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Yr1 > Respiratory > Flashcards

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
Q

How would you treat a severe asthma attack?

A
  • Nebulised salbutamol and O2
  • IV hydrocortisone or prednisole
  • add more salbutamol every 20 mins as needed
  • consider ventilator support
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26
Q

What is the 1st line of management of asthma?

A
  • Behaviour = smoking cessation, precipitants, inhaler technique
  • Breathing techniques
  • Step plan for drugs
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27
Q

What is the step plan for asthma

A
  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
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28
Q

What is pharyngitis?

A
  • Result of a viral infection (70-80%)

- Associated with acute nasal infections

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29
Q

What are the features of pharyngitis?

A
  • Sore throat
  • Dysphagia (swallowing difficulties)
  • Malaise
  • Pharyngeal mucosa is reddened
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30
Q

What is the treatment for pharyngitis?

A
  • Analgesics e.g. aspirin
  • Throat swab to be taken if bacterial infection suspected
  • if bacterial, give amoxicillin
31
Q

What is diphtheria?

A
  • Acute infectious disease by diphtheria toxin
  • Can be a upper respiratory tract infection or cutaneous infection
  • rare in UK as immunised
32
Q

What are the symptoms of diphtheria?

A
  • severe sore throat
  • fever
  • malaise
  • lymphadenopathy
  • thick grey membrane over tonsils
33
Q

How would you investigate diphtheria?

A
  • Swab

- Would show irregular gram positive rods of diphtheriae bacteria

34
Q

How would you treat diphtheria?

A
  • Anti-toxin

- Erythromycin (to prevent transfer to other susceptible subjects)

35
Q

What is sinusitis?

A
  • Inflammation of mucous membranes of paranasal sinuses
  • results from inadequate drainage of sinuses
  • triggered by a viral upper respiratory tract infection
36
Q

What are the symptoms of sinusitis?

A
  • fever
  • facial pain (ear and teeth)
  • purulent nasal discharge
37
Q

What is the treatment for sinusitis?

A
  • No antibiotics!
  • manage symptoms
  • reassess if symptoms worsen or if over 14 days give nasal corticosteroids
38
Q

What is acute epiglottitis?

A
  • localised infection of larynx
  • Haemophilus influenzae
  • rare due to vaccine
39
Q

How would you investigate acute epiglottitis?

A
  • Swab

- Gram negative cocobacilli

40
Q

How would you treat acute epiglottits?

A
  • Amoxicillin
41
Q

What are the features of acute epiglottis?

A
  • Patient 2-6 years old generally
  • unwell; grey in colour
  • muffled cough - sounds like a “quack”
  • very serious
42
Q

What is whooping cough?

A
  • Pertussi
  • Caused by gram negative bordatella pertussis
  • transmission human-human by droplets
  • highly contagious
43
Q

What are the features of whooping cough?

A
  • infectious for 21 days
  • catarrhal phase (1-2 weeks) = rhinorrhoea, conjunctivitis and fever
  • paroxysmal (1-6 weeks) = coughing spasms, whoop cough and vomiting
44
Q

What is the treatment for whooping cough?

A
  • Clarithromycin

- vaccination

45
Q

Who is at risk of pneumonia?

A
  • infants/elderly
  • COPD
  • immunocompromised
  • diabetics
  • alcoholics and IV drug users
46
Q

What is pneumonia?

A
  • describes inflammation of the lung parenchyma

- strep. pneumoniae is most common agent

47
Q

What are the symptoms of pneumonia?

A
  • Fever, sweats
  • Cough
  • Sputum (rusty)
  • SOB
  • pleuritic chest pain (worse on deep breaths)
  • Systemic illness
48
Q

What are the signs of pneumonia?

A
  • 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
Q

How would you investigate pneumonia?

A
  • CXR = look for ‘air bronchogram’
  • FBC (WBC a marker for severity)
  • Labs
  • Pulse oximetry
50
Q

What are the main pathogens involved in pneumonia?

A
  • Strep. pneumoniae

- Staph. aureus

51
Q

What is the treatment for pneumonia?

A
  • Antibiotics = amoxicillin or flucoxacillin (if S. aureus)
  • O2
  • fluids
  • analgesia
52
Q

How can pneumonia be classified?

A
  • Community acquired pneumonia (CAP)
  • hospital acquired pneumonia (HAP)
  • aspiration pneumonia
  • pneumonia in immunocompromised patients
53
Q

Describe streph pneumoniae. (2)

A
  • Most common cause of CAP

- gram positive cocci

54
Q

Describe influenza. (2)

A
  • Epidemics are common

- affects patients with underlying lung disease

55
Q

What are examples of chronic obstruction?

A
  • Chronic bronchitis
  • Emphysema
  • Asthma
  • Bronchiectasis
56
Q

What is chronic bronchitis?

A
  • Productive cough for 3 months in 2 years
  • Mucus hypersecretion
  • tobacco smoking-induced mainly
  • some asthma effects
57
Q

What is emphysema?

A
  • Enlargement of alveolar airspaces with destruction of elastin in walls
  • mostly due to cigarette smoking
58
Q

What are the clinical features of emphysema?

A
  • 1/3 lung capacity destroyed before symptoms
  • weight loss
  • right side HF
  • overinflated chest
  • poor o2 delivery
59
Q

What is bronchiectasis?

A
  • Permanent dilatation of bronchi and bronchioles

- Due to obstruction and severe inflammation

60
Q

What are the symptoms of bronchiectasis?

A
  • chronic cough
  • foul-smelling sputum
  • flecked with blood occasionally
61
Q

What is an interstitial lung disease?

A
  • Increased amount of lung tissue
  • increased stiffness
  • decreased compliance
62
Q

What can adult respiratory distress syndrome (ARDS) be due to?

A
  • Shock
  • trauma
  • infections
  • gas inhalation
  • narcotic abuse
63
Q

What is the treatment for bronchiectasis?

A
  • Lifestyle

- Exercise, nutrition and airway clearance physio

64
Q

What are the causes of lung cancer?

A
  • Cigarettes (most)
  • Occupational
  • Asbestos
  • lung fibrosis
65
Q

What are the symptoms of lung cancer?

A
  • Cough
  • recurrent chest infections
  • haemoptysis (blood in cough)
  • increasing SOB
  • general malaise
  • weight loss
66
Q

What is the most common form of lung cancer?

A
  • Carcinoma (90%)

- Metastatic is more common that primary

67
Q

What is small cell lung carcinoma?

A
  • high grade epithelial neoplasm
  • strong smoking association
  • usually spread by presentation
68
Q

What is the standard treatment for small cell lung carcinoma?

A
  • Chemotherapy
69
Q

What is non-small cell lung carcinoma?

A
  • Variable grade
  • smoking associated
  • may have metastaised by diagnosis
70
Q

What is the standard treatment for non-small cell lung carcinoma?

A
  • Surgery
  • Radiotherapy
  • drugs
71
Q

How is tuberculosis spread?

A
  • Person to person

- Via a cough, spitting or sneezing on contact or onto plate

72
Q

What is pulmonary TB?

A
  • 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
Q

How does TB present?

A
  • Weight loss
  • Low grade fever
  • Night sweats
  • Cough
  • chest pain
  • haemoptysis

Yr1 (13 decks)

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