Respiratory conditions

Question 1

COPD

Answer 1

Airflow limitation that is not fully reversible

cause:
– 90% of cases associated with smoking
– cooking in poorly ventilated places
– exposure to toxins

pathophysiology
– increase in number of mucosa secreting cells in the bronchial mucosa

Symptoms:
– productive cough with white or clear sputum
– wheeze or breathlessness
– symptoms can be worsened with cold or damp weather

advanced disease:
– pulmonary hypertension
– tachypnoeic
– reduced chest expansion due to hyperinflated lungs
– pursed lip breathing

Severity:
– FEV1(80% predicted)
– FEV2
– FEV3
– FEV4

Question 2

Lung cancer

Answer 2

3rd most common cancer in the UK
1- breast
2- prostate

cause:
– cigarette smoking (80-90%)

NSCLC:
– squamous cell carcinoma (35%)
– adenocarcinoma (25%)

SCLC:

S and S:
– shortness of breath
– cough
– haemoptysis (coughing up blood)
– finger clubbing
– recurrent pneumonia
– weight loss
– lymphadenopathy- often supraclavicular is the first nodes to be found on examination

Extrapulmonary manifestations:
– horners syndrome
– phrenic nerve palsy
– cushings syndrome

common metastases sites:
– Brain
– bones
– liver
– adrenal glands

stages can be stage 1-4 depending on the severity or the time frame of how long someone has had lung cancer for

pan coast tumour

Question 3

Asthma

Answer 3

Chronic inflammatory condition of the airways that causes intermittent attacks of bronchoconstriction.
– bronchoconstriction is where the smooth muscle in the bronchi contract meaning they reduce in size so there is a reduction of air going through

This bronchoconstriction is caused by airway hypersensitivity and is reversible airway construction

Typical triggers:
– airborne allergens
– infection
– night time or early morning
– cold and damp air

Signs and symptoms:
– episodic symptoms
– dry cough with wheeze and shortness of breath
– family history
– history of atopic conditions like- eczema, hay fever and food allergies

Acute asthma attack:
– progressively worsening shortness of breath
– use of acessory muscles
– tachpnoea
– ‘tight’ sound chest on auscultation

Question 4

Pneumonia

Answer 4

An infection of the lung tissue. It causes inflammation of the lungs and the production of sputum that fills the airways and alveoli.

Classification:
– caught outside the hospital (most common)- community acquired pneumonia

– caught 48hr after hospital admission- hospital acquired pneumonia

– caught as a result of aspiration foreign material like food- aspiration pneumonia

common causes:
– streptococcus pneumonia (50%)
– haemophilus influenzae (20%)

Presentation:
– shortness of breath
– cough
– fever
– sputum production
– haemoptysis
– pleuritic chest pain
– delirium (confusion)
– sepsis can be caused in serious cases
– bronchial breathing sounds during auscultation
– dullness on percussion of the lungs

Severity assessment (CURB65):
– C- confusion
U- urea
R- respiratory rate 30+
B- blood pressure less than 90 systolic or 60 diastolic
65- age 65+

Atypical is another type by an organism that cant be cultured in the normal way and dont respond to penicillin

there are also fungal causes

Question 5

Pneumothorax