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Supporting life > Respiratory > Flashcards

Respiratory Flashcards

1
Q

what are restrictive lung diseases characterised by?

A

a reduction in lung volume, causing difficulty inhaling

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2
Q

give some examples of restrictive lung diseases…

A

interstitial lung disease
sarcoidosis
neuromuscular disease

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3
Q

what are obstructive lung diseases characterised by?

A

a reduction in airflow, causing difficulty exhaling

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4
Q

what symptoms accompany obstructive lung diseases?

A

cough and shortness of breath

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5
Q

give some examples of obstructive lung diseases…

A

COPD
asthma
cystic fibrosis

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6
Q

what are the 2 types of restrictive lung disease?

A

intrinsic (interstitial) or extrinsic (extra-pulmonary)

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7
Q

raised serum ACE levels, indicated which intrinsic restrictive lung condition?

A

sarcoidosis

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8
Q

the triad of dry cough, crackles and finger clubbing, are commonly seen in which intrinsic restrictive lung condition?

A

idiopathic pulmonary fibrosis

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9
Q

what happens to…
total lung capacity, FVC, FEV1 and the REV1:FVC ratio
…in intrinsic restrictive lung disease?

A

reduced total lung capacity
reduced FVC
reduced FEV1
normal (>0.8) ratio

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10
Q

what happens to…
total lung capacity, FVC, FEV1 and the REV1:FVC ratio
…in obstructive lung disease?

A

slightly reduced FVC
reduced FEV1
reduced ratio (<0.7)

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11
Q

what are the 2 main conditions of the pleura

A

pleural effusion

pneumothorax

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12
Q

what is a pleural effusion?

A

build-up of fluid in the pleural space

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13
Q

what is the effect of a pleural effusion on ventilation?

A

causes limited lung expansion and therefore ventilation

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14
Q

name some different types of pleural effusion…

A

hydrothorax
hemothorax
urinothorax
pleural empyema

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15
Q

what are the symptoms of a pleural effusion?

A

chest pain
dyspnoea
dry cough (fluid outside lung)

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16
Q

what are the 2 types of fluid in a pleural effusion? + explain

A

transudate - low protein, caused by systemic problem e.g. congestive HF

exudate - high protein, caused by an inflammatory problem e.g. infection or malignancy

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17
Q

what testing is done to confirm diagnosis of a pleural effusion?

A

chest x-ray
thoracic ultrasound
thoracentesis to extract fluid for analysis

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18
Q

treatment of pleural effusion?

A

intercostal drain in 5th intercostal space mid-axillary line

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19
Q

what is a pneumothorax?

A

air in the pleural space

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20
Q

describe a typical patient presenting with a primary spontaneous pneumothorax…

A

tall, thin, young male presenting with symptoms at rest

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21
Q

symptoms of a pneumothorax?

A

sharp one-sided chest pain
dyspnoea
hyper-resonance on percussion
absent breath sounds on auscultation

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22
Q

tests to diagnose pneumothorax?

A

chest x-ray

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23
Q

how to tell the difference between a pneumothorax or tension pneumothorax?

A

x-ray: in a tension pneumothorax there will be mediastinal shift and/or tracheal deviation

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24
Q

treatment of tension pneumothorax?

A

needle chest decompression - 5th intercostal space mid-axillary line

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25
Q

give examples of a type I hypersensitivity reaction…

A

allergic rhinitis
anaphylaxis
food allergies

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26
Q

give examples of a type II hypersensitivity reaction…

A

Grave’s disease

autoimmune haemolytic anaemia

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27
Q

give examples of a type III hypersensitivity reaction…

A

SLE

rheumatoid arthritis

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28
Q

give examples of a type IV hypersensitivity reaction…

A

diabetes mellitus I
Hashimoto’s thyroiditis
MS
GCA

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29
Q

what are the characteristics of asthma?

A

increased eosinophils
chronic airway inflammation
reversible airflow limitation

30
Q

what are the symptoms of asthma?

A 
coughing
tight chest
wheeze
difficulty breathing
whistle during expiration
31
Q

what medication is given for mild intermittent asthma?

A

inhaled short-acting beta 2 agonist e.g. salbutamol

bronchodilator

32
Q

what is the first add regular preventative medication for asthma?

A

low dose inhaled corticosteroid

anti-inflammatory

33
Q

acute treatment of asthma attack?

A
  • salbutamol via neb
  • +/- ipratropium bromide
  • oxygen for 93-95% sats
  • oral / IV corticosteroids (prednisolone or hydrocortisone)
  • IV magnesium
34
Q

what is the mnemonic for signs of life-threatening asthma?

