Respiratory Medicine Flashcards
What are the 3 main disturbances that can occur within the respiratory system?
Reduced transfer of O2
Reduced ventilation of lungs
Reduced profusion of lungs
What are some respiratory symptoms?
Breathlessness Wheeze Cough Sputum production Chest pains
What is asthma defined as?
Reversible small airway obstruction
What % of adults and kids does asthma affect?
Adults 2-5%
Kids 5-10%
What are the symptoms of asthma?
Wheeze
Breathlessness not always related to exercise
Cough - Nocturnal, exercise induced, cold induced
How is asthma assessed?
Peak flow recordings
What can make someones asthma worse?
Allergens Irritants Exertion NSAIDs Emotion
What are the indications of severity in chronic asthma?
Restriction of activity
Inhaler use particularly as ‘relievers’
Peak flow readings daily
How is chronic asthma managed?
Step wise increase in medication
What is acute asthma defined by?
Sudden worsening of symptoms
What can make someones asthma unstable?
Recent infection
Poor compliance with medication
What should you do if you are treating an asthmatic patient?
Assess current symptoms
What should you do if you recognise someone symptoms as unstable?
Delay Tx and ref to GP
What are some side effects of inhaled medication?
Dry mouth
Oral candidiasis
Altered taste
What is COPD?
Chronic obstructive pulmonary disease
How is COPD defined?
Airflow obstruction that is not fully reversible
Is COPD a sudden condition or a progressive one?
Progerssive
What is airway obstruction defined as?
FEV1/FVC
If the FEV is >80% predicted normal, when should a diagnosis of COPD be made?
Diagnosis should only be made in the presence of respiratory symptoms.
What are the main processes associated with COPD?
Emphysema
Bronchitis
What is emphysema?
Alveolar destruction - lower area for gas exchange
What is bronchitis?
Airway inflammation - decreased ventilation
What are the symptoms of COPD?
Breathlessness linked to extortion
Wheeze - contant
Chronic cough and sputum production
Frequent infections
What happens to the volume of mucous a COPD patient will produce when they have an infection?
It increases
What investigations can be done in relation to COPD?
Pulmonary function tests
- Lung function
- Spirometry
How is COPD managed?
Progressive addition of oral and inhaled therapies
Stop smoking
Exercise training
If severe, home O2 but not if smoking
How is an acute exacerbation of COPD managed?
Increased inhalers
Steroids
Antibiotics
What is Pneumonia?
Infection of the lung tissue that can be diffuse of affect lobes
What is the causative agent in pneumonia?
Streptococcus pneumoniae
What are the symptoms of pneumonia?
Acute illness
- Cough with green sputum
- Breathlessnesss
- Fever
- Pleuritic chest pain
How is pneumonia managed?
Antibiotics
Hospitalisation for O2, IV fluids and airway support
When should you hospitalise a patient with pneumonia?
If their pulse is >100 bpm
Respiratory rate >20 breaths/min
BP - systolic = 2 seconds
O2 sats
Where is CURB 65 useful?
Only in hospitals
What is an pneumothorax?
Leak of air into pleural space
What are the symptoms of a pneumothorax?
Sudden onset breathlessness
Chest pains
What are the two susceptible groups in relation to pneumothorax?
Tall young people - especially if they smoke
Chronic lung disease patients
How is a pneumothorax managed?
Get rid of the air
- aspirate
- chest drain
- sometimes surgery
What is sleep apnoea?
Collapse of upper airway during sleep
What are the symptoms of sleep apnoea?
Snoring Day time sleepiness Irritability Head aches Micro sleeps
What are the risk factors for sleep apnoea?
Being over weight
Having a large neck
Sedative medication such as sleeping tablets
Unusual structure in the neck - large tonsils / small mandible
Smoking or drinking alcohol particularly before bed
How is sleep apnoea managed?
Life style changed - losing weight, cutting down alcohol
CPAP - continuous positive airway pressure device with prevents airway closing while asleep
Wearing a mandibular advancement device that holds jaw and tongue forward
What is interstitial lung disease?
Inflammation of lung tissues
What can interstitial lung disease progress to?
Fibrosis - a restrictive lung defect
What are the causes of interstitial lung disease?
Cryptogenic
Allergies
Direct damage
Auto immune
What are the symptoms of interstitial lung disease?
Cough
Breathlessness
How is interstitial lung disease managed?
Remove underlying cause
Suppression of immune system with steroids or other immunosuppressants
What is cystic fibrosis?
A genetic condition where the lungs and digestive system become clogged with stick mucus
What are the symptoms of cystic fibrosis in kids and in adults?
Kids - Recurrent respiratory infections - Malabsorption - Pancreatic duct obstruction - Bowel obstruction Adults - Male infertility - Diabetes - Osteoporosis
How is cystic fibrosis diagnosed?
Blood test done at birth
How is cystic fibrosis managed?
Prompt Tx of infections Prophylactic AB cover Nutrition Physio Heart / lung transplant
What is a DVT?
Deep vein thrombosis
Clot formation in peripheral veins
What is a PE?
Pulmonary embolism
Clot that forms in peripheral veins migrates to lungs
What are the symptoms of a DVT?
Painful lower leg
Dilated veins, hot, red, swollen
What are the symptoms of a PE?
Pleuritic chest pain Breathlessness Haemoptysis Collapse Sudden death
How are DVT and PE diagnosed?
DVT = Ultrasound PE = Chest CT, pulmonary angiogram
How are DVTs and PEs managed?
Anticoagulants
