respiratory

Question 1

what is cystic fibrosis?

Answer 1

A recessive genetic disorder that affacts the cells that produce mucous, sweat, and digestive juices - these fluids become viscous and thick, plugging up tubes, ducts and airways.

Question 2

how is cystic fibrosis diagnosed?

Answer 2

Via a Guthrie test - heelprick blood test within 48 hours after a baby has been born. This is sent to a lab and then CF is determined. Most people with CF are diagnosed by age 2.

Question 3

what are the complications of cystic fibrosis?

Answer 3

Bowel problems, diabetes, infertility, chronic respiratory failure

Question 4

what are the treatments for cystic fibrosis?

Answer 4

• antibiotics to prevent and treat infections
• inhalers to open airways
• enzymes to help thin mucous
• flu vaccination
• lung transplant
• oxygen therapy
• lung therapy (activity causing deep breathing, clearing airway of mucous).

Question 5

what is tuberculosis and what bacteria causes it?

Answer 5

An infectious disease caused by myobacterium tuberculosis

Question 6

how is tuberculosis spread?

Answer 6

Via the air when people cough/spit/speak/sneeze. It is sensitive to ultraviolet light, stays suspended in air for 2 hours, multiplies in the alveoli.

Question 7

how is tuberculosis diagnosed?

Answer 7

Via chest x-rays and body fluid cultures.

Question 8

what is the quantiferon gold test?

Answer 8

Gold standard test for diagnosing Tuberculosis. A blood test used to diagnose myobacterium tuberculosis infection.

Question 9

what are the advantages and disadvantages of a quantiferon gold test for tuberculosis?

Answer 9

advantages:
- Single blood sample required
- Results within 24 hours
- Does not boost reponses

disadvantages:
- Blood samples must be processed within 16 hours
- Limited data of use of test on patients under 17 years of age.
- False positive results can occur

Question 10

what are tuberculosis symptoms?

Answer 10

Night sweats, anorexia, coughing up blood/mucous, low grade fever

Question 11

what is the treatment for tuberculosis?

Answer 11

Combination of four antibacterial drugs - these can cause body fluids to go orange. Completing treatment is essential. They often need to be taken for 6 to 12 months.

Question 12

when should you use oxygen therapy?

Answer 12

(1) Hypoxemia (low oxygen levels)
(2) anytime tissues may be at risk for decreased O2 delivery, e.g. trauma, post-surgery, MI, asthma

Question 13

what are the four types of oxygen masks?

Answer 13

1. Simple mask
2. venturi mask
3. highflow humidified masks
4. high concentration reservoir masks

Question 14

What are simple masks used for and how much O2 should flow through them?

Answer 14

They are used for acute hypoxemia (asthma, LVF, shock, PE, trauma, pneumonia etc), should not be used at less than 4L/min - ideally 5-6L/min.

Question 15

What are nasal cannulas and what are they used for? How much O2 should flow out of them?

Answer 15

They are used for MILD hypoxemia, should not be over 4L/min, useful for chronic o2 administration. Flow rates should be 1L/min (24%), to 3L/min (40%)

Question 16

What are venturi masks, what are they used for, and how much O2 should flow?

Answer 16

Oxygen is delivered at fix flow rate (6-8L/min) into the mask - there is a hole on the side of the mask to mix with diluted o2 - useful for patients at risk of Co2 retention.

Question 17

What are high flow humidified circuits?

Answer 17

Used in critical patients that require high concentration of O2 and humidification of gases. Up to 30L/min.

Question 18

What are non-rebreather masks and what are they used for?

Answer 18

A 750ml reservoir bag is added to the system to increase the amount of pure O2 the patient breathes. Flow rate should keep bag inflated - rates are 10-15L/min (60-90% oxygen).

Question 19

How do you monitor o2 rates and what are the acceptable values?

Answer 19

With a pulse oximeter - measures oxygen concentration in the blood. Aim for saturations above 91%, preferrably above 98%. For those with COPD/resp failure aim for 88-92%.

Question 20

Patients with COPD should never be given more than …% oxygen.

Answer 20

28%.

Question 21

what is COPD

Answer 21

a chronic inflammatory lung disease that causes obstructed airflow from the lungs.

Question 22

how do you test for COPD

Answer 22

The main test for COPD is spirometry. Spirometry can detect COPD before symptoms are recognized. Spirometry can assess many important aspects of lung function by measuring airflow and the corresponding changes in lung volumes. The spirometer records inspiratory and expiratory lung volumes, and how fast a patient can inhale/exhale.

Question 23

what are treatments for COPD

Answer 23

medications such as:
1. beta- agonists- stimulate bronchodilation
2. anticholinergics- prevent bronchoconstriction therefore allowing bronchodilation
3. corticosteroids- anti inflammatory
4. oxygen- to mainatin adequate oxygen saturation
5. inhaler

Question 24

signs and symptoms of COPD

Answer 24

• barrel chest
• chronic cough
• pursing lips
• SOB
• laboured breathing
• finger clubbing
• blue tinged lips

Question 25

what is pneumonia

Answer 25

Pneumonia is an infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus (purulent material), causing cough with phlegm or pus, fever, chills, and difficulty breathing. A variety of organisms, including bacteria, viruses and fungi, can cause pneumonia.

Question 26

what are treatments for pneumonia

Answer 26

antibiotics are the most common treatment

Question 27

what are tests for pneumonia

Answer 27

• chest x-ray
• blood tests

Question 28

what is Tension Pneumothorax?

Answer 28

is accumulation of air in the pleural space under pressure, compressing the lungs and decreasing venous return to the heart. It can result in the lungs collapsing and is life threatening.

Question 29

what are tests for Tension Pneumothorax

Answer 29

• chest x-ray
• CT scan
• arterial blood gas

Question 30

what is treatment for Tension Pneumothorax

Answer 30

immediate needle decompression by inserting a large needle into the second intercoastal soace in the midclavicular line. Air will usually gush out.