Respiratory Medicine Flashcards
Define Asthma
A disease characterised by recurrent attacks of breathlessness and wheezing, which vary in severity and frequency and from person to person.
List 3 classical features of asthma
episodic wheeze, cough , reversibility
List 8 common precipitants of an asthma attack
Inhaled triggers: indoor allergens, outdoor allergens, tobacco smoke, chemical irritants (in workplace)
Other triggers: cold air, emotional arousal, exercise, certain medications
list 6 clinical features of an asthma attack
difficulty breathing, wheezing, cough, SOB, difficulty performing daily activities, chest tightness.
Briefly describe the blood gas abnormalities associated with severe asthma
Initially an asthma attack results in respiratory alkalosis, then with tiring CO2 rises and metabolic acidosis occurs.
What spirometry results would suggest obstructive disorder
FEV1 reduced, FVC reduced but to a lesser extent, FEV1/FVC ratio reduced (<0.7)
What spirometry results would suggest restrictive disorder?
FEV1 reduced, FVC reduced, FEV1/FVC ratio normal (>0.7)
Define COPD
A lung disease characterised by chronic obstruction of airflow that interferes with normal breathing and is not fully reversible.
Outline the typical history of a patient with COPD
Most patients present late in the course of their disease with the following symptoms: -cough -worsening dyspnoea -progressive exercise tolerance -sputum production -altered mental state -wheezing.
Systemic manifestations may also occur including: -decreased fat free mass -impaired systemic muscle function -osteporosis -anaemia -depression -pulmonary hypertension -cor pulmonale -left sided heart failure
A productive cough or acute chest illness is common. The cough is usually worse in the mornings and produces a small amount of colourless sputum
List recognised risk factors of COPD
-smoking -air pollution -occupational dust and chemicals -genetics (a1-antitrypsin deficiency -age
List 9 physical signs of COPD
-tachypnoea -hyperinflation -reduced criosternal distance -reduced expansion -resonant or hyperessonnt percussion -quiet breath sounds -wheeze -cyanosis- cor pulmonale
List 6 initial investigations for COPD
-spirometry -pulse oximetry -ABG -CXR -FBC -ECG
What is ‘Bronchiectasis’
A condition in which damage to the airways causes them to widen and become flabby and scarred.
Injury to the walls by infection or another condition impairs mucous clearance, leading to an environment where bacteria can grow, leading to frequent infections.
Outline the typical history of bronchiectasis
Patients present with recurrent chest infections, including a chronic daily productive cough with mucopurulent sputum production.
What are the risk factors for Bronchiectasis?
- Absent or dysfunctional CFTR protein in bronchial cells in cystic fibrosis.
- Having a whole body (systemic) disease associated with bronchiectasis
- Chronic or severe lung infections that damage the airways
