell

29
Q

Adenocarcinoma Lung Cancer

A
  • Primary Lung Cancer
  • Most common cell type in non-smokers
  • Originates from mucus- secreting glandular cells
30
Q

Squamous cell carcinoma

A

Most common in smokers

Arises from epithelial cells typically in the central bronchus.

31
Q

Carcinoid tumours & Small cell Lung canoers

A

Release neuroendocrine hormones ACTH → Paraneoplastic syndrome

32
Q

Cancer that Spreads to lungs from:

A 
→ Breast
→ Colon
→ Prostate
→ Sarcoma
→ Bladder
33
Q

Common site of metastasis

A

→ Liver
→ Bone
→ Brain
→ Adrenal glands

34
Q

Lung Cancer Symptoms

A 
Local disease:
→ Persistant cough
→ Shortness of breath
→ Haemoptysis
→ Weight loss

Metastatic disease:

  • Bone pain
  • Abdo. pain
  • Seizures, neuro deficit
35
Q

Lung Cancer Paraneoplastic changes

A
  • Increase PTH → Hyperparathyroidism → Hypercalcaemia → Stones, Bones, Groans, Psychic moans
  • Increase ADH → SIADH → Hyponatraemia → Nausea+ Vomiting → Weakness, Cramps, Tremor, Confusion
  • Increase ACTH → Cushing’s Syndrome → Mood changes, Moon face, Central fat, Buffalo hump, Proximal weakness
36
Q

Lung cancer Extrapulmonary manifestations

A
  • Recurrent laryngeal nerve palsy - hoarse voice
  • Superior vena cava obstruction - facial swelling, Pemberton ‘s sign
  • Horner ‘s syndrome - ptosis, miosis
37
Q

Lung Cancer Investigations

A

CXR - Opacified lesion, hilar enlargement, pleural effusion
Percutaneous or Bronchoscopic biopsy + histology

CT chest abdo pelvis
PET - CT
Bronchoscopy

38
Q

Lung Cancer Treatment

A

Surgery= lobectomy, segmentectomy, wedge resection

Radiotherapy

Chemotherapy

Palliative care - tracheal stenting or debulking

39
Q

Pleural Effusion

A

Collection of fluid in the pleural cavity, the space between Parietal & visceral pleura.

40
Q

Pleural effusion Pathophysiology

A

→ Exudative = High protein count (3g/L)
Related to inflammation, causes fluid + protein to leak out of capillaries into pleural space.
Cause: Lung cancer, Pneumonia, TB, RA

→ Transudative = Low protein count (3g/L)
Related to Fluid moving across into the pleural space.
Cause: Congestive HF, Fluid overload, Hypoalbuminemia

41
Q

Pleural effusion Symptoms

A
  • Dyspnoea
  • Cough
  • Stony duII percussion over effusion
  • Reduced breath sounds
  • Tracheal deviation away from effusion
42
Q

Pleural effusion Investigations

A

CXR

  • blunting of costophrenic angle
  • fluid in lung fissures
  • meniscus
  • Tracheal & mediastinal deviation
43
Q

Pleural effusion treatment

A

Fluid overload or Congestive HF - Diuretic

Infective - Antibiotics

large effusions - Aspiration or Drainage

44
Q

Whooping Cough

A

Upper respiratory tract infection caused by Bordetella pertussis (Gram -ve).

45
Q

Whooping Cough Symptoms

A
  • Mild coryzal symptoms, low grade fever
  • Paroxysmal cough - Sudden & recurrent attacks of coughing
  • large, loud inspiratory whoop
  • apnoeas (infants)
46
Q

Whooping Cough Diagnosis

A
  • Nasopharyngeal Or Nasal swab with PCR testing Or bacterial culture
  • Anti - pertussis toxin immunoglobulin G
47
Q

Whooping Cough Management

A
  • Public health should be notified
  • Macrolide antibiotics such as Azithromycin, Erythromycin & Clarithromycin
  • Or Co - trimoxazole
  • Give prophylactic antibiotics (for vulnerable group)
48
Q

Bronchiolitis

A

Inflammation & infection in the bronchioles

Caused by Respiratory Syncytial Virus
(usually occurs in children under 1

49
Q

Bronchiolitis Symptoms

A

Coryzal Symptoms : Snotty nose, Sneezing, Watery eyes, Mucus in throat

  • Respiratory distress = high respiratory rate, use of accessory muscles
  • Dyspnoea
  • Tachypnoea
  • Wheeze & crackles
50
Q

Bronchiolitis Airway Noises

A
  • Wheezing
  • Grunting
  • Stridor
51
Q

Bronchiolitis Management

A
  • IV / NG tube fluids
  • Saline nasal drops & nasal suctioning
  • Supplementary Oxygen
  • Ventilatory Support

→ Palivizumab (monoclonal antibody that targets RSV

52
Q

Interstitial Lung Disease (ILD)

A

Conditions that affect lung Parenchyma (Tissue) causing inflammation & Fibrosis.

