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Term 2 - CVS and Resp > Respiratory Disease > Flashcards

Respiratory Disease Flashcards

1
Q

Causes of bronchial asthma are

A

atopy
airway hyper-responsiveness
inflammation (by increased IgE)

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2
Q

Bronchial asthma goes on to cause

A 
inflammation of bronchi 
airflow limitation
exudation
hypertrophy
epithelial damage
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3
Q

Signs of bronchial asthma are

A

decreased ciliated cells
increased goblet cells
(metaplasia)

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4
Q

Symptoms of bronchial asthma are

A

wheeze
increased RR and HR
cough
SOB

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5
Q

To investigate bronchial asthma, one should carry out which tests?

A

PEF on walk
spirometry
blood and sputum
CXR

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6
Q

How do you treat bronchial asthma?

A 
avoidance/education
B2 agonists
antimuscarines
inhaled/oral CCS 
LTRAs
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7
Q

What ‘qualifies’ as bronchitis?

A

cough and sputum for 3/12 months for 2 years in a row

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8
Q

What causes bronchitis?

A 
smoking
pollution
occupational dust 
hypoxaemia
hypoventilation
decreased diffusion (no alveoli)
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9
Q

What does bronchitis cause in the large airways?

A

mucous gland hyperplasia

goblet cell hyperplasia

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10
Q

What does bronchitis cause in small airways?

A

goblet cells appear
inflammation
fibrosis

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11
Q

What are the signs of bronchitis (and emphysema)?

A

Wheeze
Raised RR
Hyperinflation

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12
Q

Symptoms of bronchitis (and emphysema)

A

breathlessness
cough
sputum
infection

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13
Q

Investigations for bronchitis (and emphysema)

A 
CXR
LFTs
Increased Hb
ABGs
ECG
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14
Q

Treatment of bronchitis (and emphysema)

A 
Dilators
Less smoking
Antibiotics (acute)
Diuretics (oedema)
More FlO2 (hypoventilation)
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15
Q

Causes of emphysema

A

centriacinar (smoke)
panacinar
perinacinar
scar/bullous

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16
Q

Emphysema can cause

A

increased air spaces in acinus (dilation, wall destruction)

less alveolar attachments

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17
Q

UTRIs like pharyngitis are caused by

A 
adenovirus
EBV, RSV
flu
rhino virus 
strep pyogenes
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18
Q

Signs of a UTRI include

A 
loss of appetite
lymphadenopathy
dysphagia
pus
fauces inflammation
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19
Q

Symptoms of a UTRI include

A

fever

sore throat

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20
Q

Investigations of a UTRI include

A

throat swab
nasal swab
FBC

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21
Q

What can treat a UTRI?

A

rest
paracetamol
aspirin

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22
Q

Infectious mononucleosis is caused by

A

EBV

Kissing

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23
Q

Signs of infectious mononucleosis are

A

lymphadenopathy
red rash
splenomega

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24
Q

Symptoms of infectious mononucleosis are

A

fever

pharyngitis

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25
Q

Infectious mononucleosis can be investigated using

A

blood film (atyp mononuclear cells)
monospot
IgM/IgG

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26
Q

Infectious mononucleosis can be treated with

A

steroids (severe cases)

aspirin gargles

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27
Q

What is another name for infectious mononucleosis?

A

Glandular fever

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28
Q

Pneumonia can be caused by what bacteria?

A 
Chlamydia psittachi
Staphylococcus pneumoniae 
Coxiella burnetti
Mycoplasma pneumoniae 
Legionella pneumophila
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29
Q

What else can cause pneumonia?

A

Hospital acquired
Community acquired
Health-care acquired
Aspiration

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30
Q

What can be causes by pneumonia?

A

Fibrin exudate
organisation
consolidation
leucocytosis

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31
Q

Signs of pneumonia

A

rapid/shallow breathing
asymmetric CXR
dull to percuss
bronchial breathing

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32
Q

Symptoms of pneumonia include

A 
fever (39.5)
pleuritic pain 
dry rough
rusty sputum
rub
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33
Q

Pneumonia tests are

A

CXR
Cultures
IgM/IgG
FBC

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34
Q

Pneumonia treatments include

A

CAP: amoxicillin, clarithromycin

ciprofloxacin

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35
Q

Causes of bronchiectasis

A

infection
obstruction
tissue destruction
CF

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36
Q

Bronchiectasis causes

A

dilation of bronchi near pleura

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37
Q

Signs of bronchiectasis are

A

crackles
rub
halitosis (bad breath)

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38
Q

Bronchiectasis symptoms are

A

cough
lots of foul sputum
malaise

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39
Q

Bronchiectasis investigations:

A

CXR
CT
Sputum
Serum Ig

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40
Q

Treatment of bronchiectasis

A 
localised surgery 
drainage
antibiotics
dilators
anti inflammatories
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41
Q

What are the main causes of lung cancer?

