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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
Infectious mononucleosis can be investigated using
blood film (atyp mononuclear cells) monospot IgM/IgG
26
Infectious mononucleosis can be treated with
steroids (severe cases) | aspirin gargles
27
What is another name for infectious mononucleosis?
Glandular fever
28
Pneumonia can be caused by what bacteria?
``` Chlamydia psittachi Staphylococcus pneumoniae Coxiella burnetti Mycoplasma pneumoniae Legionella pneumophila ```
29
What else can cause pneumonia?
Hospital acquired Community acquired Health-care acquired Aspiration
30
What can be causes by pneumonia?
Fibrin exudate organisation consolidation leucocytosis
31
Signs of pneumonia
rapid/shallow breathing asymmetric CXR dull to percuss bronchial breathing
32
Symptoms of pneumonia include
``` fever (39.5) pleuritic pain dry rough rusty sputum rub ```
33
Pneumonia tests are
CXR Cultures IgM/IgG FBC
34
Pneumonia treatments include
CAP: amoxicillin, clarithromycin | ciprofloxacin
35
Causes of bronchiectasis
infection obstruction tissue destruction CF
36
Bronchiectasis causes
dilation of bronchi near pleura
37
Signs of bronchiectasis are
crackles rub halitosis (bad breath)
38
Bronchiectasis symptoms are
cough lots of foul sputum malaise
39
Bronchiectasis investigations:
CXR CT Sputum Serum Ig
40
Treatment of bronchiectasis
``` localised surgery drainage antibiotics dilators anti inflammatories ```
41
What are the main causes of lung cancer?
Smoking | Occupation
42
What are the 4 main types of lung cancer?
``` Small Cell Non-Small Cell: - adenocarcinoma - large cell carcinoma - squamous carcinoma ```
43
Signs of lung cancer are:
``` lymphadenopathy pleural effusion compressed phrenic nerve hoarse voice Horner's syndrome (eyelids drop) Clubbing ```
44
Symptoms of lung cancer?
``` shoulder pain (pancoast) cough pain haemoptysis SOB malaise ```
45
Treatment options for lung cancer are
stage TNM surgery chemo/radio theraphy tracheobronchial stent (stridor)
46
Signs of a pleural effusion are:
bronchial breathing decreased vocal resonance raised JVP trachea away
47
Symptoms of pleural effusion are
increased SOB (weeks) pleuritic pain dry cough
48
Investigations for pleural effusion include a biopsy of how many samples? And what physical examination?
3 histology, 1 microbiology thoracoscopy
49
A small pneumothorax =
50
A large pneumothorax =
> 2 cm
51
Causes of a pneumothorax =
spontaneous primary - no disease secondary - disease trauma
52
What diseases can cause a pneumothorax?
COPD TB Asthma Pneumonia
53
Pneumothorax leads to
air in thorax collapsed lung pleural breach
54
Signs of a pneumothorax are
absent breath sounds | trachea away
55
Symptoms of a pneumothorax are
acute SOB | pleuritic pain
56
How to fix a pneumothorax
drain | aspirate to lung felt on venflon
57
Where do you place a chest drain for a pneumothorax?
3rd intercostal space midaxillary line | the safe triangle
58
Where do you place a chest drain for a haemothorax?
5th intercostal space midaxillary line
59
What is the best aspiration site for pleural fluid?
9th intercostal space midaxillary line
60
What is mesothelioma?
asbestos induced lung cancer
61
A sign of mesothelioma includes
pleural effusion
62
Symptoms of mesothelioma include
pleuritic pain | breathlessness
63
How to look for mesothelioma
biopsy thoracoscopy pleurodesis CXR/CT
64
Treatment options for mesothelioma
pneumonectomy (early) | radiotherapy
65
Asbestosis is caused by what type of asbestos fibre most commonly?
crocidolite (blue)
66
What two other types of asbestos fibre are there?
chrysotile (white) | amosite (brown)
67
Who tends to get asbestosis/pleural plaques?
plumbers | electricians
68
Asbestosis/pleural plaques can cause
pleural thickening (parietal) calcification restricted ventilation inflammation/injury
69
Mesothelial cells pull _____ into pleural space, forming ____________
fluid | pleural effusion
70
Signs of asbestosis/pleural plaques =
progressive dyspnoea clubbing crackles
71
What causes diffuse alveolar damage?
``` trauma chemicals/toxins shock drugs infection radiation ```
72
What can diffuse alveolar damage lead to?
``` exudate hyaline membranes fibrin more epithelium and fibroblasts fibrosis consolidation ```
73
Sarcoidosis is caused by
type 4 hypersensitivity | multiorgan formation of granulomas
74
Sarcoidosis leads to
granulomas (giant cells) | non caseating
75
Signs of sarcoidosis
lymphadenopathy abnormal CXR lung/liver involvement
76
Sarcoidosis symptoms
SOB cough arthralgia (joint pain)
77
Investigations for sarcoidosis =
CXR, biopsy | increased Ca2+ or ACE
78
Corticosteroids alone treat which diseases?
sarcoidosis hypersensitive pneumonitis unusual interstitial pneumonitis asbestosis
79
Hypersensitive pneumonitis is known as
farmers lung
80
Hypersensitive pneumonitis is cause by
fungi (aspiration) bird/animal faeces chemicals
81
Hypersensitive pneumonitis can cause
``` Type 3/4 hypersensitivity Ig/Ag deposits in lung centriacinar granuloma fibrosis eoisoniphilia bronchitis obliterans ```
82
Signs of Hypersensitive pneumonitis are
crackles wheeze increased RR
83
Symptoms of Hypersensitive pneumonitis are
``` fever dry cough malaise chills SOB ```
84
Hypersensitive pneumonitis can be looked into with
CXP | sputum
85
TB is caused by
``` HIV myobacterium (m) tuberculosis m. avium m. kansasii m. bovis cows milk ```
86
TB causes It is mediated by
``` neutrophil granulomas macrophages --> necrosis langerhans cells calcification fibrosis ``` Th1
87
TB signs are
night sweats haemoptosis pleural effusion mucual sputum
88
Symptoms of TB =
cough general illness asymptomatic
89
TB tests include
``` CXR Culture Biopsy PCR Heaf Test/Mantoux ```
90
TB treatments are _____ and cause ______
Rifampicin - orange fluids Isoniazid - hepatitis Ethambutol - optic nerve damage Pyrzine - gout
91
Transplant criteria for CF is
FEV1
92
Contraindications for transplant in CF are
``` organ failure CCS>20mg malignant drugs/nicotine peripheral vascular disease ```
93
CF causes patients to have
no change in FEV1 | vitamin E deficiency
94
Signs of CF are
``` increased salt in sweat pancreatic insufficiency failure to thrive orange, pale, offensive stools scarring abscess chest infections ```
95
Symptoms of CF are
nasal polyps males are infertile meconium ileus IBD (inflammatory bowel disease)
96
CF tests include
Guthrie test immunoreactive trypsinogen mutation analysis heelstick (newborns)
97
CF treatments are
``` enzyme pellets high energy diet (not low fat) vitamins A D E and K hypertonic saline mucolytics proton pump inhibitors ```
98
Sleep apnoea can be causes by
obesity
99
Sleep apnoea can cause
URT obstruction | O2 desaturation
100
Snoring, unrefreshing sleep, daytime tiredness, decreasec concentration are all caused by
sleep apnoea
101
Sleep apnoea can be studied using
over night sleep study | polysomnography
102
Sleep apnoea can be treated by
decreasing alcohol and weight treat endocrine disorder mandibular splint
103
Type I respiratory failure =
decreased PaO2
104
Type II respiratory failure =
decreased PaO2 | increased PCO2
105
ARDS - acute rest distress syndrome a cause of
respiratory failure
106
Type I resp failure can cause
``` lung disease VQ mismatch shunts oedema pneumothorax acute hypoxia ```
107
Type II resp failure can cause
ventilation failure COPD overdose decreased effort when breathing
108
Signs of resp failure are
increased RR hypoxia crackles
109
Symptoms of resp failure are
``` ARDS fibrosis oedema exudate haemorrhage ```
110
Investigations for rest failure include
pulse oximetry ABGs capnography (monitoring PCO2)
111
TED stands for
thromboembolic disorder
112
TED, DVT and PE are caused by
``` pelvic clot cardiac thrombi septic emboli air amniotic fluid ```
113
PE, DVT and TED can cause
surgery, burns, trauma cancer, stroke paralysed legs obesity
114
Signs of PE, DVT and TED are
Systolic BP
115
PE, DVT and TED symptoms include
pain cough haemoptysis fever
116
Investigations for PE, DVT and TED are
``` D-Dimer ABG CXR, ECG Doppler Echo ```
117
PE, DVT and TED can be treated using
``` anticoags resp support O2 ventilation IV fluids analgesia heparin thrombolytics ```
118
If V/Q is positive you ALWAYS
treat it
119
PHT (Pulmonary Hypertension) =
>25mmHg at rest | >35mmHg during exercise
120
PHT causes
hypoxic vasoconstriction decreased RR & surface area of pulmonary vascular bed severe RHF RV vol/pressure overload
121
PHT signs are
loud P2 R ventricle heave ejection systolic murmur on inspiration
122
PHT symptoms are
``` SOB fatigue syncope tightness ankle swelling haemoptysis RUQ pain ```
123
PHT tests include
CXR Echo ECG VQ scan
124
PHT treatments include
``` warfarin O2 diuretics CCBs NO surgery transplant ```

Term 2 - CVS and Resp (8 decks)

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