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Respiratory Flashcards

1
Q

What is COPD?

A
  • Chronic Obstructive Pulmonary Disease

- the flow of air to the lungs is restricted - long term illness

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2
Q

What are the risk factors in COPD?

A
  • SMOKING - lining of airway becomes inflammed and damaged by smoking
  • air pollution
  • genetics
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3
Q

What are the symptoms of COPD?

A
  • Cough (first symptom)
  • breathlessness on exertion
  • sputum
  • chest infections more common
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4
Q

How would you diagnose COPD?

A
  • Spirometry

- also could use CXR and pulse oximetry

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5
Q

What is the treatment for COPD?

A
  • Smoking cessation
  • inhaled b2 agonist e.g. salbutamol
  • anticholinergic = ipratropium
  • long-term oxygen therapy (for non-smokers)
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6
Q

What is the drug combination most people have in COPD?

A
  • Salbutamol
  • Tiotropium
  • Seretide
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7
Q

Name some respiratory tract infections.

A
  • Tonsilitis
  • Pharyngitis
  • Laryngitis
  • Tracheitis
  • Bronchitis
  • Pneumonia
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8
Q

Name the paranasal sinuses

A
  • Frontal
  • Ethmoidal
  • Sphenoidal
  • Maxillary
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9
Q

What is the role of the paranasal sinuses?

A
  • Warm and humidify

- Reduce weight of the skull

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10
Q

What are the parts of the pharynx?

A
  • Nasopharynx
  • Oropharynx
  • Laryngopharynx
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11
Q

What are the muscles of the pharynx innervated by?

A
  • Vagus nerve

- Stylopharyngeus is innervated by glossopharyngeal

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12
Q

Where does the sensory innervation for the pharynx come from?

A
  • Nasapharynx = CN V2

- Oropharynx = CN IX

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13
Q

What are the intrinsic muscles of the larynx innervated by?

A

Recurrent laryngeal nerve

- Cricothyroid is innervated by superior laryngeal

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14
Q

What is hypoxia?

A
  • Deficiency of oxygen at the tissue level

- 4 types

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15
Q

What is hypercapnia?

A
  • An increase in the PCO2 in the arterial blood
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16
Q

What would indicate COPD rather than asthma?

A
  • Increasing age
  • History of smoking
  • Sputum production
  • Irreversible
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17
Q

What is asthma?

A
  • A chronic relapsing/episodic inflammatory condition of the airways.
  • Characterised by airflow limitation and bronchial inflammation
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18
Q

What are the two main types of asthma?

A
  • Intrinsic = not immunologically mediated. Often called late-onset asthma
  • Extrinsic = type 1 hypersensitivity. Atopic = childhood
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19
Q

What is atopic asthma?

A
  • Type 1 hypersensitivity
  • Runs in families
  • Increased IgE antibodies
  • Associated with eczema and hayfever
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20
Q

What are some triggers for asthma?

A
  • Allergens
  • Viral infections
  • Cold air
  • Emotion
  • Irritant dust (smoke)
  • Exercise
  • Occupation
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21
Q

What happens pathologically in asthma?

A
  • Inflammation - histamine is released
  • Bronchoconstriction
  • Oedema and mucus
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22
Q

What are the features of asthma?

A
  • Episodes of SOB and wheezing
  • Bilateral, expiratory and widespread
  • Worse at night = diurnal variation
  • Cough
  • Tachypnoea
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23
Q

How would you diagnose and investigate asthma?

A
  • Spirometry = would show reduced FEV1
  • Peak expiratory flow = reduced
  • exercise test or blood count rare
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24
Q

How would you treat a moderate asthma attack?

