Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

3rd Year > Respiratory conditions > Flashcards

Respiratory conditions Flashcards

1
Q

What is the prevalence of asthma?

A

5-8% of the population

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the characteristics of asthma?

A

Recurrent episodes of dyspnoea, cough and wheeze caused by reversible airways obstruction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What three factors contribute to airway narrowing in asthma?

A

Bronchial muscle contraction
Mucosal swelling/inflammation
Increased mucus production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the symptoms of asthma?

A

Intermittent dyspnoea
Wheeze
Cough (often nocturnal)
Sputum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is it important to ask about in an asthma history?

A 
Precipitants
Diurnal variation
Exercise
Disturbed sleep
Acid reflux
Other atopic disease
The home
Job
Days per week off work/school
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How many people with asthma have acid reflux?

A

40-60%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What conditions are in the ectopic triad?

A

asthma
eczema
hayfever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What precipitants are there for asthma?

A 
Cold air
Exercise
Emotion
Allergens
Infection
Smoking
Pollution
NSAIDS
Beta blockers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the signs of asthma?

A 
Tachypnoea
Audible wheeze
Hyperinflated chest
Hyperresonant percussion
Reduced air entry
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the signs of a severe asthma attack?

A

inability to complete sentences
Pulse >110bpm
Respiratory rate >25/min
PEF 33-50% predicted rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the signs of a Life threatening asthma attack?

A 
Silent chest
Confusion
Exhaustion
Cyanosis
Bradycardia
PEF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What tests should be done in an acute asthma attack?

A 
PEF
Sputum culture
FBC, U&E, CRP
Blood cultures
ABG
CXR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What should be done if PaCO2 is normal or raised?

A

Transfer to high dependency unit or ITU for ventilation as this signified failing respiratory effort

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the differentials of a severe asthma attack?

A 
Acute infective exacerbation of COPD
Pulmonary oedema
Upper respiratory tract obstruction
Pulmonary embolus
Anaphylaxis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the treatment of life threatening or severe asthma?

A

Assess severity of attack
Salbutamol 5mg nebuliser
Hydrocortisone/Prednisolone
O2 therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

If life threatening features of asthma are still present after initial treatment what actions should be taken?

A

Inform ICU and seniors
Salbutalmol nebulizers every 15mins
Add ipratropium 0.5mg to nebulizers
Give single dose of magnesium sulfate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What sort of drug is salbutamol?

A

beta2 agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the standard dose inhaled steroid added to an asthmatics treatment course if they need to use their Beta2 agonist inhaler more than once daily?

A

Beclametasone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Why should patients rinse their mouth adter corticosteroid inhalation?

A

To avoid oral candiasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How is COPD characterized?

A

By airflow obstruction that is not fully reversible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is FEV1 and FVC?

A

FEV1: forced expiratory volume in 1 second

FVC: forced vital capacity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How can we define airflow obstruction?

A

FEV1/FVC:

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How is chronic bronchitis defined?

A

Clinically as cough, sputum production on most days for 3 months of 2 successive years. Symptoms improve if they stop smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How is emphysema defined?

A

Histologically as enlarged air spaces distal to terminal bronchioles with destruction of alveolar walls

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Signs of pink puffers?

A

increased alveolar ventilation
normal Pa02 and normal/low PaC02
Breathless but not cyanosed
May progress to type 2 respiratory failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Signs of blue bloaters?

A

reduced alveolar ventilation
low PaC02 and high PaC02
Cyanosed but not breathless
May develop cor pulmonale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Why should supplementary oxygen be given with care to blue bloaters?

A

Their respiratory centres are relatively insensitive to C02 and they rely on hypoxic drive to maintain respiratory effort

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Symptoms of COPD?

A

Cough
Sputum
Dyspnoea
Wheeze

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Signs of COPD?

A 
Tachypnoea
use of accessory muscles
hyperinflation
Decreased cricosternal Distance
Decreased expansion
Hyperresonant percussion
Quiet breath sounds
Wheeze
Cyanosis
Cor pulmonale
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How can we distinguish COPD form asthma

A

Asthma is reversible, COPD is not

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are the complications of COPD?