A

33 92 CHEST

  • PEF <33%
  • oxygen <92%
  • cyanosis
  • hypotension
  • exhaustion
  • silent chest
  • tachycardia
35
Q

what are the 4 possible signs of acute severe asthma?

A

PEF 33-50%
respiratory rate >25/min
heart rate >110/min
inability to complete sentences in one breath

36
Q

what is respiratory failure?

A

the blood has not enough oxygen or too much carbon dioxide

37
Q

what is type 1 respiratory failure? what typical values will be produced?

A

hypoxia

  • lung failure
  • low oxygen <8kPa
  • normal or low CO2
38
Q

what is type 2 respiratory failure? what typical values will be produced?

A

hypercapnia

  • respiratory muscle pump failure
  • high CO2 >6kPa
  • low oxygen <8kPa
39
Q

treatment of hypoxia?

A

oxygen

40
Q

treatment of hypercapnia?

A

ventilation (non-invasive or invasive)

41
Q

when is ECMO used?

A

to treat severe hypoxia or hypercapnia

42
Q

what are the symptoms of COPD?

A
  • dyspnoea
  • cough
  • wheeze
  • sputum
  • reduced exercise tolerance
  • barrel chest
  • cyanosis
  • asterixes
43
Q

what 2 processes cause COPD?

A
  • chronic bronchitis

- emphysema

44
Q

what are the management steps of COPD?

A
  1. stop smoking
  2. SABA or SAMA
  3. FEV>50% - LABA or LAMA
  4. FEV<50% - LABA + ICS
  5. LABA + LAMA + ICS
45
Q

what can cause an acute exacerbation of COPD?

A

infections

46
Q

treatment of acute COPD exacerbations?

A
  • controlled oxygen (88-92% sats)
  • nebuliser
  • IV hydrocortisone and oral prednisolone for 7-14 days
  • antibiotics if infection
47
Q

what is pneumonia?

A

infection of the air sacs

48
Q

what is the most common causative organism of typical pneumonia?

A

streptococcus pneumoniae

49
Q

what is the most common causative organism of typical pneumonia in COPD patients?

A

haemophiliac influenza

50
Q

what is the most common causative organism of pneumonia in HIV patients?

A

pneumocystis jivoreci

51
Q

how does pneumocystis jivoreci often present?

A

HIV patient

dry cough and exercise induced desaturation

52
Q

what are the 2 most common causative organism of atypical pneumonia?

A

mycoplasma pneumoniae

legionella (infected air conditioning units)

53
Q

symptoms of typical pneumonia?

A

high fever
productive cough
chest pain
myalgia

54
Q

signs of typical pneumonia?

A

crackles
tachypnoea, tachycardia
shadows on x-ray
lobar consolidation on CT

55
Q

signs and symptoms of atypical pneumonia?

A 
moderate fever
dry cough
myalgia
abdo pain
headache
may have clear examination and x-ray
56
Q

what score is used to asses pneumonia?

A

CURB-65

57
Q

what does CURB-65 stand for?

A 
confusion AMTS<8
serum urea >7
RR >30
BP <90 systolic or <60 diastolic
age >65
58
Q

management of pneumonia?

A

antibiotics (amoxicillin, co-amoxiclav)

  • oxygen to maintain 94-98%
  • IV fluids if dehydrated
59
Q

what disease is caused by respiratory syncytial virus?

A

bronchiolitis

60
Q

who is normally affected by bronchiolitis?

A

babies and children <2 y/o

61
Q

symptoms of bronchiolitis?

A

runny nose
fever
dry cough
wheezing

62
Q

management of bronchiolitis?

A

supplemental oxygen

63
Q

what is the cause of cystic fibrosis?

A

abnormal CFTR protein - reduced Cl pumped into secretions - less water follows - thick mucus

64
Q

symptoms of cystic fibrosis?

A

new borns: meconium ileus
early childhood: pancreatic insufficiency
children: infections in lungs

65
Q

what is croup and what is it caused by?

A

viral infection in infants

parainfluenza virus

66
Q

barking cough, stridor, fever in infant

diagnosis?

A

croup

67
Q

treatment of croup?

A

oral dexamethasone to reduce tracheal swelling

68
Q

following birth a baby develops fast breathing, fast HR, chest wall retractions, expiratory grunting, nasal flaring and a blue skin discolouration
what is going on?

A

infant respiratory distress syndrome

69
Q

what is infant respiratory distress syndrome caused by?

A

insufficiency of surfactant production by type II pneumocytes at birth

70
Q

treatment of infant respiratory distress syndrome?

A

oxygen

severe: endotracheal tube

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