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RCR2 > Respiratory > Flashcards

Respiratory Flashcards

1
Q

5 categories of lung cancer symptoms?

A

Local

Constitutional

Metastatic

Paraneoplastic

Ectopic hormones

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2
Q

Local lung cancer symptoms?

A

Cough

Breathlessness

Haemoptysis

Hoarse voice

Superior vena cava obstruction

Pancoast tumour

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3
Q

Constitutional lung cancer symptoms?

A

Anorexia

Fevers/sweats

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4
Q

Metastatic lung cancer areas?

A

lymph

Brain

Bone

Breast

Liver

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5
Q

Ectopic hormones in lung cancer?

What do they cause?

A

ADH - Hyponatraemia

PTH - hypercalcaemia

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6
Q

What is courtesy stigma?

A

Stigma experienced by association with the person

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7
Q

Stages of stigma formation?

A

People identify and label differences

These differences are linked to negative attributes

Individuals are labelled as distinct

Loss and discrimination by labelled individuals

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8
Q

Two forms of stigma?

A
  1. Felt stigma: shame associated with stigma and fear of exclusion
  2. Enacted stigma: actual rejection/discrimination
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9
Q

What is the mechanism of pathogenesis associated with smoking and the p53 gene?

A

Benzopyrene damages the p53 gene, which is a tumour suppressant gene. This increases the chance of cancer

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10
Q

4 main types of lung tumours?

A

Squamous cell carcinoma

Adenocarcinoma

Large cell undifferentiated carcinoma

Small cell carcinoma

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11
Q

What structures do squamous cell and adenocarcinoma originate in?

A

Squamous cell - bronchial epithelia

Adenocarcinoma - Airway surface epithelium

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12
Q

Clinical definition of chronic bronchitis?

A

Cough productive of sputum for at least three months in two or more consecutive years

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13
Q

Clinical definition of emphysema?

A

Permanent distension of alveoli with destruction of the alveolar septum

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14
Q

What is bronchiolitis?

A

Small airway infection mostly in children, affecting bronchioles, mostly caused by RSV, can lead to fibrosis

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15
Q

4 examples of inflammatory lung disease?

A

Pneumonia

Bronchiectasis

TB infection

Asthma

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16
Q

What is bronchiectasis?

A

Dilatation of the bronchi associated with suppuration and persistent infection

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17
Q

What are the features and causes of bronchiectasis?

A

Features:

  • chronic productive cough
  • exacerbations
  • haemoptysis

Causes:

  • Tumour
  • Enlarged lymph node
  • Post-infection
18
Q

Presentation of pneumonia?

A

Cough
Fever
Dyspnoea

Fatigue
Headache
Myalgia

SIgns:

  • Tachycardia
  • Tachypnoea
  • Hypertension
  • Crepitations
  • Bronchial breathing
19
Q

What causes aspiration pneumonia?

A

Abnormal gag reflex

20
Q

Definitions of sepsis, sever sepsis and septic shock?

A

Sepsis: Two or more SIRS criteria in response to infection

Severe sepsis: sepsis associated with organ dysfunction

Septic shock: sepsis induced hypotension

21
Q

General process of sepsis?

A

There is and injury or trigger that causes an inflammatory response, this leads to endothelial inflammation and a systemic overspill of inflammatory components in the cardiovascular system.

22
Q

Cytokines involved in sepsis/inflammation?

A

TNF-α, IL-1/6/10

23
Q

Signs and symptoms of sepsis?

A

Lowered conscious level

Tachypnoea

Hypoxia

Oliguria/anuria

Tachycardia

Hypotension

Acidosis

24
Q

Organs that fail in sepsis, whats normally the first?

A

Respiratory (normally first)

CVS

GI

Renal

25
Q

Treatment of sepsis?

A

Broad spectrum antibiotics until blood culture then treat with narrow spectrum

26
Q

What is a COPD exacerbation?

A

Acute event characterised by worsening of the patients respiratory symptoms, beyond normal day-to-day variation

27
Q

COPD exacerbation treatment?

A

Controlled oxygen therapy

Nebulisers

Steroids

Antibiotics

Chest physiotherapy

28
Q

What is the FEV1/FVC ratio in COPD?

A

Below 0.7

29
Q

Why do smokers get chronic bronchitis?

A

Mucus gland hypertrophy and hyperplasia

Cilia are damaged, impairing the mucociliary elevator

30
Q

Why do smokers get emphysema?

A

Permanent enlargement of the distal alveoli due to septal damage

Elastin damage leading to premature closing of the airways

31
Q

What systemic effects of smoking lead to cardiovascular disease?

A

Activation of clotting pathways

Raised cholesterol - increased oxidised LDL

Raised blood pressure - effects of nicotine

32
Q

What can be done to support smoking cessation?

A

Nicotine replacement therapy - e.g. gum

Antidepressants

Nicotine receptor partial agonist - champix

Behavioural support

33
Q

Presentation of TB?

A

Cough, weight loss, night sweats

34
Q

Specific treatment for influenza?

A

Neuroaminidase inhibitors

35
Q

What’s atypical pneumonia? Causes?

A

Pneumonia caused by organisms without a cell wall

Legionella, Mycoplasma, chlamydia

36
Q

Interaction of elastase, A1 antitrypsin and smoking?

A

Smoking causes the increased release of elastase, due to inflammation (neutrophil accumulation)

Elastase breaks down the elastin in alveoli

A1 antitrypsin usually breaks down elastase, smoking also reduces the amount of A1 antitrypsin

37
Q

Examples of bronchodilators?

A

B2 agonists - salbutamol

methyl xanthines - theophylline

Antimuscarinics - ipratropium

38
Q

What things would show up too black on a CXR?

A

Pneumothorax

COPD

Air trapping

Cavity containing gas

39
Q

What things would show up too white on a CXR?

A

Consolidation

Collapse

Tumour

Fluid (in pleura)

Interstitial lung disease

40
Q

Examples of restrictive and obstructive lung diseases?

A

Restrictive:

Fibrosis
Chest wall issues

Obstructive:

COPD
Asthma

41
Q

Differences in obstructive vs restrictive lung disease?

A

Obstructive (over inflated lung):

  • Reduced FEV1 and so a reduced FEV1 to FVC ratio

Restrictive (under-inflated lung)

  • Both FEV1 and FVC are reduced and so no ratio change

RCR2 (3 decks)

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