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BAMS Bds2 > Respiratory Medicine > Flashcards

Respiratory Medicine Flashcards

1
Q

What does “respiratory” mean?

A

Designating, relating to, or affecting the organs involved in respiration; of or relating to respiration.
Of or relating to the processes of oxygen transport and respiration.

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2
Q

What is respiration?

A

-The action of taking air into the lungs and expelling it again, especially as a continuous physiological process.
-A single act of breathing.
-The exchange of oxygen and carbon dioxide between an organism or cell and the environment, including the process by which oxygen is distributed to tissues.

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3
Q

What is disease?

A

Sickness (in a person, animal, or plant); disturbance or impairment of the function (and often also the structure) of the body, a part of the body, or the mind.

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4
Q

What is the normal respiratory rate for different age groups?

A

-Adult: 12–20 breaths per minute
-Newborn: 30–40 breaths per minute
-Toddler: 20–30 breaths per minute
-6–10 yo: 18–25 breaths per minute
->10 yo: 12–20 breaths per minute

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5
Q

What is FEV1 in spirometry?

A

The volume of air forcibly expired in the first second after a full inhalation.
Normal FEV1 is calculated based on age, weight, and sex.
Healthy adult male: >3.5L
Healthy adult female: >2.5L

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6
Q

What is FVC in spirometry?

A

The maximum volume of air that can be expelled from the lungs forcibly.

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7
Q

What are common rheumatological conditions associated with auto-immune mediated pulmonary damage?

A

Rheumatoid Arthritis
Systemic Sclerosis
Systemic Lupus Erythematosis
Myositis

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8
Q

Upper Respiratory Tract diseases

A

OSA
Common Cold
Epiglottitis
Tonsillitis

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9
Q

What is Obstructive Sleep Apnoea (OSA), and what are its key symptoms?

A

OSA is the most common disorder of breathing during sleep, affecting 5–15% of the population.
Key symptoms include snoring, apnoea periods, dry mouth, daytime fatigue, somnolence, poor concentration, headaches, and depression.

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10
Q

What are the risk factors for Obstructive Sleep Apnoea (OSA)?

A

Male gender
Obesity
Type 2 diabetes
Smoking
Alcohol consumption
Down’s syndrome
Craniofacial abnormalities
Hypothyroidism
Acromegaly

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11
Q

What are the diagnostic methods for OSA?

A

STOP-BANG Questionnaire
Epworth Sleepiness Scale
Sleep studies, including polysomnography

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12
Q

OSA Treatment

A

Lifestyle changes
Continuous Positive Airway Pressure (CPAP)
Mandibular Advancement Devices

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13
Q

What is Common Cold ?

A

The common cold is common, self-limiting illnesses that resolve without intervention in up to 10 days

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14
Q

Wha are the causes of Common Cold ?

A

Most commonly caused by rhinoviruses.
Other implicated viruses include:
Influenza viruses.
Parainfluenza viruses.
Respiratory syncytial virus (RSV).
Adenoviruses.

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15
Q

What is Epiglottits?

A

Epiglottitis is a potentially life-threatening condition characterized by localized swelling of the epiglottis, often due to infection, which obstructs the laryngeal inlet.
Caused by Haemophilus influenza.

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16
Q

Q2: What clinical findings are often seen on examination in a patient with Epiglottits?

A

Unwell, scared pt
Muffled voice
if the child coughs it may sound like a “quack”
increasing dysphagia
drooling
stridor

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17
Q

What are common symptoms of tonsillitis?

A

Sore throat, otalgia (ear pain), headache, and malaise.

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18
Q

What clinical findings are often seen on examination in a patient with tonsillitis?

A

Pyrexia, enlarged tonsils with possible exudate from the crypts, swollen and tender lymph nodes, and halitosis.

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19
Q

When should a patient with tonsillitis be referred to ENT urgently?

A

If they have difficulty swallowing or unilateral swelling.

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20
Q

What is the first-line management for tonsillitis?

A

Analgesia, soft diet.

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21
Q

What is Chronic Obstructive Pulmonary Disease (COPD), and what are its two primary pathological components?

A

COPD is airflow obstruction due to chronic inflammation.
Pathological components:
1- Chronic bronchitis – inflammation, excess mucus, chronic productive cough for >3 months in 2 consecutive years.
2- Emphysema – alveolar membrane degradation, scarring, and loss of parenchymal lung texture.

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22
Q

COPD Pathology

A

Mucous hypersecretion
Cailiary dysfunction
Airflow obstruction and air trapping/hyperinflation.
Gas exchange abnormalities
Pulmonary hypertension

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23
Q

COPD Symptoms

A

Chronic cough, fatigue, dyspnoea, excess mucus, shortness of breath, and chest discomfort.

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24
Q

What are common causes of COPD?

A

Smoking
Pollution
Occupational exposure
Genetics (e.g., alpha-1 antitrypsin deficiency)
Asthma

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25
Q

How is COPD diagnosis?

A

History
Spirometry to monitor disease progression
Chest radiograph to exclude other pathologies
Full blood count
SpO2

26
Q

How is COPD treated?

A

Prevent COPS sequelae
Minimise progression of disease
Minimise exacerbations
Lifestyle measures (Smoking cessation -Exercise)
End stage – oxygen therapy

27
Q

What immediate action should you take if a patient with COPD becomes acutely short of breath and distressed in a dental practice?

A

Seat the patient upright, administer oxygen if available, and seek immediate medical assistance. Monitor SpO₂ and provide reassurance.

28
Q

What are the key features of asthma?

A

Chronic respiratory condition associated with airway inflammation and hyper-responsiveness.

29
Q

What is the main difference between extrinsic (atopic) asthma and intrinsic (non-atopic) asthma?

A

Extrinsic asthma is triggered by allergens and involves IgE-mediated responses, while intrinsic asthma is not related to atopic conditions or IgE.

30
Q

What are the typical symptoms of asthma?

A

Cough, wheeze, chest tightness, shortness of breath, and variable expiratory airflow limitation.

31
Q

What are common triggers for asthma?

A

Exercise, allergens, irritants, weather changes, viral infections, NSAIDs, and beta-blockers.

32
Q

What are some potential asthma sequelae?

A

Death, pneumonia, respiratory failure, pneumothorax, status asthmaticus, and impaired quality of life.

33
Q

What is the aim of asthma management?

A

To control the disease, prevent exacerbations, reduce morbidity and mortality, and maintain normal lung function with minimal side effects.

34
Q

What are the two main types of asthma medication?

A

Controllers (taken daily on a long-term basis)
Relievers (used as needed).

35
Q

Which medication is typically used as a reliever for acute asthma symptoms?

A

Short-acting beta-agonists (SABA) like salbutamol

36
Q

What is cystic fibrosis, and how is it diagnosed?

A

Cystic fibrosis is a multisystem disorder caused by a mutation in chromosome 7 (CTRF), impairing mucus clearance and increasing lung infections.

37
Q

What is the genetic cause of Cystic Fibrosis?

A

Autosomal recessive mutation on chromosome 7 (CFTR gene).

38
Q

What is a key diagnostic test for Cystic Fibrosis?

A

Sweat test (sweat chloride >60 mmol/L).

39
Q

What airway clearance techniques are used in Cystic Fibrosis management?

A

Active cycle of breathing techniques (ACBT) and airway clearance devices.

40
Q

What is the primary goal of exercise in Cystic Fibrosis patients?

A

To improve lung function and overall fitness.

41
Q

What are the common symptoms of lung cancer?

A

Persistent cough (≥3 weeks)
Unintended weight loss
New-onset dyspnoea
Pleuritic chest pain
Fatigue
Bone pain
Cervical lymphadenopathy

42
Q

Mention some Investigations uses for lung cancer

A

Chest X-ray (1st line), CT chest-abdomen-pelvis, bronchoscopy and biopsy, PET CT for staging.

43
Q

Which type of lung cancer is treated with surgery, chemotherapy, and immunotherapy?

A

Non-small cell lung cancer (NSCLC).

44
Q

What is the treatment approach for Small Cell Lung Cancer (SCLC)?

A

Chemotherapy and radiotherapy.

45
Q

What is the most common bacterial cause of community-acquired pneumonia?

A

Streptococcus pneumoniae (pneumococcus).

46
Q

List some common symptoms of community-acquired pneumonia.

A

Cough, breathlessness, pleuritic pain, pyrexia, tachypnoea, tachycardia.

47
Q

Which populations are at increased risk for more severe pneumonia?

A

Older age, cardiorespiratory comorbidities, low socioeconomic status, new weight loss/cachexia, immunocompromised.

48
Q

Which organism is primarily responsible for tuberculosis (TB)?

A

Mycobacterium tuberculosis.

49
Q

What are the primary symptoms of TB?

A

Malaise, productive cough, weight loss, shortness of breath, fever, chest pain, night sweats.

50
Q

What is miliary tuberculosis?

A

Disseminated disease spread through the blood, leading to tuberculomas in organs like the brain, kidney, and bone, often following primary or post-primary infection.

51
Q

How is TB typically diagnosed?

A

Chest X-ray, sputum sample, blood tests (IGRA), GeneXpert nucleic acid amplification test, Ziehl-Neelsen stain for acid-fast bacilli.

52
Q

What is a poor prognosis associated with in TB?

A

TB meningitis and miliary TB.

53
Q

What is a pulmonary embolus, and where do the clots typically originate?

A

A pulmonary embolus occurs when a clot detaches and lodges in the pulmonary arterial tree.
Clots often originate in the venous sinuses of the calf, the femoral vein, or the pelvis.

54
Q

What are the key risk factors for pulmonary embolism?

A

Age
Obesity
Previous VTE
Malignancy
Hormone Replacement Therapy (HRT)/Combined Oral Contraceptive Pill (COCP)
Pregnancy
Immobility
Hospitalization
Cancer
Atrial fibrillation
Factor V Leiden deficiency

55
Q

What are the main acute treatments for a pulmonary embolus?

A

Thrombolysis
Percutaneous catheter removal of the clot

56
Q

What are the long-term anticoagulation options for pulmonary embolism, and how long is treatment typically required?

A

Anticoagulation is required for a minimum of 6 months.
Options include:
Direct Oral Anticoagulants (DOACs) like apixaban or rivaroxaban
Low Molecular Weight Heparin (LMWH) such as enoxaparin
Warfarin

57
Q

What are the common forms of corticosteroids used for asthma?

A

Inhaled (with spacer), oral (for severe disease), and intravenous (for emergencies).

58
Q

Give an example of an inhaled corticosteroid (ICS).

A

Becotide

59
Q

What are the types of beta-2 agonists used for respiratory conditions?

A

Short-acting beta-2 agonists (SABAs) like salbutamol
Long-acting beta-2 agonists (LABAs) like salmeterol or formoterol.

60
Q

Which beta-2 agonist is used for rapid onset relief?

A

Salbutamol or terbutaline.

61
Q

Name a commonly used leukotriene receptor antagonist.

A

Montelukast

62
Q

What is an example of an inhaled muscarinic antagonist?

A

Ipratropium

BAMS Bds2 (4 decks)

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