Respiratory Disease Flashcards
What is dyspnoea?
Shortness of breath
What is orthopnoea?
Shortness of breath when lying flat
(Type of dyspnoea)
What is paroxysmal nocturnal dyspnoea?
When patient is awakened by shortness of breath
Usually indicative of cardiovascular problem (eg left ventricular failure)
What diseases cause sudden shortness of breath?
Foreign body
Pulmonary embolism
Pneumothorax
What diseases cause shortness of breath that lasts for HOURS?
Asthma
Pulmonary oedema
Pneumonia
Extrinsic allergic alveolitis
What diseases cause shortness of breath for DAYS?
Pleural effusion
Lung cancer?
What causes shortness of breath for MONTHS?
Pulmonary fibrosis
Chronic airflow limitation
What is wheeze?
Small airway noise
Expiratory
Any cause
Typically asthma
What is stridor?
Upper airway noise
Typically inspiratory harsh sound
What is haemoptysis ?
What are examples of conditions where it may occur?
Coughing blood
TB
Pneumonia
Pulmonary oedema
Cancer?
Symptoms of respiratory disease?
- Cough
- Dyspnoea (+ the two types mentioned)
- Wheeze
- Stridor
- Haemoptysis
7 examples of Upper Respiratory Tract infections?
- Common cold
- Sinusitis
- Rhinitis
- Pharyngitis
- Laryngo-tracheo-bronchitis
- Influenza
- Inhalation of foreign body
Common cold?
80-90% viral
Pyrexia (fever)
Malaise
Sinusitis?
Inflammation of sinus lining
Leads to instructed antral ostia
Which leads to increased pressure therefore PAIN
Can cause toothache
Rhinitis?
Sneezing
Blocked nose
Seasonal - pollen , hay fever
Medical prescription - antihistamines
Pharyngitis ?
Also known as sore throat
Typically viral
Occasionally bacterial Eg:
- Beta haemolytic strep sore throat -> RHEUMATIC FEVER
- Staphylococcus Aureus
Laryngo-tracheo-bronchitis?
Caused by?
Usually caused by viral such as measles + parainfluenza
Laryngeal oedema
Common in children
Croup (barking cough)
Stridor
Medication - oxygen, steam inhalation
Influenza?
How do they always change ?
Orthomyxovirus A/B
Antigens are H and N
H = Haemogluttin -> for ADHESION
N = neuraminidase -> breaching mucosal membrane
Vulnerable to secondary bacterial opportunistic infection such as PNEUMONIA
Change because of ANTIGENIC DRIFT (of the H and N)
Inhalation of foreign body?
Typically children/drunk adult/ could be DENTAL ENDO FILE
Back blows and Heimlich manoeuvre
What is asthma
A common chronic reversible airway obstruction that resolves spontaneously or with treatment and features :
Hyper responsive airways
Inflammatory airway changes
Excess mucus produciton
Epidemiology of asthma
M>F in childhood BUT M=F in adults
Most common in first decade
Causes of asthma
Extrinsic?
Intrinsic?
Additional?
Extrinsic:
House dust mite faeces
Pollen
Cat, dog, pets
Intrinsic:
Increased sensitivity due to raised igE levels
Bronchial hyper-reactivity
Short arm of chromosome 11
Additional:
Cold air
Exercise
Stress
Pollution
Infection
Drugs eg NSAIDS, B BLOCKERS
Diet
Pathogenesis of asthma
Oedema
Bronchoconstriction
Increased mucus secretions
Mediated by
Mast cells - release histamine
Lymphocytes
Symptoms of asthma
SOB
WHEEZE
cough
Symptoms worse in the morning
Signs of asthma
Quieting of voice and shortness of sentences
Increased EXPIRATORY time
Decreased FEV1/FVC
Hyperinflation
Barrel chest
Test for asthma
No single test but there are a range of tests can do
Management of asthma
Education - medication use
Prevention - avoid allergens
Therapy :
sodium chromoglycate - mediates mast cells
B 2 adrenoceptor agonist - bronchodilator
What is it common to have from inhalers?
How can you get over this?
Oral candidiasis (oral thrush)
(White marks+fungal)
Can get over this by using a spacer
What are two types of chronic obstructive airway diseases?
Chronic bronchitis
Emphysema
What is chronic bronchitis
Bronchi inflamed
Obstruction by narrowing airway lumen
Oedema
Excess mucus
Airflow limited
Cough produces sputum (fleghm) for 3 months of 2 successive years
Epithelial cell layer can ulcerate and heal as squamous epithelium (metaplasia)
What is emphysema
Alveoli are damaged
Dilatation of air spaces by wall destruction
Obstruction by decreasing lungs elastic recoil that golds airways open in expiration -> expiratory airflow limitation
Aetiology and pathogenesis of chronic obstructive airway diseases?
Smoking
Atmospheric pollution
Alpha 1 anti trypsin deficiency
Symptoms of chronic obstructive airway diseases
Cough
Sputum
Wheeze
Dyspnoea
Signs of chronic obstructive airway diseases
Hyperinflation
Quiet breathing sounds
Wheeze
Risk factors for chronic obstructive airway disease
Smokers
People who live in dusty environment
People who live in polluted environment
Blue bloater vs pink puffer
Blue bloater = BRONCHITIS
Pink puffer = EMPHYSEMA
Cystic fibrosis
Complication
Treatment
INHERITED
Autosomal recessive
Mutation on CFTR gene
Affects lungs and digestive system
Heavy thick sticky mucus - blocks airway passage
Complication - respiratory failure
Pneumothorax
Treatment - stop smoking
Drug therapy
Bronchiectasis
Dilatation of bronchi
Dilatations caused by inflammation eg:
Measles
Obstruction
Congenital
What are examples of lung parenchyma
Pneumonia
Lung abscess
Pneumonia
Inflammation of substance of the lung
Usually bacterial
Can be viral or others
What are the types of pneumonia
(A) LOBAR pneumonia - affects 1 lobe
BRONCHIAL pneumonia - affects lobules and bronchi
(B) By causative organism:
- community acquired eg strep pneumonia
- hospital acquired
Risk factors of pneumonia
Smokers
Immunocompromised
Underlying lung disease
Signs and symptoms of pneumonia
Pyrexia
Cough -DRY OR RED SPUTUM /fhlegm
Aspiration pneumonia
(From Google - inflammation when food/liquid breathed into airways or lungs instead of being swallowed)
Aspiration of gastric acid into lungs (Mendelson syndrome)
Often fatal
Associated with period of loss of consciousness - EG DENTAL SEDATION
What is a complication of pneumonia
Lung abcess
Tuberculosis
Affects?
Risk factors?
Most common infective cause of death
Affect lungs, lymph nodes and gut
Risk factors- immunocompromised
Diabetics
Alcoholic
Immigrants - Asians
Doctors / nurses
Multi drug resistant tb organisms
Pneumoconiosis?
Examples
Lung diseases that are caused by inhaling dusts
Pneumoconiosis - coal miners lungs
Asbestosis - brake linings, railway carriage insulation - Asbestos fibres cannot be broken down by macrophages
Silicosis - mining, builders
Berylliosis- electronics
Bronchial carcinoma
Aetiology
Most common malignant tumour
More men than women
Aetiology - smoking cigarette
Occupation
Air pollution
Pneumothorax
Collapsed lung
Air in pleural space
Air sucked in but cannot escape
Treatment is chest drain