Fibrosis = lung tissue replaced with scar tissue

53
Q

ILD Diagnosis

A

High resolution CT scan of thorax
- shows ground glass appearance

Lung biopsy & histology

54
Q

ILD Management

A
  • Home Oxygen
  • Stop smoking
  • Physiotherapy & pulmonary rehab.
  • Pneumococcal & flu vaccine
  • Lung transplant
55
Q

Sarcoidosis

A

Noncaseating Granulomatous inflammatory condition.

Granulomas are nodules of inflammation full of macrophages.

56
Q

Sarcoidosis associated diseases

A

Mediastinal / bilateral hilary lymphadenopathy

TB

Hodgekin lymphoma

Heart failure

57
Q

Sarcoidosis tests

A

Histology from biopsy

FBC:

  • Raised serum ACE
  • Hypercalcaemia
  • Raised serum soluble interleukin-2 receptor
  • Raised CRP
  • Raised Ig

Imaging:
chest X- Ray → shows hilar lymphadenopathy

58
Q

Sarcoidosis Management

A

Corticosteroids

Oxygen

Lung transplant

Hydroxychloroquine

59
Q

Sarcoidosis Symptoms

A

Lofgren ‘s Triad:

→ Erythema Nodosum

→ Bilateral Hilar Lymphadenopathy

→ Polyarthritis (joint pain)

→ Uveitis

  • Weight loss
60
Q

Pulmonary Hypertension

A

Increased resistance & pressure of blood in the pulmonary arteries.

This causes strain on the right side of the heart, this causes back pressure of blood into systemic venous system.

61
Q

Causes of Pulmonary Hypertension

A

1) Primary P.H or Connective tissue disease e.g. SLE
2) Left Heart Failure due to MI or systemic hypertension
3) COPD
4) Pulmonary Embolism
5) Miscellaneous - Sarcoidosis, Glycogen storage disease

62
Q

Pulmonary hypertension Symptoms

A

Shortness of breath

  • Syncope
  • Tachycardia
  • Raised JVP
  • Hepatomegaly
  • Peripheral oedema
63
Q

Pulmonary hypertension Investigations

A

ECG Changes:
→ Right ventricular hypertrophy ( large r waves on V1-3 & S waves on V4-6 )
→ Right axis deviation
→ Right bundle branch block

CXR:

  • Dilated pulmonary arteries
  • Right ventricular hypertrophy
64
Q

Pulmonary hypertension Management

A
  • IV Prostanoids (e.g. Epoprostenol )
  • Endothelin receptor antagonists (e.g. macitentan)
  • Phosphodiesterase - 5 inhibitors (e.g. sildenafil)
65
Q

Pancoast Tumour

Sx

Ix

Tx

A

Cancer at apex of lung.

Sx: Horner’s Syndrome - droopy eyelid, Pupil constriction, lack of sweat on left side of face. (Due to compression of sympathetic nerve Pathway.), Weakness, Shoulder blade pain

Ix: Imaging & biopsy

Tx: Chemo, Radio., Surgery

66
Q

Haemophilus Influenza

A
  • Gram -ve Coccobacillus

Sx: Cough up green phlegm, Fever, malaise

Ix: CURB - 65 (Confusion, Urea, Resp. rate, BP, Age > 65)

Tx: Co- amoxiclav, Doxycycline

67
Q

Pleural Effusion & Pneumothorax

Diff. in Resp. exam & Hx

A

Resp. Exam:

  • P.E= dullness on percussion
  • Pneumo.= hyper - resonant on percussion

Hx:

  • P.E= Slower onset, PMH of heart failure, cancer
  • Pneumo.= Rapid onset, Hx. of trauma / Pneumothorax

Phase 2a Revision (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions