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Diseases of Human Systems > Respiratory Disease > Flashcards

Respiratory Disease Flashcards

1
Q

what is polycythaemia

A

this is when the bone marrow produces more red blood cells to carry more oxgyen

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2
Q

what does respiratory mean

A

designating, relating to, or affecting the organs involved in respiration, or of relating to respiration

of or relating to the processes of oxygen transport and respiration

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3
Q

what is respiration

A

the action of taking air into the lungs and expelling it again, especially as a continuous physiological process

a single act of breathing

the exchange of oxygen and carbon dioxide between an organism or cell and the environment, the process by which this occurs, also the process by which oxygen is distributed to the tissues of an organism

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4
Q

what is disease

A

sickness in a person, animal or plant, disturbance or impairment of the function and structure of the body, a part of the body, or the mind

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5
Q

normal respiratory rate for an adult

A

12-20 breaths a minute

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6
Q

normal respiratory rate for a newborn

A

30-40 breaths a minute

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7
Q

normal respiratory rate for a toddler

A

20-30 breaths a minute

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8
Q

normal respiratory rate for a 6-10 year old

A

18-25 breaths a minute

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9
Q

normal oxygen saturation

A

96-100%

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10
Q

what is the FEv1

A

the volume of air forcibly expired in the first second after a full inhalation
this is normally calculated based on age, weight and sex
the percentage of normal will be indication of disease severity

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11
Q

FEV1 in healthy adults is

A

greater than 3.5 litres for a male
greater than 2.5 litres for a female

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12
Q

what is the FVC

A

the maximum volume of air that can be expressed from the lungs forcibly

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13
Q

what are some rheumatological conditions

A

rheumatoid arthritis
systemic scelorosis
systemic lupus erythmatosis
myositis

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14
Q

what is obstructed sleep apnea

A

this is the most common disorder of breathing during sleep which affects 5-15% of the population
there is an upper airway obstruction but movement of the chest wall will persist.

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15
Q

which sleep zone is the most common for sleep apnoea to occur in and why

A

REM due to low muscle tone

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16
Q

what are the symptoms of OSA

A

snoring
apnoea periods
dry mouth
daytime fatigue
daytime somnolence
poor concentration
headaches
depression

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17
Q

what are the risk factors for OSA

A

male
obesity
type 2 diabetes
smoking
alcohol
down syndrome
craniofacial abnormalities
hypothyroidism
acromegaly

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18
Q

what is the STOP BANG questionnaire

A

used to diagnose OSA

S - do you snore loudly
T - do you often feel tired
O - has anyone observed you stop breathing or gasping during sleep
P - high blood pressure

B - BMI over 35
A - age over 50
N - neck circumference greater than 17 male or 16 female
G - gender, are you male

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19
Q

what are the methods used to diagnose OSA

A

STOP BANG questionnaire
epworth sleepiness scale
sleep studies
polysomnograph

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20
Q

how is OSA treated

A

lifestyle changes
continuous positive airway pressure (CPAP)
mandibular advancement devices

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21
Q

describe the common cold

A

a common, self limiting illness resolving without intervention in up to 10 days
predominantly viral (rhinovirus)
influenza, parainfluenza, adenovirus have been implicated

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22
Q

what is epiglottitis

A

localised swelling of the epiglottis caused by infection, obstructing the laryngeal inlet, leading to haemophilus influenzae

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23
Q

what does epligglotitis present as

A

unwell scared patients
muffled voices
quack cough in a child
increasing dysphagia
drooling
stridor

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24
Q

how does tonsillitis present as

A

patient c/o
- sore throat
- otalgia (earache)
- headache and malaise

on examination
- patient is pyrexial (raised body temperature)
- tonsils enlarged and exuding pus
- lymph nodes enlarged or tender
- foetar oris / halitosis (bad breath)

can be viral or bacterial

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25
Q

how to manage tonsillitis

A

analgesia
soft diet
if there is difficulty swallowing, refer to ent

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26
Q

what is COPD

A

chronic obstructive pulmonary disease
airflow obstruction due to chronic inflammation

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27
Q

describe chronic bronchitis

A

inflammation and excess mucous

chronic productive cough for over three months in two consecutive years

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28
Q

what is emphysema

A

an alveolar membrane degradation leading to recurrent inflammation, scarring and loss of parenchymal lung texture

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29
Q

how many people affected by COPD

A

1.2 million

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30
Q

is COPD curable

A

no

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31
Q

what is the pathology of COPD

A

mucous hypersecretion

ciliary dysfunction

airflow obstruction and hyperinflation

gas exchange abnormalities

pulmonary hypertension

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32
Q

describe mucous hypersecretion

A

increased goblet cells and size of bronchial submucosal glands

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33
Q

describe ciliary dysfunction

A

squamous metaplasia of epithelium
dysfunction of the mucociliary escalator
difficulty expectorating

