Respiratory Diseases Flashcards
What are the key common symptoms of respiratory diseases? (4)
- Cough
- Chest pain
- Haemoptysis (coughing blood)
- Dyspnoea (shortness of breath)
What are other (minor) symptoms of respiratory diseases? (5)
- Wheezing
- Fever
- Hoarse voice
- Weight loss
- Stridor (Harsh inspiratory noise)
What does the SOCRATES pain assessment stand for?
- Site (where?)
- Onset (when?)
- Character (what is the pain like?)
- Radiation (does pain radiate anywhere?)
- Associations (other symptoms?)
- Time course (any pattern?)
- Exacerbating factors (does anything change the pain?)
- Severity
What history do you need to ask when someone has symptoms of Dyspnoea?
- Onset
- Severity
- Exacerbating factors
What history do you need to ask when someone has symptoms of a Cough?
- Onset
- Character
- Exacerbating factors
- Associations
What history do you need to ask when someone has symptoms of Chest pain?
SOCRATES
What questions do you need to ask someone who’s coughing phlegm? (5)
- Frequency
- Quantity
- Colour
- Consistency
- Smell
What questions do you need to ask someone who’s coughing Blood? (4)
(Haemoptysis)
- Frequency
- Quantity
- Colour
- Whether they’re not vomiting blood
What features from a hand examination could suggest respiratory diseases? (4)
- Tar staining
- Peripheral Cyanosis (blue finger tips)
- Tremors
- Finger clubbing
What is asthma?
Common chronic inflammatory condition of the airways
Name some clinical symptoms of asthma
- Wheeze
- Dyspnoea
- Chest tightness
- Cough
When are symptoms of asthma the worst?
The night and early morning
What does PEFR stand for
Peak expiatory flow rate
How can the use of a bronchodilator help diagnose between asthma and COPD
- If PEFR improves after bronchodilator then patient has asthma
- If no improvement and patient is a smoker then COPD
How can asthma be investigated? (3)
- PEFR
- Spirometry
- Blood test
How can asthma be managed? (4)
- Patient education
- Smoking advice
- Avoiding triggers
- Use of inhalers
What is the dental relevance of asthma? (3)
- GA & IV best avoided
- Avoid trigger drugs
- Increased tooth erosion
What is Chronic obstructive pulmonary disease (COPD)?
Common, progressive, poorly reversible airflow limitation associated with persistent inflammatory response of the lungs
What are the risk factors associated with COPD?
- Smoking
- Air pollutants
- Occupational dust/chemicals
- Alpha-1 antitrypsin deficiency (early COPD)
What is chronic bronchitis?
Airway obstruction from chronic mucosal inflammation, mucus gland hypertrophy, mucus hypersecretion and bronchospasm
Explain the link between cough and sputum production with chronic bronchitis?
Persistent cough and sputum production on most days for three months of the year in two successive years
What is emphysema?
Dilatation of airspaces distal to the terminal bronchioles with destruction of alveoli, reducing the alveolar surface area available for gaseous exchange
What is the dental relevance of COPD? (4)
- Best treated upright
- Advised to bring inhaler
- Rubber dan can obstruct breathing
- Best treated under LA
What is Pneumonia?
Acute infection of the lung parenchyma, usually by bacteria
What risk factors are associated with Pneumonia? (5)
Think habits and associated diseases
- Smoking
- Chronic lung disease
- Chronic heart diseases
- Alcohol abuse
- Immunosuppression
What is primary pneumonia?
Pneumonia that develops independently of other diseases
What colour sputum does someone with pneumonia produce?
Yellow-Green due to infection
How can Pneumonia be managed? (3)
- Antibiotics
- Supplemental oxygen therapy
- Smoking/Tobacco advice
What complications can arise from Pneumonia?
- Lung abscess
- Respiratory failure
- Empyema (pus in body cavity)
Dental relevance of pneumonia?
- Defer all dental treatment until recovery
- Avoid GA
What is Tuberculosis (TB)?
Chronic granulomatous infection caused by Mycobacterium tuberculosis
When can active TB develop?
Shortly after infection in impaired immunity due to ageing/substance abuse/HIV/cancer
What are the symptoms of someone with TB? (7)
- Chronic cough
- Haemoptysis
- Weight loss
- Night sweats
- Fever
- Productive sputum
- Lymphadenopathy
TB is treated with a combination of which 4 drugs? (RIPE)
How long for?
- Rifampicin (6 months)
- Isoniazid (6 months)
- Pyrazinamide (2 months)
- Ethambutol (2 months)
What is the dental relevance of TB? Contagious? Splatter? Sedation? Complications of TB?
- TB is contagious, dental treatment best deferred until treated
- Use rubber dam and avoid ultrasonic instruments
- Avoid GA, LA safe
- Ulcers in mouth
What is the male:female incidence of lung cancer
3:1
What are some causes of lung cancer? (5)
- Smoking (major)
- Asbestos
- Radon (from granite)
- Arsenic
- Coal tar
What is cystic fibrosis?
Autosomal recessive hereditary disorder where the body produces thick and sticky mucus that can clog the lungs and obstruct the pancreas
Cystic fibrosis is caused by a defect in which protein?
What does this protein regulate?
- CFTR
- Cl- and Na+ transport across exocrine glands