A 
Acute exacerbations with/without infection
Polycythaemia
Respiratory failure
Cor pulmonale
Pneumothorax
Lung carcinoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are bullae?

A

Fluid filled sacs or lesions (latin for bubble)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What investigations are there for COPD?

A 
FBC (increased PVC)
CXR
ECG
ABG
Lung function (spirometry)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is FEV1 is shown in very severe COPD

A

FEV1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Non pharmaceutical treatment for COPD?

A

Smoking cessation
Diet advice (supplements may help)
Encourage exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Pharmaceutical treatment for mild/moderate COPD

A

Inhaled long acting antimuscarinic/ Beta agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Pharmaceutical treatment for severe COPD?

A

Combination of long acting beta2 agonists and corticosteroids or tiotropium (anticholinergic bronchodilator)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is LOTT

A

Long term O2 therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is hypercapnia?

A

Abnormally elevated C02

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is the management of acute COPD?

A

Nebulized bronchodilators (salbutamol and ipratropium)
Controlled 02 therapy
Steroids (IV hydrocortisone and oral prednisolone)
Antibiotics (if evidence of infection amoxicillin 500mg)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is a pneumothorax?

A

A collection of air in the pleural cavity resulting in collapse of the lung on the affected side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Causes of pneumothorax?

A 
Spontaneous (especially in young tall thin men) due to rupture of a subpleural bulla
Chronic lung diseases
Infection
Traumatic (including iatrogenic)
Carcinoma
Connective tissue disorders
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Symptoms of pneumothorax

A

Can be asymptomatic (in fit young people with small pneumothorax)
Sudden onset dyspnoea
Pleuritic chest pain
Sudden deterioration of asthma or COPD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Signs of pneumothorax

A

Reduced expansion
Hyper resonance
Diminished breath sounds on the affected side
Tachycardia
With a tension pneumothorax the trachea will be deviated away and the patient will be very unwell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

When should a CXR not be performed?

A

A CXR should not be performed if a tension pneumothorax is suspected as it will delay immediate necessary treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Investigations for pneumothorax

A

CXR

Ultrasound (supine trauma patients)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What occurs in a tension pneumothorax?

A

Air drawn into the pleural space with each inspiration has no route of escape during expiration. The mediastinum is pushed over into the contralateral hemithorax, kinking and compressing the great veins

48
Q

Signs of tension pneumothorax

A 
Respiratory distress
Tachycardia
Hypotension
Distended neck veins
Deviated trachea
Reduced air entry/sounds on affected side
49
Q

Treatment of tension pneumothorax?

A

Insertion of large bore needle with syringe into second intercostal space midclavicular line
Following this insert chest drain

50
Q

In a primary pneumothorax when should aspiration be attempted?

A

SOB and/or rim of air >2cm on chest Xray

51
Q

What is the management criteria for chest drain or aspiration in a secondary pneumothorax?

A

If SOB and age >50 and rim of air >2cm on CXR chest drain. If not aspiration should still occur

52
Q

What is pneumonia?

A

An acute lower respiratory tract illness associated with fever, symptoms and signs in the chest and abnormalities on the CXR

53
Q

What are the three most common classifications of pneumonia?

A

Community acquired
Hospital acquired
Aspiration

54
Q

What are the most common microbes to cause CAP?

A

Streptococcus pneumonia
Mycoplasma pneumonia
Haemophilus influenzae

55
Q

How often do mixed pathogens occur in CAP?

A

25% of the time

56
Q

How can we define a hospital acquired pneumonia?

A

Pneumonia occurring >48 hours after hospital admission

57
Q

What are the risk factors for aspiration pneumonia?

A 
Stroke
Myasthenia
bulbar palsies
Reduced consciousness
Oesophageal disease
Poor dental hygeine
58
Q

Symptoms of pneumonia?

A 
Fever
Rigor
Malaise
Anorexia
Dyspnoea
Cough
Purulent sputum
Haemoptysis
Pleuritic pain
59
Q

What are the sings of pneumonia?

