Respiratory - Lecture 4 Flashcards
What are the 4 common presentations for respiratory problems?
wheezing
coughing
hemoptysis
dyspnoea - HVS
4 things that can cause dyspnoea
Increased ventilatory demand - exertion
Decreased ventilatory capacity - pleural effusion, pneumothrax
Increased airway resistance - asthma
Decreased pulmonary compliance - intersitial fibrosis
Pneumothorax....compared to pul. embol. on other side MUST KNOW occurs spontaneusly abrupt sharp chest pain & tachypnea diminished breath sounds hyperresonance
Pulmonary embolism MUST KNOW occurs spontaneously, diff risk factors abrupt sharp chest pain & tachypnea tachycardia
Common asthma symptoms
wheezing
chest tightness
coughing
Hyperventilation syndrome - acute, 6 things
severe dyspnoea agitation fear chest pain paraesthesia pre syncope/syncope
Hyperventialtion syndrome - chronic, 4 things
increased sighing
hard to detect
associated with depression
musculoskeletal change
Pneumonia....compared to COPD on other side MUST KNOW acute cough look unwell fever productive cough occasionally pleuritic chest pain areas of consolidation on lung
COPD MUST KNOW acute cough high effort on breathing accessory muscle use cough, may or may not be productive wheezing areas of hyperresonance
Chronic dyspnoea - think of lungs & heart
Restrictive lung disease - pneumonia TB rib fracture scoliosis
Obstructive lung disease -
COPD
chronic bronchitis - haemoptysis, fever, wheezing
asthma
Cough red flags
dyspnoea
haemoptysis
weight loss
risk factors for TB & HIV
Chronic bronchitis symptoms
haemoptysis a productive cough on most days dyspnoea fever wheezing - note: asthma is just wheezing, no other sym.
Upper respiratory tract infection & ace inhibitors both produce what symptoms
cough that is dry & non productive
can last for weeks or months
Haemoptysis - 3 sources & how much before it is considered a red flag?
True - from the lungs, bright red
Pseudo - from the nasopharynx
haematemesis - stomach/GI, coffee coloured
more than 600 mls in 24 hours…..red flag!
Chronic Obstructive Pulmonary Disease (COPD)
MUST KNOW
Epi - 3rd highest cause of death
Aet - smoking, genetic factors, child resp. disorders, pollutants
Pathogenesis - airflow limitation by airway obstruction, respiratory infection or inhalation exposure
Signs & Symptoms - cough, with or without mucus
fatigue, shortness of breath, wheezing, increased expiration, ,barrell chest, accessory muscle use
Asthma
MUST KNOW
Chronic inflammatory disease, narrowing airways and increased mucus production.
Epi - 1 in 6 adults, 1 in 4 NZ children
Aet - environmental allergens, resp. tract infections, NSAID sensitivity, GERD, emotional factors
agg: -Exercise (cold/dry air), -Occupation (air irritant)
-Allergy (pets, pollen)
Patho - airway inflamm, intermittent airflow obstruction, bronchial hyperresponsiveness
Signs/symp - Dyspnea (SOB), wheezing W exhale, coughing, chest tighness, tachypnea, tachycardia, access. muscle use, prolonged exp phase breathing.
-nocturnal SOB, cough, wheeze
Tx: brown inhaler: Blue inhaler: Bronchodilator to relieve inhaler symptoms breathless, wheezy or tight-chested.
Brown:Prevention steroid inhaler
Bronchitis
MUST KNOW
Epi - males more than females, one of top 5 reasons for a doctor visit
Aet - Acute: viral 90% & bacterial infections Chronic: smoking, air pollutants
Patho - acute: inflammation airway= narrowing- bronchial lining irritated, mucous membrane becomes swollen- air passages become clogged/irritated & lots of muscous forms, hence classic bronchial cough
chronic - Irreversible damage narrowing airway + obstruction- smoking impairs cilliary movement, inhibits function of alveolar, leads to hypertrophy & hyperplasia
Signs/symptoms - Dry cough turns to productive cough W sputum, chest pain, sore/runny nose, wheezy, finger clubbing, HA, extreme fatigue
Chronic: productive cough, wheeze, HA, Cyanosis
