Respiratory medicine for dental students Flashcards
Hamoptysis?
Coughing up blood
Dyspnoea?
Breathlessness
Physical Respiratory system examination?
Pulse rate
Respiratory rate
Listen to breathing
Lung auscultation
Investigation for lungs?
Arterial blood gas (ABG) - pO2, pCO2, pH
CXR
CT scan
Peak flow
Pulmonary function test
Bronchoscopy
Bronchoscopy?
procedure to look directly at the airways in the lungs using a thin, lighted tube (bronchoscope)
Pulmonary function test?
tests measure lung volume, capacity, rates of flow, and gas exchange. This information can help your healthcare provider diagnose and decide the treatment of certain lung disorders.
Type I and II respiratory failure?
Type 1 - PO2 is low, PCO2 normal or low, acute asthma, pneumonia
Type 2 - PC02 is low, high PCO2, COPD & OHS
Low/ normal PCO2 indicates what?
Pneumonia
What is type 1 respiratory failure?
Hypoxia
What is type II respiratory failure?
Hypercapnoea
Examples of type 1 respiratory failure?
Acute asthma
Pneumonia
Examples of type II respiratory failure?
COPD
Ohs
What type of disease are asthma and COPD?
Obstructive airways disease
Asthma?
Reversible airflow obstruction
Intermittent symptoms
COPD?
Irreversible airflow obstruction
Are asthma symptoms continuous?
No , intermittent symptoms
What causes COPD?
Smoking
Who commonly has COPD vs asthma?
COPD older adults
Asthma common in children
Are COPD symptoms continuous?
Yes
Symptoms of asthma/copd?
Dyspnoea, cough, wheeze, chest tightness
Management of asthma / copd?
Consequences of steroids?
early heart attacks, strokes, liver tumors, kidney failure, and psychiatric problems.
Example of inhaled corticosteroids?
Beclomethasone
Pneumonia?
inflammation and fluid in your lungs caused by a bacterial, viral or fungal infection
Acute illness
Fever, myalgia, headache
Cough, chest pain, sputum, dyspnoea
May require admission to hospital
May have type I respiratory failure
Consolidation on CXR
Treated with antibiotics, oxygen, intravenous fluids
Clinical symposium of pneumonia?
Fever, myalgia, headache
Cough, chest pain, sputum, dyspnoea
Treatment for pneumonia?
Antibiotics, oxygen, intravenous fluids
Bacteria causing pneumonia?
S. Pneumoniae
Causes of pulmonary embolism?
- clot in leg often arise in legs
Recent major operations
Recent major Rama
Immobility
Major chronic disease e.g. cancer
Symptoms of pulmonary embolism?
Dysponoea
Chest pain
Haemoptysis
Treatment for pulmonary embolism?
Anticoagulation - injection to stomach or tablet form
- apixaban
thrombolysis - uses drugs (thrombolytics) to get rid of blood clots.
CXR?
Chest x-ray
Sleep apnoea?
serious sleep disorder that happens when your breathing stops and starts while you’re asleep
Symptoms of sleep apnea?
Loud snoring and obstructive apnoeas (cessation of breathing)
Daytime sleepiness
Poor concentration
Management of sleep apnoea?
Weight loss
CPAP
Mandibular repositioning splint
What is sleep apnoea associated with?
Obesity hypoventilation syndrome
does sleep apnoea have increased risk with LA or GA?
General anaesthetic
Pneumothorax?
Collapsed lung
Types of pneumothorax?
Primary pr secondary
Primary pneumothorax?
No cause
Secondary pneumothorax?
Underlying lung disease - usually COPD
Symptoms of pneumothorax?
Chest pain (sudden onset)
Dyspnoea
How o diagnose pneumothorax?
Clinical examination and CXR
Treatment of pneumothorax?
Based on high - risk characteristic and pt wishes
- observation/conservative
- aspiration
- chest pain
- ambulatory care
Ambulatory care?
Outpatient care
Main cause of lung cancer?
Smoking
Symptoms of lung cancer?
Cough
Haemoptysis (coughing up blood)
Weight loss
How to diagnose lung cancer?
CXR
Ct scan
Bronchoscopy/ebus (biopsy- could have a mutataion and medication can be tailored according to the mutation)
Management of lung cancer?
Surgery
Chemotherapy
Radiotherapy
Palliative
If pt is experiencing haemoptysis- what is you diagnosis?
Initial diagnosis = lung cancer
Chronic cough?
Cough lasting over 8 weeks
What is the main thing to do if a pt has a chronic cough?
Exclude serious causes first
Investigation of chronic cough?
CXR
Lung function
Common causes fochrocn cough?
Asthma
Gastro-oesophageal reflux
Post nasal drip
Treatment for chronic cough?
Inhales corticosteroids
Gastric acid suppression e.g. omeprazole
Intranasal steroid spray e.g. beconase
Bronchiectasis?
Dilated, damaged airways
Clearance of muscles in lungs is not good and lungs get clogged up
Symptoms of brnchiectasis?
Cough
Sputum , often copious
Hamoptysis
How to diagnose bronchiectasis?
Clinica examination
CT thorax
Tx for brinchiectasis?
Chest physio
Antibiotics
Inhaled bronchodilator and inhaled corticosteroids
Why prescribe steroids?
treat rheumatoid arthritis, inflammatory bowel disease (IBD), asthma, allergies and many other conditions
reduce redness and swelling (inflammation). This can help with inflammatory conditions such as asthma and eczema. Steroids also reduce the activity of the immune system, which is the body’s natural defence against illness and infection.
Interstitial ling disease?
Thickening, inflammation of interstitium of lung
Typical in older pts
Symptoms of interstitial lung disease?
Dyspnoea
Dry cough
How to diagnose interstitial ling disease?
Clinical examination
Ct scan
Tx for interstitial lung disease?
Corticosteroids
Oxygen
Pulmonary rehabilitation
Pirfenidone
Effect of Covid-19 on lungs?
Pneumonia
Causes Acute respiratory disease syndrome
Respiratory failure
Possible tx for Covid-9?
Anti-retrovirals
Supportive therapy (antipyretics, IV fluids)
Oxygen if hypoxic
Steroids (dexamethasone). If on O2
Symptoms of Covid?
Cough
Dyspnoea
Sputum
Fever
Long Covid?
Group of health problems persisting or developing after initial period of Covid-19 infections
Common symptoms of long covid?
Extreme tiredness (fatigue, feeling short of breath, problems with your memory and concentration (brain fog), heart palpitations, dizziness, joint pain, muscle aches
Management of long Covid?
Rule out other causes (PE, fibrosis)
Conservative management
Respiratory systems and the dentists?
Be aware of diagnosis
Contagious infections
PPE
Medications
Mandibular splints