A 
Pyrexia
Cyanosis
Confusion
Tachypnoea
Tachycardia
Hypotension
Signs of consolidation
Pleural rub
60
Q

What are the signs of consolidation?

A

Diminished expansion
Dull percussion note
Increased tactile vocal fremitus/resonance
Bronchial breathing

61
Q

For what three reasons do we test pneumonia?

A

To establish a diagnosis
To assess severity
To identify responsible pathogens

62
Q

How do we assess pneumonia severity?

A

CURB 65

63
Q

What does CURB 65 stand for?

A

Confusion (amts 7mmol/L)
Respiratory rate (>30/min)
BP (65)

64
Q

Management for Pneumonia?

A 
Antibiotics
Oxygen 
IV fluids
Analgesia
Follow up
65
Q

What are the possible complications of pneumonia?

A 
Pleural effusion
Empyema
Lung abscess
Respiratory failure
Septicaemia
Brain abscess
Pericarditis
Myocarditis
Cholestatic jaundice
66
Q

Which form of pneumonia tends to occur in epidemics every 4 years?

A

Mycoplasma pneumonia

67
Q

Which form of pneumonia colonises water tanks?

A

Legionella pneumophilia

68
Q

What are the ABG signs in type 1 respiratory failure?

A

Pa02

69
Q

What are the ABG signs in type 2 respiratory failure?

A

Pa02 6.5kPa

70
Q

What is empyema?

A

Pus in the pleural space

71
Q

What are the environmental risk factors for carcinoma of the bronchus?

A 
Smoking
Asbestos
Chromium
arsenic
iron oxides
radioation
72
Q

What are the two classifications of primary bronchial cancers?

A

15% SCLCs (small cell lung cancer)

85% NSCLC (non-small cell carcinoma)

73
Q

What are the symptoms of lung cancer?

A 
Cough
Haemoptysis
Dyspnoea
Chest pain
Recurrent/slowly resolving pneumonia
Lethargy
Anorexia
Weight loss
74
Q

What are the signs of lung cancer?

A 
Cachexia
Anaemia
Clubbing
HPOA
Supraclavicular/axillary nodes
Chest signs
Metasrases
75
Q

What are the chest signs in lung cancer?

A

Sometimes none
Consoldation
Collapse
Pleural effusion

76
Q

Signs of metastases?

A 
Bone tenderness
Hepatomegaly
Confusion
Fits
Focal CNS signs
Proximal myopathy
Peripheral neuropathy
77
Q

Non-environmental risk factors for lung cancer?

A

Increased age
COPD
History of cancer

78
Q

Local complications of lung cancer?

A 
Recurrent laryngeal palsy
Phrenic nerve palsy
Horners syndrome
Pancoasts syndrome
SVC obstruction
Pericarditis
AF
Rib erosion
79
Q

What is pancoasts syndrome?

A

Classically caused by an apical malignant neoplasm of the lung resulting in Horners syndrome, ipsilateral reflex sympathetic dystrophy and shoulder and arm pain that leads to wasting of the hand muslces and paraesthesiae in the medial side of the arm

80
Q

What is HPOA?

A

hypertrophic pulmonary oseoarthropathy

81
Q

Tests for lung cancer?

A 
Cytology
CXR
Fine needle aspiration/biopsy
CT
Bronchoscopy
82
Q

Treatment for non-small cell tumours?

A

Depending on severity:
Excision
Curative radiotherapy
Chemotherapy with/without radiotherapy

83
Q

Treatment for small cell tumours?

A

These are nearly always disseminated at presentation, they may respond to chemotherapy but invariably relapse

84
Q

What types of medication are used for palliation in lung cancer?

A 
Analgesia
Steroids
Antiemetics
Cough linctus (codeine)
Bronchodilators
Antidepressants
85
Q

What is the prognosis of non small cell lung carcinoma?

A

50% 2yr survival without spread 10% with spread

86
Q

What is the prognosis of small cell lung carcinoma?