A

Smoking

Occupation

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42
Q

What are the 4 main types of lung cancer?

A 
Small Cell 
Non-Small Cell:
- adenocarcinoma
- large cell carcinoma
- squamous carcinoma
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43
Q

Signs of lung cancer are:

A 
lymphadenopathy
pleural effusion
compressed phrenic nerve
hoarse voice
Horner's syndrome (eyelids drop)
Clubbing
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44
Q

Symptoms of lung cancer?

A 
shoulder pain (pancoast) 
cough
pain 
haemoptysis
SOB
malaise
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45
Q

Treatment options for lung cancer are

A

stage TNM
surgery
chemo/radio theraphy
tracheobronchial stent (stridor)

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46
Q

Signs of a pleural effusion are:

A

bronchial breathing
decreased vocal resonance
raised JVP
trachea away

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47
Q

Symptoms of pleural effusion are

A

increased SOB (weeks)
pleuritic pain
dry cough

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48
Q

Investigations for pleural effusion include a biopsy of how many samples? And what physical examination?

A

3 histology, 1 microbiology

thoracoscopy

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49
Q

A small pneumothorax =

A
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50
Q

A large pneumothorax =

A

> 2 cm

51
Q

Causes of a pneumothorax =

A

spontaneous
primary - no disease
secondary - disease
trauma

52
Q

What diseases can cause a pneumothorax?

A

COPD
TB
Asthma
Pneumonia

53
Q

Pneumothorax leads to

A

air in thorax
collapsed lung
pleural breach

54
Q

Signs of a pneumothorax are

A

absent breath sounds

trachea away

55
Q

Symptoms of a pneumothorax are

A

acute SOB

pleuritic pain

56
Q

How to fix a pneumothorax

A

drain

aspirate to lung felt on venflon

57
Q

Where do you place a chest drain for a pneumothorax?

A

3rd intercostal space midaxillary line

the safe triangle

58
Q

Where do you place a chest drain for a haemothorax?

A

5th intercostal space midaxillary line

59
Q

What is the best aspiration site for pleural fluid?

A

9th intercostal space midaxillary line

60
Q

What is mesothelioma?

A

asbestos induced lung cancer

61
Q

A sign of mesothelioma includes

A

pleural effusion

62
Q

Symptoms of mesothelioma include

A

pleuritic pain

breathlessness

63
Q

How to look for mesothelioma

A

biopsy
thoracoscopy
pleurodesis
CXR/CT

64
Q

Treatment options for mesothelioma

A

pneumonectomy (early)

radiotherapy

65
Q

Asbestosis is caused by what type of asbestos fibre most commonly?

A

crocidolite (blue)

66
Q

What two other types of asbestos fibre are there?

A

chrysotile (white)

amosite (brown)

67
Q

Who tends to get asbestosis/pleural plaques?

A

plumbers

electricians

68
Q

Asbestosis/pleural plaques can cause

A

pleural thickening (parietal)
calcification
restricted ventilation
inflammation/injury

69
Q

Mesothelial cells pull _____ into pleural space, forming ____________

A

fluid

pleural effusion

70
Q

Signs of asbestosis/pleural plaques =

A

progressive dyspnoea
clubbing
crackles

71
Q

What causes diffuse alveolar damage?

A 
trauma
chemicals/toxins
shock
drugs
infection
radiation
72
Q

What can diffuse alveolar damage lead to?

A 
exudate
hyaline membranes
fibrin
more epithelium and fibroblasts
fibrosis
consolidation
73
Q

Sarcoidosis is caused by

A

type 4 hypersensitivity

multiorgan formation of granulomas

74
Q

Sarcoidosis leads to

A

granulomas (giant cells)

non caseating

75
Q

Signs of sarcoidosis

A

lymphadenopathy
abnormal CXR
lung/liver involvement

76
Q

Sarcoidosis symptoms

A

SOB
cough
arthralgia (joint pain)

77
Q

Investigations for sarcoidosis =

A

CXR, biopsy

increased Ca2+ or ACE

78
Q

Corticosteroids alone treat which diseases?

