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respiratory Flashcards

1
Q

what is stertor?

A

hot potato speech due to nasopharyngeal or orophrarangeal blockage

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2
Q

cause of biphasic stridor?

A

tracheal narrowing

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3
Q

cause of inspiratory stridor?

A

narrowing at vocal cords

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4
Q

what does wheeze on waking indicate?

A

COPD

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5
Q

what is wheeze?

A

high pitched whistling from upper airways

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6
Q

why is sputum green?

A

dead neutrophils release veroperoxidase

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7
Q

what colour sputum will a patient with COPD and infection produce?

A

in the morning-green from dead stagnated neutrophils, it will become yellow throughout the day as more live ones are coughed up

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8
Q

what is red sputum an indicator of

A

pneumococcal pneumonia

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9
Q

causes of clubbing

A

cardiac-IE -congenital cyanotic disorders
respiratory-bronchiectasis -TB -neoplasm -sarcoidosis -IPF -empyema
GI-IDB -PBC -achalasia -liver cirrhosis
familial

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10
Q

how might a patient describe dyspnoea?

A

hard to get enough air in
short of breath
tiredness

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11
Q

what is dyspnoea?

A

unecessary awareness of breathing

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12
Q

cardiac causes of dyspnoea

A 
heart failure
MI
cardiomyopathy
constrictive pericardits
pericardial effusion
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13
Q

respiratory causes of dyspnoea

A 
asthma
COPD
bronchiectasis
fibrosis
tumour
sarcoidosis
alveolitis
pneumonia
PE
pulmonary HTN
pneumothorax
pleural effusion
ank spond
kyphoscoliosis
myasthenia gravis
Guillian Barre syndrome
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14
Q

if dyspnoea was sudden onset (minutes), what is a likely diagnosis?

A 
PE
pneumothorax
pleural effusion
asthma
inhaled foreign body
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15
Q

what is orthopneoa often a sign of?

A 
left ventricular failure and less commonly:
r muscle weakness
pleural eff
massive ascites
morbid obesity
GORD
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16
Q

onset of dyspnoea from hours to days

A

asthma
pneumonia
COPD exacerbation

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17
Q

dyspnoea onset weeks to months

A

anaemia
PE
neuromuscular disorders

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18
Q

dyspnoea onset months to years

A

COPD
pulmonary fibrosis
pulmonary TB

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19
Q

breathlessness RELIEVED by lying down

A

platypnoea from R>L PFO

ASD

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20
Q

dyspnoea on waking is associated with?

A

asthma

left ventricular failure

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21
Q

what is breathlessness on waking associated with?

A

COPD-SOB that wakes is more typical of asthma

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22
Q

what symptoms should you ask about if someone presents with SOB?

A

chest pain
wheeze
cough

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23
Q

where does pleural pain localise

A

if originates above 6th rib, it’s localised
if below 6th rib-referred to upper abdo
if over the diaphragm, it’s referred to shoulder tip or neck

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24
Q

causes of pleuritic chest pain?

A

pneumonia
pleural effusion
pulmonary embolism
fractured ribs

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25
Q

describe the chest pain in lung cancer

A

dull, aching, progressive, unrelated to breathing, disrupts sleep

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26
Q

what is Pancoast’s tumour?

A

a tumour in the apex of the lung that compresses the brachial plexus and causes pain down medial side of arm

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27
Q

reterosternal, raw, burning pain, worse on coughing

A

mediastinum pain caused by irritants or infection of trachobronchial tree

28
Q

central chest pain?

A

MI or massive PE causing increased pressure in RV

29
Q

define tachypnoea

A

over 25 b/min

30
Q

causes of tachypnoea

A 
fever
acute asthma
COPD exac
pneumonia
pul oedema
interstitial lung disease
31
Q

define bradypnoea and give causes

A

under 10 b/min
opioid toxicity
hypothryoidism
raised ICP

32
Q

causes of painless breathlessness

A 
PE
pneumonia
pneumothorax
metabolic acidosis
hypovolaemia
acute left ventricular failure
33
Q

what is Cheyne-Stokes respiration?