A

Median survival is 3 months if untreated

1-1.5 years if treated.

87
Q

What is pleural effusion?

A

Fluid in the pleural space

88
Q

How are pleural effusions caregorised?

A

By their protein concentration into transudates (35g/L)

89
Q

What is blood in the plurals pace called?

A

haemothorax

90
Q

What is pus in the pleural space called?

A

empyema

91
Q

What is chylothorax?

A

chyle (lymoh with fat) in the pleural space

92
Q

What are the common medical causes of pleural transudates?

A 
Heart failure
Cirrhosis
Hypoalbuminaemia
Peritoneal dialysis
Hypothyroidism
93
Q

What are transudates caused by?

A

Disturbances of hydrostatic or colloid osmotic pressure

94
Q

What are the common medical causes of pleural exudates?

A 
Pneumonia
Malignancy
Pulmonary infarction
TB
SLE
95
Q

What are the symptoms of pleural effusion?

A

Normally asymptommatic
Dyspnoea
Pleuritic chest pain

96
Q

Signs of pleural effusion?

A 
On the side of expansion:
Decreased expansion
Stony dull percussion note
Diminished breath sounds
Tracheal deviation (with large effusions)
97
Q

Tests for pleural effusion?

A

CXR
Ultrasound
Diagnostic aspiration
Pleural biopsy

98
Q

Management for pleural effusion?

A

Management of the underlying cause
Drainage
Pleurodesis
Surgery (for persistent collections and increasing pleural thickness)

99
Q

What is pleurodesis?

A

This is injection of a sclerosant to cause adhesion of the visceral and parietal pleura. (tetracycline, sterile talc, bleomycin)

100
Q

If pleural fluid is clear what does that indicate?

A

Transudate

101
Q

What are the causes of bloody pleural fluid?

A

malignancy
PE with infarction
Trauma
Post cardiac injury syndrome

102
Q

When should aspiration of a pleural be avoided?

A

If a transudate is confirmed aspiration should be avoided

103
Q

What does turbid yellow appearing e indicate?

A

Empyema, parapnuemonic effusion

104
Q

What does a high pleural fluid Lymphocyte count indicate?

A 
Malignancy
TB
RA
SLE
Sarcoidosis
105
Q

Risk factors for PE?

A 
Recent surgery
Thrombophilia
Leg fracture
Prolonged bed rest/reduced mobility
Malignancy
Pregnancy
Previous PE
106
Q

Symptoms of PE?

A 
Vary depending on number, size and distribution of emboli:
acute breathlessness
pleuritic chest pain
haemoptysis
Dizziness
syncope
107
Q

Signs of PE?

A 
Pyrexia
Cyanosis
Tachypnoea
Tachycardia
Hypotension
Raised JVP
PLeural rub
Pleural effusion
108
Q

Tests for PE?

A 
FBC, U&E, D-dimers
CXR (mainly exclusive)
ECG
ABG
Echocardiography
CTPA (CT pulmonary angiography)
109
Q

Why should D-dimers only be performed in people without a high probability of a PE?

A

A negative test is used to exclude a PE. However a positive test does not prove a diagnosis of a PE

110
Q

What is the recommended first line imaging for a PE?

A

CTPA (CT pulmonary angiography)

111
Q

When should we always suspect a PE?

A

In a patient with sudden collapse 1-2 weeks after surgery

112
Q

What are the casues for a D-dimer increase?

A 
Thrombosis
inflammation
post op
infection
malignancy
113
Q

What is acute the management of a large PE?

A 
Oxygen
Morphine (if in pain/distressed)
Immediate thrombolysis (if critically ill) 50mg alteplase
IV heparin
Maintain BP (fluids)
Warfarin regimen
114
Q

What are the goals of pneumonia testing?

A

To establish a diagnosis
Identify pathogens
Assess severity

115
Q

How is pneumonia severity assessed?

A

CURB 65

116
Q

What does CURB 65 stand for?

A

Confusion (7mmol/L)
Respiratory rate (>30mins)
Bp (

3rd Year (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions