Respiratory Extras Flashcards
What are the effects of a panic attack on the respiratory system?
- Panic attacks result in hyperventilation which causes a respiratory alkalosis.
- pO2 will be normal as there is no problems with gas exchange.
- There would be no metabolic compensation as the panic attack resolves rapidly.
What is Kartagener’s syndrome?
- Kartagener’s syndrome also known as primary ciliary dyskinesia
- Dynein arm defect results in immotile cilia
What is Kartegener’s syndrome associated with?
- Dextrocardia
- Presents with
- Quiet Heart Sounds
- Small volume complexes in lateral leads
What are features of Kartegener’s syndrome?
- Dextrocardia or complete situs inversus
- Bronchiectasis
- Recurrent sinusitis
- Subfertility (secondary to diminished sperm motility and defective ciliary action in the fallopian tubes)
What are the 3 main types of Altitude Related Disorders?
- Acute mountain sickness (AMS)
- High altitude pulmonary edema (HAPE)
- High altitude cerebral edema (HACE).
All three conditions are due to the chronic hypobaric hypoxia which develops at high altitudes
What are symptoms of Acute Mountain Sickness?
- Headache
- Nausea
- Fatigue
How is Acute Mountain sickness prevented?
- Risk of AMS may actually be positively correlated to physical fitness
- Gain altitude at no more than 500 m per day
- Acetazolamide (a carbonic anhydrase inhibitor) is widely used to prevent AMS
How can Acute Mountain Distress be treated?
Descent
What can AMS develop into and how?
A minority of people above 4,000m go on to develop:
- High altitude pulmonary oedema (HAPE) or High altitude cerebral oedema (HACE), potentially fatal conditions
How do HAPE and HACE present?
HAPE presents with
- Classical Pulmonary Oedema features
HACE presents with:
- Headache
- Ataxia
- Papilloedema
How is HACE managed?
- Descent
- Dexamethasone
How is HAPE managed?
- Descent
- Nifedipine, Dexamethasone, Acetazolamide, Phosphodiesterase type V inhibitors*
- Oxygen if available
What are some predisposing factors for Sleep Apnoea?
- Obesity
- Macroglossia: acromegaly, hypothyroidism, amyloidosis
- Large tonsils
- Marfan’s syndrome
What is the consequence of Sleep apnoea?
- Daytime somnolence
- Hypertension
How is Sleep Apnoea assessed?
- Epworth Sleepiness Scale: Questionnaire completed by patient +/- partner
- Multiple Sleep Latency Test (MSLT): measures the time to fall asleep in a dark room (using EEG criteria)
