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Systems 1 Respiration (ME2508) > Respiratory Diseases, Investigations and Treatments > Flashcards

Respiratory Diseases, Investigations and Treatments Flashcards

1
Q

Define bronchitis.

A
  • LRTI
  • inflammation of the bronchus
  • usually caused by a viral infection
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2
Q

List some symptoms of bronchitis.

A
  • hacking cough
  • thick, yellow-grey sputum
  • coryza
  • dyspnoea
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3
Q

What are the most common infective agents in bronchitis?

A

haemophilus influenzae

- pneumococcus

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4
Q

Define pleural empyema.

A

An accumulation of pus in the pleural cavity.

- may or may not follow pneumonia or bronchietasis

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5
Q

What is the most common bacteria causing pleural empyema?

A
  • Streptococcus
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6
Q

List some symptoms of empyema.

A
  • chest pain
  • high swinging fever
  • absence of cough
  • dyspnoea
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7
Q

What is the treatment for empyema?

A
  • chest drain

- IV antibiotics

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8
Q

Define asthma.

A

Immune system mediated inflammation of airways, leading to widespread narrowing of airways.

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9
Q

List the risk factors for asthma.

A
  • genetic (inherited tendency to IgE response to allergens)
  • occupations
  • smoking
  • maternal smoking
  • obesity
  • diet
  • reduced microbe exposure
  • pollution
  • environmental allergens
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10
Q

List the symptoms of asthma.

A
  • WHEEZE
  • dyspnoea
  • chest pain/tightness
  • cough (paroxysmal/dry)
  • occasional sputum

Symptoms are variable and intermittent

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11
Q

How do you measure asthmatic control?

A

SANE

S - short-acting beta agonist
A - absence form school/nursery
N - nocturnal symptoms
E - exertional symptoms

all how often per week

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12
Q

How would you treat asthma in children?

A
  • start SABA (salbutamol)
  • add ICS (beclamethasone)
  • add LTRA (instead of ICS in under 5’s)
  • add LABA
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13
Q

How would you treat asthma in adults?

A
  • start SABA (salbutamol)
  • add ICS (beclamethasone)
  • add LABA
  • add LTRA
  • oral steroids
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14
Q

Define COPD.

A

A chronic, slowly progressive disorder characterised by airflow obstruction that doesn’t change markedly over several months.

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15
Q

List the symptoms of COPD.

A
  • breathless on exertion
  • chronic cough
  • sputum (clear or mucoid)
  • weight loss
  • peripheral oedema
  • chest tightness
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16
Q

List the signs of COPD.

A
  • breathless
  • pursed lip breathing
  • use of accessory breathing muscles
  • cyanosis
  • flapping tremour
  • hyperexpanded chest
  • laryngeal descent
  • decreased breath sounds
  • prolonged expiration w/ wheeze
  • cardiac dullness to precussion
  • hepatomegaly
  • oedema
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17
Q

What are the essential investigations for COPD?

A
  • spirometry
  • pulmonary function test
  • chest radiograph
  • full blood count
  • ECG
  • CO gas transfer
  • cor pulmonale
  • tachycardia
  • increased JVP
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18
Q

What is the treatment for COPD?

A
  • start with SABA
  • add LAMA or LABA
  • then LAMA and LABA
  • then ICS
  • perhaps diuretic or oxygen therapy
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19
Q

Define pneumonia.

A

Inflammation of lung tissue accompanied with swelling and filling up of alveoli with inflammatory cells.

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20
Q

What the patterns of pneumonia?

A 
Broncopneumonia = often bilateral basal patchy opacification
Lobar = one whole lobe effected
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21
Q

List the symptoms of pneumonia.

A
  • malaise
  • fever
  • pleuritic chest pain
  • cough
  • purulent sputum
  • headache
  • dyspnoea

initial symptoms are generally vague

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22
Q

List the signs of pneumonia.

A
  • pyrexia
  • tachycardia
  • tachypnoea
  • central cyanosis
  • dullness of percussion of affected lobe(s)
  • bronchial breath sounds
  • inspiratory crepitations
  • increased vocal resonance
  • reduced expansion of effected side
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23
Q

What investigations are carried out when pneumonia is suspected?

A
  • chest x-ray
  • serum biomarkers
  • full blood count
  • throat swab
  • blood cultures
  • sputum microscopy and culture
24
Q

Which two bacteria are the most common cause of pneumonia?

A
  • strep. pneumonia

- haemophilus influenzae

25
Q

How do you assess the severity of pneumonia?

A 
CURB 65
C - confusion
U - blood urea >7
R - respiratory rate >30
B - diastolic blood pressure <60
65 - age >65
26
Q

How would you treat a patient with pneumonia?

A

CURB 0-1 = amoxicillin or clarithromycin/doxycycline
CURB 2 = amoxicillin and clarithromycin/levofloxacin
CURB 3-5 = Co-amoxiclav and clarithromycin

  • oxygen
  • IV fluids
  • analgesia
  • intubation/ventilation
27
Q

How would you treat a child with pneumonia?