A

sarcoidosis
hypersensitive pneumonitis
unusual interstitial pneumonitis
asbestosis

79
Q

Hypersensitive pneumonitis is known as

A

farmers lung

80
Q

Hypersensitive pneumonitis is cause by

A

fungi (aspiration)
bird/animal faeces
chemicals

81
Q

Hypersensitive pneumonitis can cause

A 
Type 3/4 hypersensitivity
Ig/Ag deposits in lung
centriacinar granuloma
fibrosis
eoisoniphilia
bronchitis obliterans
82
Q

Signs of Hypersensitive pneumonitis are

A

crackles
wheeze
increased RR

83
Q

Symptoms of Hypersensitive pneumonitis are

A 
fever
dry cough
malaise
chills
SOB
84
Q

Hypersensitive pneumonitis can be looked into with

A

CXP

sputum

85
Q

TB is caused by

A 
HIV
myobacterium (m) tuberculosis
m. avium 
m. kansasii
m. bovis
cows milk
86
Q

TB causes

It is mediated by

A 
neutrophil granulomas
macrophages --> necrosis
langerhans cells
calcification
fibrosis

Th1

87
Q

TB signs are

A

night sweats
haemoptosis
pleural effusion
mucual sputum

88
Q

Symptoms of TB =

A

cough
general illness
asymptomatic

89
Q

TB tests include

A 
CXR
Culture
Biopsy
PCR
Heaf Test/Mantoux
90
Q

TB treatments are _____ and cause ______

A

Rifampicin - orange fluids
Isoniazid - hepatitis
Ethambutol - optic nerve damage
Pyrzine - gout

91
Q

Transplant criteria for CF is

A

FEV1

92
Q

Contraindications for transplant in CF are

A 
organ failure
CCS>20mg
malignant
drugs/nicotine
peripheral vascular disease
93
Q

CF causes patients to have

A

no change in FEV1

vitamin E deficiency

94
Q

Signs of CF are

A 
increased salt in sweat
pancreatic insufficiency
failure to thrive
orange, pale, offensive stools
scarring
abscess
chest infections
95
Q

Symptoms of CF are

A

nasal polyps
males are infertile
meconium ileus
IBD (inflammatory bowel disease)

96
Q

CF tests include

A

Guthrie test
immunoreactive trypsinogen
mutation analysis
heelstick (newborns)

97
Q

CF treatments are

A 
enzyme pellets
high energy diet (not low fat) 
vitamins A D E and K 
hypertonic saline
mucolytics
proton pump inhibitors
98
Q

Sleep apnoea can be causes by

A

obesity

99
Q

Sleep apnoea can cause

A

URT obstruction

O2 desaturation

100
Q

Snoring, unrefreshing sleep, daytime tiredness, decreasec concentration are all caused by

A

sleep apnoea

101
Q

Sleep apnoea can be studied using

A

over night sleep study

polysomnography

102
Q

Sleep apnoea can be treated by

A

decreasing alcohol and weight
treat endocrine disorder
mandibular splint

103
Q

Type I respiratory failure =

A

decreased PaO2

104
Q

Type II respiratory failure =

A

decreased PaO2

increased PCO2

105
Q

ARDS - acute rest distress syndrome a cause of

A

respiratory failure

106
Q

Type I resp failure can cause

A 
lung disease
VQ mismatch
shunts
oedema
pneumothorax
acute hypoxia
107
Q

Type II resp failure can cause

A

ventilation failure
COPD
overdose
decreased effort when breathing

108
Q

Signs of resp failure are

A

increased RR
hypoxia
crackles

109
Q

Symptoms of resp failure are

A 
ARDS
fibrosis
oedema
exudate
haemorrhage
110
Q

Investigations for rest failure include

A

pulse oximetry
ABGs
capnography (monitoring PCO2)

111
Q

TED stands for

A

thromboembolic disorder

112
Q

TED, DVT and PE are caused by

A 
pelvic clot
cardiac thrombi
septic emboli
air
amniotic fluid
113
Q

PE, DVT and TED can cause

A

surgery, burns, trauma
cancer, stroke
paralysed legs
obesity

114
Q

Signs of PE, DVT and TED are

A

Systolic BP

115
Q

PE, DVT and TED symptoms include

A

pain
cough
haemoptysis
fever

116
Q

Investigations for PE, DVT and TED are

A 
D-Dimer
ABG
CXR, ECG
Doppler
Echo
117
Q

PE, DVT and TED can be treated using

A 
anticoags
resp support
O2 ventilation
IV fluids
analgesia
heparin
thrombolytics
118
Q

If V/Q is positive you ALWAYS

A

treat it

119
Q

PHT (Pulmonary Hypertension) =

A

> 25mmHg at rest

>35mmHg during exercise

120
Q

PHT causes

A

hypoxic vasoconstriction
decreased RR & surface area of pulmonary vascular bed
severe RHF
RV vol/pressure overload

121
Q

PHT signs are

A

loud P2
R ventricle heave
ejection systolic murmur on inspiration

122
Q

PHT symptoms are

A 
SOB
fatigue
syncope
tightness
ankle swelling
haemoptysis
RUQ pain
123
Q

PHT tests include

A

CXR
Echo
ECG
VQ scan

124
Q

PHT treatments include

A 
warfarin
O2 diuretics
CCBs
NO
surgery
transplant

Term 2 - CVS and Resp (8 decks)

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