Respiratory Conditions Flashcards
Aetiology COPD
Smoking
alpha-1 trypsin deficiency
Pathology COPD
Chronic inflammatory condition causing progressive airflow obstruction
Symptoms COPD
SOB, Cough, sputum, wheeze
Little diurnal variation
Weight loss, peripheral oedema
Investigations COPD
CXR, FBC, BMI, ECG
Spirometry - FEV1 <80%, FEV1/FVC <0.7
CO transfer
ABG
Signs COPD
Cyanosis, CO2 flap, decreased breathing sounds
Treatment COPD
Avoid RFs
SABA, LABA
Inhaled glucocorticoids
Long term oxygen - if paO2 less than 7.3/oedema
Types of obstructive airway diseases
Chronic bronchitis
Emphysema
Asthma
COPD
What is cor pulmonale
Pulmonary HT causing hypertrophy of LV and RHF
Types of restrictive lung diseases
Sarcoidosis
Idiopathic pulmonary fibrosis
Pleural causes of restrictive lung disease
Pleural effusions (fluid between visceral and parietal pleura) Pneumothorax (accumulation of air in pleura) Pleural thickening (scarring)
Presentation of restrictive lung diseases
Abnormal chest x-ray
SOB
Respiratory and heart failure
Normal FEV1/FVC ratio
RFs for asthma
Genetic
Occupation (paints, solder, animals, grains)
Smoking
Gender
Pathophysiology of asthma
Chronic reversible inflammation of airways caused by increased sensitivity leading to airway obstruction (variable)
Symptoms of asthma
Wheeze, SOB, Chest tightness, dry cough (nocturnal)
Signs of asthma
Tachypnoea, tachycardia, cyanosis, wheeze
Investigations of asthma
FBC, U+E, spirometry, PEFR, trial of treatment
Treatment of asthma
SABA, LABA, ICS, steroid tablet
Treatment of acute asthma
Oxygen, steroids, nebulisers
Aetiology of Lung Cancer
Smoking, asbestos, radon, occupational exposure, pollution, pulmonary fibrosis
Symptoms of lung cancer
Haemoptysis, recurrent infection, cough, SOB, pain weight loss, lump, chest pain, hoarseness
Signs of lung cancer
Clubbing, lymphadenopathy, Stridor, collapsed lung, reduced expansion, reduced percussion, reduced breath sounds
Local effects of lung cancer
Pleural effusion Collapse Pneumonia Infection Abscess Bronchiectasis SVC syndrome
Investigations of lung cancer
CXR, bronchoscopy, biopsy, CT, PFTs, PET, sputum cytology,
DDx of lung cancer
Infection, lung abscess, benign tumour, granuloma, fibrosis
Treatment lung cancer
Surgery, radiotherapy, chemotherapy
Subtypes of lung cancer
Small cell
Non small cell - squamous cell, adenocarcinoma, large cell carinoma
Pleural effusion aetiology
Transudate - HF, cirrhosis, PE, hypoalbuminaemia
Exudate - SLE, TB, carcinoma, RA
Symptoms pleural effusion
SOB
Pleuritic chest pain
Signs pleural effusion
Tracheal deviation, decreased expansion, stony dull percussion, diminished breath sounds
Investigations pleural effusion
CXR, bronchoscopy, HRCT
Aspirate
Treatment pleural effusion
Underlying cause
Pluerocentesis
Chest drain
Pneumothorax causes
Spontaneous
Traumatic - stab wound, iatrogenic
Symptoms pneumothorax
Asymptomatic
SOB
Pleuritic chest pain
Tension pneumothorax treatment
Thoracostomy
Treatment pneumothorax
Aspiration or chest drain
Investigation pneumothorax
CXR
CF aetiology
Genetic - AR
Pathophysiology CF
Abnormal Cl channels causing increased Na reabsorption causing increased viscosity secretions
Symptoms CF
Recurrent childhood chest infections, FTT, meconium ileum, steatorrhea
Signs CF
Clubbing, purulent sputum, central cyanosis, bilateral crackles
Investigations CF
Sweat testing, genetic testing
Treatment CF
Physio, antibiotics, steroids, nutritional support, transplants
Virchow’s triad
stasis, abnormal vessels, hypercoaguable states
Aetiologies PE
Immobility, trauma, recent surgery, pregnancy, malignancy
Symptoms PE
Dyspnoea, tachypnoea, pleuritic pain, haemoptysis, cough
Signs PE
Tachycardia, hypotension, increased JVP
Investigations PE
Bloods, ECG, V/Q scan, Doppler
Treatment PE
Anticoagulation, thrombolysis, oxygen
Pulmonary hypertension pathophysiology
increased pulmonary aftery pressure
Aetiology PHT
COPD, PE, Cardiac disesse
Symptoms PHT
SOB, fatigue, chest tightness,
Signs PHT
Peripheral oedema
Investigations PHT
CXR, ECG, PFTs, ECHO, CT chest
Treatment PHT
Warfarin, oxygen, diuretics, CCBS, surgery
RFs TB
DM, previous TB, alcohol, poor social circumstances
Investigations TB
Mantoux test, 3 sputum samples, CXR
Symptoms TB
Cough, sputum, haemoptyis, pleuritic pain, SOB, systemically unwell
Treatment TB
2 months rifampicin, isoniazid, pyrazinamide, ethambutol then 4 months rifampicin and isoniazid
Notifiy health board and contact tracing
Side effect of rifampicin
red-orange urine