A
  • first try oral amoxicillan
  • second try oral macrolides

Only give IV if vomiting

28
Q

Define bronchiectasis.

A

Localised pathological dilation and damage of the bronchi.

29
Q

List some causes of bronchiectasis.

A
  • idiopathic
  • immotile cilia syndrome
  • cystic fibrosis
  • childhood infections such as measles
  • hypogammaglobulinaemia
  • allergic bronchopulmonary aspergillosis (exagerated immune response to aspergillus fungus)
30
Q

What are the symptoms of bronchietasis?

A
  • chronic cough
  • daily sputum production (often copious/purulent)
  • wheeze
  • dyspnoea
  • tiredness
  • fitting chest pain
  • haemoptysis
31
Q

Give two signs of bronchiectasis.

A
  • finger clubbing

- course inspiratory crepitations

32
Q

What investigations would you carry out if you suspect bronchiectasis?

A
  • High resolution CT thorax
  • sputum culture
  • serum immunoglobulin.
33
Q

How would you treat brochiectasis?

A
  • chest physiotherapy
  • antibiotics appropriate to infection (high dose and long course)
  • may be treated with SABA/ICS
34
Q

Where would a lung abscess be most likely to occur?

A
  • an obstructed bronchus
35
Q

What are the most likely organisms to cause a lung abscess?

A
  • staph. aureus

- pseudomonas

36
Q

How would you treat a lung abscess?

A
  • prolonged antibiotics
37
Q

Define emphysema.

A

A condition is which the alveoli are damages and enlarged.

38
Q

What are the symptoms of emphysema?

A
  • dyspnoea
  • cough
  • frequent chest infections
39
Q

Define tuberculosis.

A

A bacterial infection triggering a Th1 cell immunological response which leads to tissue damage and progressive disease.

40
Q

List the symptoms of tuberculosis.

A
  • usually no initial symptoms
  • fever
  • malaise
  • erythema nodosum
  • cough
  • sputum
  • haemoptysis
  • pleuritic pain
  • dyspnoea
  • weight loss
  • crackles/bronchial breathing
41
Q

What is the organism causing tuberculosis?

A
  • Mycobacteria

(numerous species)

  • ubiquitous in soil and water
42
Q

What are the three outcomes of a primary infection of tuberculosis?

A
  • progressive disease
  • contained and latent
  • cleared/cured
43
Q

Define cystic fibrosis.

A

An autosomal recessive gene mutation.

it can lead to bacterial colonisation, inflammation, mucous plugging, airway damage, ulceration and brochiectasis.

44
Q

What is the gene prevalence of cystic fibrosis?

A

one in twenty-five

45
Q

Where is the gene mutation in cystic fibrosis?

A
  • CFTCR (cystic fibrosis transmembrane conductance regulator) on chromosome seven
46
Q

Name two things that the CFTCR gene is responsible for.

A
  • transport for active chlorine

- regulating liquid volume on epithelial surface

47
Q

List the symptoms of cystic fibrosis.

A
  • recurrent chest infections
  • pneumonitis
  • bronchiectasis
  • abscesses
  • chronic, purulent sputum
  • onset diabetes
  • weight loss
  • fever
48
Q

List the signs of cystic fibrosis.

A
  • haemopytsis
  • pneumothorax
  • failure to thrive
  • osteoporosis
  • malnutrition
49
Q

What are the investigations into cystic fibrosis?

A
  • guthrie test
  • sweat test
  • pulmonary function test/ spirometry
  • chest x-ray
50
Q

How would you treat cystic fibrosis?

A
  • oral or IV antibiotics
  • anti-inflammatories
  • ivacaftor - new class of drug addressing primary defect in the CFTCR gene
  • often will need a lung transplant
51
Q

What are the three main biological agents causing symptoms in cystic fibrosis?

A
  • pseudomonas aeruginosa (60%)
  • staph. aureus (42%)
  • haemophilus influenzae (15%)
52
Q

Define sarcoidosis.

A

A chronic disorder in which lymph nodes in many parts of the body are enlarged and a granulomatous presentation of inflammatory cells causing a multi-system disorder.

53
Q

What are symptoms of sarcoidosis?

A
  • may be none
  • dsypnoea
  • cough
  • chest pain
54
Q

List the signs of sarcoidosis.

A
  • acute arthralgia
  • erythema nodosum
  • bilateral hilar lymphadenopathy
  • abnormal chest x-ray
  • heart failure
  • hypercalcaemia
55
Q

Who is most at risk of developing sarcoidosis?

A
  • females
  • blacks
  • younger population
56
Q

What is the treatment for sarcoidosis.

A
  • corticosteroids
    (only if affecting organs)
  • NSAIDs

Systems 1 Respiration (ME2508) (7 decks)

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