Respiratory Medicine 1 Flashcards
What are the most common respiratory diseases to cause death?
- Pneumonia
- COPD
- Lung cancer
What is the role of the respiratory system?
What are the 3 main disturbances in the respiratory system?
Gas exchange, O2 in, CO2 out
Three main disturbances:
- reduced transfer of oxygen
- reduced ventilation of lungs
- reduced perfusion of lungs
What are some respiratory symptoms?
- breathlessness –> fatigue
- caused by one of the 3 main disturbances
- wheeze
- narrowing of airways
- cough
- protective reflex
- sputum production
- chest pain
- classically ‘pleuritic’ - pain in chest during deep inhalation
What is pneumonia?
What are its symptoms?
List some causative organisms:
Pneumonia: infection of the lung
- community acquired, hospital acquired, aspiration pneumonia
Symptoms:
- cough, sputum, haemoptysis (coughing blood), pleuritic chest pain, breathlessness, fever, malaise
Causative agents:
- streptococcus pneumonia, haemophilus influenzae, mycoplasma pneumonia
Gram negatives in aspiration pneumonia
How is pneumonia managed?
- ABCDE approach
- Hopsital or home treatment? CRB65
Confusion
Respiratory rate > 30/min
Blood pressure: SBP<90 or DBP<60
Age >65
- score a point for each of the above if ‘yes’
0 points = low risk
1 or 2 points = intermediate risk
3 or 4 points = high risk - mortality
Antibiotics guided by local antibiotic formulary
What is obstructive sleep apnoea?
List some risk factors:
- breathing stops and starts during sleep due to obstruction of pharynx
- sleep interrupted many times during the night
- unfreshing sleep, headaches, poor memory
Risk Factors:
- male > female
- overweight or obese
- small airway, small lower jaw, large tonsils
How is obstructive sleep apnoea diagnosed?
Managed?
Diagnosis:
- symptom assessment - Epworth Sleepiness scale
- sleep study
Management
- weight management
- continuous positive airway pressure (mask while sleep)
What is pneumothorax?
Symptoms:
Pneumothorax - when lung lining punctures and air escapes into pleural space
- can be spontaneous or occur from trauma
Symptoms:
- pleuritic chest pain
- breathlessness
If tension pneumothorax, cause collapse and cardiac arrest
How is pneumothorax managed?
- admission for assessment
- may need chest drain to allow lung reinflation
What is interstitial lung disease?
Symptoms?
Treatment?
Many different conditions:
- Idiopathic pulmonary fibrosis
- Extrinsic allergic alveolitis
One common pathology of inflammation of interstitial lung tissues (not the airways), can lead to lung scarring and fibrosis
Symptoms:
- breathlessness, often progressive, cough
Treatment:
- depends on cause, specialist respiratory clinics for management
What is Cystic Fibrosis?
Symptoms?
- autosomal recessive genetic disease woth multiple systems affected, especially the lungs - disrupts movement of salt and water
- more viscous mucous secretions in the lungs
- specialist care teams available for advice and support
- may have had a transplant –> immunosuppressants
Symptoms:
- frequent chest infections
- infertility
- cough
What are pulmonary embolus and DVT due to?
List some symptoms and treatment:
- often due to thrombus in deep veins of legs, migrating as an embolus to the lung
- breathlessness, cough, chest pain
Treatment:
Anticoagulation
List some dental aspects of respiratory conditions:
- as with COPD and asthma, any patient who is breathless, may find lying flat uncomfortable
- may be anticoagulated
- care required with sedation in people with chronic lung disease who have less respiratory reserve
- complex pts (cystic fibrosis) may need treatment by a specialist care dentist depending on morbidity
