Respiratory Flashcards
What is pneumonia?
Inflammation and fluid collection in lungs due to infection
Pneumonia - 1 Causative organism
Strep pneumoniae
Pneumonia - Signs and symptoms
Signs - BP drop, fever, increased resp rate, sputum
Symptoms - Pleuritic chest pain, cough with sputum
Pneumonia - Investigations
Listen to chest with stephoscope
CXR (Chest X-Ray) is gold standard for consolidation
To assess severity use CURB-65
To determine causative organism - take sputum sample and blood culture
Pneumonia - Treatment 5 (PAITO)
Oxygen (be vary of COPD) Thromboprophylaxis Antibiotics - Amoxicillin IV fluids (prevent dehydration) Paracetamol for pleuritic chest pain
How is Tuberculosis (TB) spread?
Airborne droplets
TB - Signs and symptoms
Signs - Coughing up blood
Symptoms - Fever, night sweats, chest pain
TB - Diagnosis
3x Sputum test
CXR
CT scan
TB - Treatment
‘RIPE’
Most commonly prescribed resp drugs
Salbutamol (SABA) - Asthma and COPD Salmeterol (LABA) - Asthma and COPD Prednisolone - Anti-inflammatory Ramipril (ACE inhibitor) - Hypertension Amoxacillin (Antibiotics)
What is COPD?
Chronic obstructive pulmonary disease
Collection of 2 lung diseases (Chronic bronchitis and emphysema)
Which type of respiratory failure is COPD?
Type 2 (Low O2, high CO2)
Cause of COPD?
Smoking
COPD - Signs and symptoms
Signs - Sputum, chronic cough, barrel shaped chest
Symptoms - Shortness of breath, tiredness/low energy
COPD - Investigations
Spirometry - FEV/FVC = <90%
CXR
COPD - Treatment
Lifestyle - Stop smoking
Oxygen therapy
SABA/LABA
Which of COPD and asthma is reversible and irreversible?
COPD - Irreversible
Asthma - Reversible
What is asthma?
Reversible COPD
Hypersensitivity type 1 reaction
2 Types of asthma
Atopic (Allergic)
Non-atopic (Non-allergic)
Asthma - Pathophysiology
1) Allergen inhaled and remembered
2) Next time inhaled causes inflammation and constriction of airways
Asthma - Causes
Allergic - Genetics, environmental stimuli
Non-allergic - (Intrinsic) Stress, cold air, infection
Asthma - Exacerbating factors
Pollution Smoking Stress Infection Trauma
Asthma - 3 Symptoms
SOB
Wheeze
Dry cough
Is asthma worse in morning or evening?
Morning
Asthma - 2 Investigations
Spirometry - FEV/FVC = <70%
Peak flow diary
Asthma - Treatment
SABA - Salbutamol
Lifestyle - Stop smoking, avoid allergens/stress
What is the pleura?
Double membrane surrounding lungs (Parietal - chest wall, visceral - lungs)
3 Functions of pleura
Allow lungs to move with chest wall for efficient breathing
Cushioning
Lubrication
What is a pleural effusion?
Build up of fluid in the pleural space
Fluids - Blood, serous, urine, pus
Difference between transudate and exudate
Transudate (Clear) - Excessive production of pleural fluid/Reduced resorption (Heart failure, nephrotic syndrome)
Exudate (Cloudy) - Result from damaged pleura (PE, pneumonia, cancer)
Pleural effusion - Signs and symptoms
Signs - Decreased chest movement, reduced breath sounds
Symptoms - SOB, cough, chest pain
Pleural effusion - Investigations
CXR - White=fluid
CT
Ultrasound
Listen to chest - tap on chest (dull to percussion)
Pleural effusion - Treatment
Chest drain
Pleurodesis
What is pneumothorax?
Build up of air in pleural space
Pneumothorax - Causes
Trauma - Rib fracture
Primary - Lung damage with no pathology
Secondary - Lung damage with pathology
Pneumothorax - Signs and symptoms
Signs - Low BP, low O2 levels
Symptoms - SOB, sharp one-sided chest pain
Pneumothorax - Investigations
CXR
Pneumothorax - Treatment
Chest drain
Surgery
What is tension pneumothorax?
Medical emergency where trachea has deviated away from affected lung (Need to insert chest drain immediately)
What is mesothelioma of lungs?
Cancer of the pleura that surrounds lungs
Mesothelioma - Cause
Asbestos
Mesothelioma - Symptoms
SOB Persistent cough Fever Weight loss Fatigue
Mesothelioma - Investigations
CXR
CT
Mesothelioma - Treatment
Poor prognosis means palliative care
What is lung cancer?
Carcinoma of the bronchus or pleura
Lung cancer - Causes
Smoking
Asbestos
Lung cancer - Signs and symptoms
Signs - Weight loss, anaemia, clubbing
Symptoms - Cough, haemoptysis (coughing up blood from lungs), dyspnoea (difficulty breathing), chest pain
Lung cancer - investigations
CXR
Chest CT
Bronchoscopy
Needle/surgical biopsy
Lung cancer - Management
Stage 1/2) Surgical
Stage 3/4) Chemo/Radiotherapy, palliative care
What is cystic fibrosis?
Chronic disease
Autosomal recessive genetic disorder causing defect in CTFR channel protein (chlorine-) resulting in thick mucus clogging ducts
Presents in childhood
Affects airways, pancreas, GI tract
Cystic fibrosis - Signs and symptoms
Signs - Steatorrhea (excretion of abnormal levels of fat in faeces), rectal prolapse
Symptoms - Cough, heavy mucus production
Cystic fibrosis - Complications
Resp tract infections
Bronchiectasis
Cystic fibrosis - Investigations
90% diagnosed before age 8
Genetics testing
Sweat (NaCl) test - parents taste salt when kissing baby
Cystic fibrosis - Treatment
No cure
Non-pharm - Physio for airway clearance
Pharm - Antibiotics, bronchodilators
What is bronchiectasis?
Irreversible dilation of bronchioles
Build up of mucus increases chance of infection
Bronchiectasis - Causes
Complications of lung diseases - COPD, CF
Infection
Bronchiectasis - Investigations
HRCT (High res CT) Sputum culture (look for infectious agents)
Bronchiectasis - Treatment
No cure
Non-pharm - Stop smoking, physio for airway clearance exercises
Pharm - Antibiotics, bronchodilators
What are occupational lung disorders?
Lung diseases caused by exposure to agents at work
Occupational lung disorders - Examples
Bronchitis
Fibrosis
Carcinoma
Asthma
Occupational lung disorders - Causes
Agents such as asbestos and silicon
What is hypersensitivity pneumonitis?
Inflammatory response to mould spores
Hypersensitivity pneumonitis - Symptoms
Chronic cough
Dyspnoea
Fatigue
Hypersensitivity pneumonitis - Management
Avoid allergen
Corticosteroids