A

periodic breathing, increasing in depth and rate and then there’s a 10-20s period of apnoea or hypopnea, it’s due to altered CO2 sensitivity from congestive heart failure (bad prognosis), altitude sickness, encephalitis, brainstem lesions, raised ICP

34
Q

causes of Kussmaul’s breathing?

A 
DKA
AKI
lactic acidosis
methanol poisoning
salicylate poisoning
35
Q

reduced chest expansion is seen in?

A

lung cancer
pneumonia
IPF
pleural effusion

36
Q

hyperinflation seen in?

A

asthma

COPD

37
Q

what areas does fibrosis affect?

A

starts basally

38
Q

what respiratory diseases may cause ankle swelling?

A

COPD from cor pulmone

IPF

39
Q

what would cause diminished vesicular breathing?

A 
pleural effusion
pleural thickening
pneumothorax
hyperinflation
over an area of collapse
40
Q

what will speech sound like over pleural effusion?

A

muffled

41
Q

respiratory diseases in which there will be raised eosinophil count

A

allergic asthma
pulmonary eosinophilia
allergic bronchopulmonary aspergillosis
churg strauss

42
Q

what ion will severe pneumonia reduce?

A

sodium

43
Q

what respiratory disease causes Ig deficiency?

A

bronchiectasis

44
Q

what requires a high resolution CT scan?

A

bronchiectasis

interstitial lung disease

45
Q

indications for bronchoscopy

A

? lung cancer
? foreign body aspiration
specimens for microbiology

46
Q

causes of respiratory acidosis

A

acute ventilatory failure from severe acute asthma, severe pneumonia, COPD exa, skeletal abnormality or neuromuscular disorder

47
Q

respiratory alkalosis causes

A

hyperventilation (asthma, PE, pleurisy)

CNS-stroke; subarachnoid; early salicylate poisoning

48
Q

causes of metabolic acidosis

A
  • DKA
  • poisoning from alcohol, methanol, ethylene glycol, iron, salicylate
  • AKI
  • lactic acidosis-shock, cardiac arrest
  • loss of bicarb from renal tubular acidosis, severe diarrhoea, Addison’s
49
Q

metabolic alkalosis causes

A
  • loss of acid from severe vomiting, NG suction

- loss of potassium from XS diuretic, hyperaldosteronism, Cushing’s, liquorice, XS alkali ingestion

50
Q

what does haemoptysis suggest?

A

PE

malignancy

51
Q

Which organisms are most likely to cause COPD exacerbation?

A

Moraxella carrhalis, S. pneumoniae, H influenzae, rhinovirus, influenza

52
Q

features of bronchiectasis on CXR?

A

tram track bronchi
ring like shadows
thick dilated airways

53
Q

what is the faulty protein in CF?

A

CF transmembrane conductance regulator

54
Q

GI complications of CF?

A

DIOS, autodigestion+malabsorption+steatorrhoea, cholesterol stones, cirrhosis, PUD, GI cancer

55
Q

add to the list of: SOB, haemoptysis, bronchiectasis, steatorrhoea sx of CF

A

meconium ileus, nasal polyps, sinusitis, liver/kidney failure, GORD

56
Q

how can you prove CFTR dysfunction?

A

nasal PD, sweat test and small bowel ion studies

57
Q

how do you treat a CF exacerbation?

A

o2 support, antibiotics, control hyperglycaemia, increased physio and nutrition support

58
Q

is bronchitis obstructive or restrictive?

A

obstructive

59
Q

transudate PE causes?

A

liver cirrhosis, kidney failure, hypothyroidism, heart failure, low protein, a haemothorax

60
Q

sx of PE?

A

atelectasis leading to PE, pleuritic chest pain, asymptomatic, stony dull to percussion, reduced breath sounds, reduced expansion

61
Q

why does systemic bp fall in PE?

A

decrease in cardiac output because pulmonary artery pressure has increased

62
Q

what is a massive PE?

A

both pulmonary arteries blocked

63
Q

what would you hear on auscultating a PE?

A

coarse crackles, possibly a pleural rub

64
Q

what might a PE CXR look like?

A

normal or blunting of the costophrenic angles or atelectasis

65
Q

management of PEs?

A

high flow o2
adrenaline
consider surgery if massive
LMWH until INR over 2 then warfarin

clinical (15 decks)

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