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34
Q

describe airflow obstruction and hyperinflation

A

small airways inflammation and narrowing
loss of lung elastic recoil
progressive air trapping during expiration
hyperinflation of the lungs

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35
Q

describe gas exchange abnormalities

A

hypoxaemia with or without hypercapnia
abnormal distribution of ventilation and perfusion ratios

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36
Q

describe pulmonary hypertension

A

late COPD, loss of pulmonary capillary bed
endothelial dysfunction

remodelling of the pulmonary arteries

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37
Q

what are the symptoms of COPD

A

chronic cough
fatique
dyspnoea /difficulty breathing
excess mucous
shortness of breath
chest discomfort

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38
Q

causes of COPD

A

smoking
pollution
occupational exposure
genetics
lung development
asthma

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39
Q

deficiency in which gene leads to COPD

A

alpha 1.- antitrypsin

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40
Q

how to diagnose COPD

A

take a history
spirometry
chest radiograph
full blood count
SpO2

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41
Q

what is spirometry

A

most reproducible and objective measurement of airflow limitation
measure the post bronchodilator spirometry to confirm diagnosis of COPD
should be used to monitor disease progression

42
Q

what is the function of a radiograph in diagnosing COPD

A

to exclude other pathologies

43
Q

why is a full blood count taken to diagnose COPD

A

looking at anaemia or polycythaemia

44
Q

what is the GOLD criteria for COPD diagnosis

A

persistent or worsening dyspnea
chronic cough
chronic sputum production
exposure risk factors eg smoking, dust or chemicals
family history

45
Q

how to treat COPD

A

aim to prevent sequelae
minimise the progression of disease
minimise exacerbations
lifestyle measures
smoking cessation
exercise
end stage oxygen therapy

46
Q

what are some after effects of COPD

A

reduced quality of life
Cor Pulmonale
frequent LRTI
secondary polycythaemia
pneumothorax
respiratory failure
lung cancer
muscle wasting and cachexi

47
Q

what is cor pulmonale

A

right side heart failure due to lung failure

48
Q

what is pneumothorax

A

this is where air leaks into the pleural space between the lung and the chest wall

49
Q

what is asthma

A

a chronic respiratory condition associated with airway inflammation and hyper responsiveness
most common long term conditions worldwide
higher in children than in adults
more boys than girls, but more women than men have it

50
Q

what is the asthma pathology

A

atopy
airway hyperactivity

51
Q

what is atopy

A

the genetic tendency to develop allergic diseases such as allergic rhinitis, asthma and atopic dermatitis

susceptible individuals produce large amounts of IgE in response to trivial extrinsic allergens

52
Q

describe airway hyperactivity in asthmatics

A

an increased responsiveness of the airways to non specific stimuli which may in part be due to inflammation of the bronchus

53
Q

describe how a combination of atopy and airway hyperactivity can lead to airway limitation

A

bronchoconstriction which is contraction of the bronchial smooth muscle
mucosal oedema
an increased secretion of tenacious mucous

54
Q

what is intrinsic asthma

A

late onset, unrelated to atopic conditions
no evidence of IgE mediation
no seasonal variation
pathophysiology is unknown

55
Q

what are the symptoms of asthma

A

coughing
wheezing
chest tightness
shortness of breath
variable expiratory airflow limitation
varies over time and in intensity

56
Q

what are the triggers of asthma

A

exercise
allergen or irritant exposure
changes in weather
viral respiratory infections
NSAIDs
beta blockers

57
Q

how is asthma diagnosed

A

history
peak flow
trial SABA
blood tests

58
Q

what does asthma lead to

A

death
respiratory complications
impaired quality of life

59
Q

describe the respiratory complications arising from asthma

A

pneumonia
pulmonary collapse (atelectasis caused by mucous plugging of the airways) leading to respiratory failure
pneumothorax
status asthmaticus

60
Q

how does asthma impair quality of life

A

fatigue
underperformance and time off school or work

61
Q

what is atelectasis

A

collapse of a lung

62
Q

how is asthma managed

A

aim to control the disease by avoiding exacerbations and reduce the risk of morbidity and mortality

complete control of asthma as there is no daytime symptoms, no nigh time awakening due to asthma, no need for rescue medication, normal lung functions and minimal medication side effects

63
Q

what are some asthma medications categorised into

A

controllers, which are taken daily on a long term basis

relievers used as needed

64
Q

what are some asthma control medications

A

systemic corticosteroids
methotrexate
leukotriene antagonists
LABA
inhaled corticosteroids

65
Q

what are some asthma reliever medications

A

SABA
short acting theophylline
inhaled anticholinergics

66
Q

describe cystic fibrosis

A

rare autosomal recessive condition

multisystem disorder affecting the lungs, pancreas, liver and intestine
impairs the normal clearance of mucous from the lungs which facilitates the colonisation and infection of the lungs by bacteria

