Respiratory Flashcards
main respiratory symptoms
breathlessness
wheeze
cough
sputum production
chest pain
what is sputum?
Mucus and other matter brought up from the lungs by coughing
what is pneumonia?
inflammation of the lungs, usually caused by an infection
symptoms of pneumonia
cough
sputum production
sometimes haemoptysis
pleuritic chest pain
breathlessness
fever, sweats, rigors
malaise
what is haemoptysis?
Sometimes there is blood in the sputum and that symptom is called haemoptysis
causative organisms of pneumonia
streptococcus pneumoniae
haemophilus influenzae
mycoplasma pneumoniae
how would you manage pneumonia?
ABDCE approach
CRB65 score
Antibiotics
what is the CRB65 score?
CRB 65 - C - confusion
R - respiratory rate
B - blood pressure
This is to find out the risk of patient having pneumonia
what score in the CRB 65 states low risk?
0
what score in the CRB 65 states intermediate risk?
1 or 2
what score in the CRB 65 states high risk?
3 or 4
what is obstructive sleep apnoea?
breathing stops and starts during sleep due to obstruction of pharynx
sleep interrupted many times during the night
unrefreshing sleep, headaches, poor memory
risk factors of obstructive sleep apnoea
male>female
overweight/obesity
small airway, small lower jaw, large tonsils
diagnosis of obstructive sleep apnoea
symptom assessment - epworth sleepiness scale
sleep study
what is pneumothorax?
when the lung lining punctures and air escapes into the pleural space
symptoms of pneumothorax
pleuritic chest pain
breathlessness
may cause collapse and cardiac arrest
management of pneumothorax
admission for assessment
may need chest drain to allow lung reinflation
what is interstitial lung disease?
a group of about 100 chronic lung disorders characterized by inflammation and scarring that make it hard for the lungs to get enough oxygen.
examples of interstitial lung disease
idiopathic pulmonary fibrosis
extrinsic allergic alveolitis
what can interstitial lung disease lead to?
lung scarring and fibrosis
symptoms of interstitial lung disease
breathlessness, often progressive
cough
treatment for interstitial lung disease
depends on cause
specialist respiratory clinic for management
what is cystic fibrosis?
Autosomal recessive genetic disease in which the lungs and digestive system can become clogged with thick, sticky mucus
what is pulmonary embolus
occurs when a blood clot gets stuck in an artery in the lung, blocking blood flow to part of the lung
what is Deep Vein Thrombosis (DVT)?
Deep vein thrombosis (DVT) is a condition in which a blood clot develops in the deep veins, most commonly in the lower extremities
treatment for pulmonary embolus
anticaogulants
what is asthma?
Asthma is a common lung condition that causes occasional breathing difficulties.
inflammatory and allergic condition
symptoms of asthma
wheeze
breathlessness
cough
peak flow recording (PEFR) for moderate acute asthma
50-75%
peak flow recording (PEFR) for acute severe asthma
33-50%
peak flow recording (PEFR) for life threatening asthma
<33%
how would you treat moderate acute asthma?
give salbutamol and reassess
how would you treat acute severe asthma?
phone 999
give salbutamol
give oxygen
how would you treat life threatening asthma?
phone 999
give salbutamol
give oxygen
In detail how would you manage a medical emergency acute asthma attack in your surgery?
ABCDE approach
give salbutamol inhaler - 2 puffs with spacer - if patient does not respond satisfactorily phone 999
high flow oxygen
send someone for AED
give salbutamol 5mg nebuliser or 2-10 puffs via spacer
if part of an anaphylactic reaction, give IM adrenaline
repeat salbutamol every 10 mins
write a handover note to hospital
how could unstable asthma be managed
steroids
oral side effects of inhaled therapy
candidiasis
altered taste
dry mouth
what are the markers of acute severe asthma?
PEFR 33-50%
respiratory rate >25 per minute
heart rate >110
inability to complete sentences in one breath
what dose of salbutamol inhaler should you give in an acute asthma attack in your dental surgery?
initially 2 puffs via MDI
If does not respond satisfactorily then call 999, high oxygen flow, salbutamol 5mg nebulized or 2-10 puffs via MDI
Oral side effects of salbutamol
oral and throat irritation
oral side effects of inhaled corticosteroids
oral candidiasis, altered taste, altered voice
oral side effects of leukotriene receptor antagonists (montelukast)
dry mouth
oral side effects of long acting muscarinic agonists (tiotropium)
dry mouth, dysphonia, altered taste
oral side effects of oral corticosteroids
oral candidiasis
what is COPD?
Chronic Obstructive Pulmonary Disease
airway obstruction that is not fully reversible
progressive overtime
caused by smoking mostly or air pollution
how is COPD diagnosed?
history
exam
spirometry
symptoms of COPD
breathlessness
wheeze
chronic cough and sputum production
frequent infections (stagnant mucous)
COPD management
smoking cessation
pulmonary rehabilitation
vaccination - reduce chance of flu etc
what are the 4 main medications used for COPD?
SABA
LABA
LAMA
ICS
what is SABA?
salbutamol or terbutaline
what is LABA?
formoterol, salmeterol, vilanterol
what is LAMA?
tiotropium, glycopyrronium, aclidinium
what is ICS?
Beclomethasone, fluticasone
how would you manage acute breathlessness in a person with COPD in your surgery?
ABCDE approach
salbutamol 2 puffs via spacer
oxygen to maintain sats 88-92
may need to be hospitalised
how is COPD different to asthma?
irreversible airway obstruction
chronic cough is common
persistent and progressive breathlessness over time
aetiology is usually inhalation of toxins (smoking, air pollution)