A
  • SABA and corticosteroid
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25
How would you treat a severe asthma attack?
- Nebulised salbutamol and O2 - IV hydrocortisone or prednisole - add more salbutamol every 20 mins as needed - consider ventilator support
26
What is the 1st line of management of asthma?
- Behaviour = smoking cessation, precipitants, inhaler technique - Breathing techniques - Step plan for drugs
27
What is the step plan for asthma
1. SABA. If over 1+ daily go to step 2 2. Add inhaled beclometasone 3. LABA (salmeterol), leukotriene antagonist 4. increase beclometasone; theophylline 5. oral prednisole; refer to asthma clinic
28
What is pharyngitis?
- Result of a viral infection (70-80%) | - Associated with acute nasal infections
29
What are the features of pharyngitis?
- Sore throat - Dysphagia (swallowing difficulties) - Malaise - Pharyngeal mucosa is reddened
30
What is the treatment for pharyngitis?
- Analgesics e.g. aspirin - Throat swab to be taken if bacterial infection suspected - if bacterial, give amoxicillin
31
What is diphtheria?
- Acute infectious disease by diphtheria toxin - Can be a upper respiratory tract infection or cutaneous infection - rare in UK as immunised
32
What are the symptoms of diphtheria?
- severe sore throat - fever - malaise - lymphadenopathy - thick grey membrane over tonsils
33
How would you investigate diphtheria?
- Swab | - Would show irregular gram positive rods of diphtheriae bacteria
34
How would you treat diphtheria?
- Anti-toxin | - Erythromycin (to prevent transfer to other susceptible subjects)
35
What is sinusitis?
- Inflammation of mucous membranes of paranasal sinuses - results from inadequate drainage of sinuses - triggered by a viral upper respiratory tract infection
36
What are the symptoms of sinusitis?
- fever - facial pain (ear and teeth) - purulent nasal discharge
37
What is the treatment for sinusitis?
- No antibiotics! - manage symptoms - reassess if symptoms worsen or if over 14 days give nasal corticosteroids
38
What is acute epiglottitis?
- localised infection of larynx - Haemophilus influenzae - rare due to vaccine
39
How would you investigate acute epiglottitis?
- Swab | - Gram negative cocobacilli
40
How would you treat acute epiglottits?
- Amoxicillin
41
What are the features of acute epiglottis?
- Patient 2-6 years old generally - unwell; grey in colour - muffled cough - sounds like a "quack" - very serious
42
What is whooping cough?
- Pertussi - Caused by gram negative bordatella pertussis - transmission human-human by droplets - highly contagious
43
What are the features of whooping cough?
- infectious for 21 days - catarrhal phase (1-2 weeks) = rhinorrhoea, conjunctivitis and fever - paroxysmal (1-6 weeks) = coughing spasms, whoop cough and vomiting
44
What is the treatment for whooping cough?
- Clarithromycin | - vaccination
45
Who is at risk of pneumonia?
- infants/elderly - COPD - immunocompromised - diabetics - alcoholics and IV drug users
46
What is pneumonia?
- describes inflammation of the lung parenchyma | - strep. pneumoniae is most common agent
47
What are the symptoms of pneumonia?
- Fever, sweats - Cough - Sputum (rusty) - SOB - pleuritic chest pain (worse on deep breaths) - Systemic illness
48
What are the signs of pneumonia?
- Abnormal vital signs e.g. raised HR, RR, low BP | - Signs of lung consolidation on percussion = decreased air entry, bronchial breath sounds, crackly and wheezy
49
How would you investigate pneumonia?
- CXR = look for 'air bronchogram' - FBC (WBC a marker for severity) - Labs - Pulse oximetry
50
What are the main pathogens involved in pneumonia?
- Strep. pneumoniae | - Staph. aureus
51
What is the treatment for pneumonia?
- Antibiotics = amoxicillin or flucoxacillin (if S. aureus) - O2 - fluids - analgesia
52
How can pneumonia be classified?
- Community acquired pneumonia (CAP) - hospital acquired pneumonia (HAP) - aspiration pneumonia - pneumonia in immunocompromised patients
53
Describe streph pneumoniae. (2)
- Most common cause of CAP | - gram positive cocci
54
Describe influenza. (2)
- Epidemics are common | - affects patients with underlying lung disease
55
What are examples of chronic obstruction?
- Chronic bronchitis - Emphysema - Asthma - Bronchiectasis
56
What is chronic bronchitis?
- Productive cough for 3 months in 2 years - Mucus hypersecretion - tobacco smoking-induced mainly - some asthma effects
57
What is emphysema?
- Enlargement of alveolar airspaces with destruction of elastin in walls - mostly due to cigarette smoking
58
What are the clinical features of emphysema?
- 1/3 lung capacity destroyed before symptoms - weight loss - right side HF - overinflated chest - poor o2 delivery
59
What is bronchiectasis?
- Permanent dilatation of bronchi and bronchioles | - Due to obstruction and severe inflammation
60
What are the symptoms of bronchiectasis?
- chronic cough - foul-smelling sputum - flecked with blood occasionally
61
What is an interstitial lung disease?
- Increased amount of lung tissue - increased stiffness - decreased compliance
62
What can adult respiratory distress syndrome (ARDS) be due to?
- Shock - trauma - infections - gas inhalation - narcotic abuse
63
What is the treatment for bronchiectasis?
- Lifestyle | - Exercise, nutrition and airway clearance physio
64
What are the causes of lung cancer?
- Cigarettes (most) - Occupational - Asbestos - lung fibrosis
65
What are the symptoms of lung cancer?
- Cough - recurrent chest infections - haemoptysis (blood in cough) - increasing SOB - general malaise - weight loss
66
What is the most common form of lung cancer?
- Carcinoma (90%) | - Metastatic is more common that primary
67
What is small cell lung carcinoma?
- high grade epithelial neoplasm - strong smoking association - usually spread by presentation
68
What is the standard treatment for small cell lung carcinoma?
- Chemotherapy
69
What is non-small cell lung carcinoma?
- Variable grade - smoking associated - may have metastaised by diagnosis
70
What is the standard treatment for non-small cell lung carcinoma?
- Surgery - Radiotherapy - drugs
71
How is tuberculosis spread?
- Person to person | - Via a cough, spitting or sneezing on contact or onto plate
72
What is pulmonary TB?
- Primary focus and mediastinal lymph node enlargement causes Ghon complex - As granuloma grows, it develops into a cavity - more likely in apex of lung as there is more air and less blood supply
73
How does TB present?
- Weight loss - Low grade fever - Night sweats - Cough - chest pain - haemoptysis

Yr1 (13 decks)

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