67
Q

which chromosome is mutated in cystic fibrosis

A

7 CTRF

68
Q

how to diagnose cystic fibrosis

A

sweat tests, where if the chloride levels are higher than 60mmol/L is suggestive of CF

gene tests

69
Q

how to manage cystic fibrosis

A

antibiotics
airway clearance techniques such as active cycle of breathing techniques or use of airway clearance devices
regular exercise to improve lung function and overall fitness
heart lung transplant

70
Q

lung cancer stats

A
71
Q

which lung cancer types are non small cell carcinomas

A

adenocarcinoma
squamous cell carcinoma
large cell carcinoma

72
Q

which categories can lung cancer types be put into

A

non small cell carcinoma and small cell carcinoma

73
Q

describe adenocarcoma

A

located peripherally in the smaller airways of the lungs
glandular differentiation histology

more common in non smokers and asian females
metastasise early

responds well to immunotherapy

74
Q

describe squamous cell carcinoma

A

located centrally in the bronchi of the lungs

squamous differentiation and keratinisation is the histology

more common smokers
secretes PTHrP causing hypercalcaemia
metastisise late via the lymph nodes

75
Q

describe large cell carcinomas

A

these are located peripherally and centrally

large and poorly differentiated

more common in smokers and will metastisise early

76
Q

describe small cell carcinoma

A

located centrally
poorly differentiated histology

more common in older smokers
metastisise early
secretes ACTH leading to cushings syndome and ADH

associated with Lambert eaton syndrome

77
Q

what are the symptoms of lung cancer

A

50% of cases are symptomatic
unexplained cough for over three weeks
unintended weight loss
new onset shortness of breath
pleuritic chest pain
bone pain
fatigue

78
Q

what are the signs of cancer

A

cachexia
finger clubbing
cervical lymphadenopathy
wheeze

79
Q

what is cachexia

A

a condition that causes muscle and fat tissue to waste away

80
Q

what are some investigations for lung cancer

A

chest x ray
ct chest abdomen and pelvis
bronchoscopy and biopsy
PET CT for staging

81
Q

describe non small cell lung cancer treatment

A

surgery
targeted therapy
immunotherapy
chemotherapy
palliative care

82
Q

what are the treatment options for small cell lung cancer

A

chemo and radiotherapy

83
Q

what is the pathogen that causes community acquired pneumonia

A

streptococcus pneumoniae

84
Q

what are the symptoms and signs of pneumonia

A

cough
breathlessness
pleuritic pain
pyrexia
tachypnoea
tachycardia

85
Q

which groups have greater severity of pneumonia

A

older age groups
cardiorespiratory comorbidities
low socioeconomic group
new eight loss or cachectic state
immunocompromised - should consider atypical organisms

86
Q

describe tuberculosis

A

this causes more deaths than any other infectious disease
most cases were in Southeast Asia Africa and the western pacific

87
Q

what are the signs and symptoms of tuberculosis

A

asymptomatic
malaise
weight loss
fever
night sweats
productive cough
shortness of breath
Chet pain
extra pulmonary disease

88
Q

what causes the tuberculosis

A

mycobacterium tuberculosis

89
Q

describe the course of tuberculosis

A

can reactivate when the immune system is impaired
there is destructive caveatting in the upper zone pneumonia, and multiplication of organisms within these cavities
airway communication with cavities leads to endobronchial spread within the lungs and airborne spread to others

90
Q

describe military tuberculosis

A

this is when the disseminated disease begins to spread through the blood causing tuberculosis in the brain kidney and bone
this leads to tuberculosis meningitis and may follow primary or post primary infection
poor prognosis

91
Q

how to diagnose tuberculosis

A

chest x ray
sputum sample
blood tests
HIV serology
brain MRI for miliary tuberculosis
lumbar puncture

92
Q

describe the use of sputum sampling in the diagnosis of tuberculosis

A

ziehl nelson stain for acid fast bacilli
culture for confirmation of diagnosis and sensitivity testing

93
Q

describe the blood testing used to diagnose tuberculosis

A

interferon gamma release assay
geneXpert nucleic acid amplification test and antibiotic sensitivity

94
Q

describe the use of lumbar puncture

A

investigation for tuberculosis meningitis

95
Q

describe pulmonary embolus

A

this is when a clot form a vein, originating in the venous sinuses of the calf of the femoral vein or the pelvis detaches and becomes lodged in the pulmonary arterial tree

96
Q

what are the risk factors for a pulmonary embolism

A

age
obesity
previous venous thromboembolism
malignancy
hrt
pregnancy
immobility
hospitalisation
cancer
atrial fibrillation
factor v leiden deficiency

97
Q

describe acute pulmonary embolus treatment

A

thrombolysis
percutaneous catheter removal of clot

98
Q

describe what can be used for anticoagulation in pulmonary embolus treatment

A

DOAC
LMWH
warfarin

99
Q

describe use of corticosteriods

A

inhaled pressurised metered dose inhalers with spacer
oral for severe disease and intravenous when emergency

100
Q

how are muscarinic antagonists taken

A

inhaledd

Diseases of Human Systems (1 decks)

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