Respiratory - obstructive diseases Flashcards
What structures are affected by obstructive and restrictive diseases
airways are affected by obstructive diseases
Lungs are affected by restrictive diseases
What characteristics of asthma can be used to classify the condition (4)
level of type 2 cytokines
Onset
(Non)atopic
Extrinsic or intrinsic
What is the triad associated with asthma
reversible airflow obstruction
Airway hyper responsiveness
T2 airway
What are the hallmarks of airway remodelling (3)
thickening of the basement membrane
Collagen deposits in submucosa
Hypertrophy of smooth muscle
Describe the inflammatory cascade of asthma (4)
inherited acquired factors trigger a response
Eosinophilic inflammation
Mediators are released (TH2 cytokines)
Hypperreactivity of smooth muscle
What are the different methods that can be used to manage the steps of the inflammatory cascade (4)
Avoiding the precipitating
Anti-inflammatory medication
Anti-Leukotrienes/anti-histamines
Bronchodilators
Describe the characteristics of asthma (4)
episodic symptoms
Diurnal variability
Non-productive cough
Wheeze
What type of medication is asthma responsive to (2)
steroids
Beta agonists
Presence of what indicates that an individual has asthma (4)
Raised eosinophils
Raised FeNO
Diurnal variation of peak flow
Reduced forced expiratory ratio
What can be used to diagnoses asthma (3)
history
Examination
Provocation testing
What is the main symptom of COPD
Breathlessness
What are the components of COPD (2)
chronic bronchitis
Emphysema
Describe chronic bronchitis (6)
chronic neutrophilic inflammation
Hypersecretion of mucus
Mucocilliary dysfunction
Altered lung biome
Smooth muscle spasms
Smooth muscle Hypertrophy
Describe emphysema (3)
Alveolar destruction
Impaired exchange of gases
Loss of bronchial support
Which component of COPD is irreversible
Emphysema
What are the characteristics of COPD (5)
chronic (not episodic)
Worsened by smoking
Non-atopic
Productive cough
Exacerbated by infection
Describe the chronic cascade of COPD (5)
progressive and fixed airflow obstruction
Impaired alveolar gas exchange
Respiratory failure
Pulmonary hypertension
Right ventricular Hypertrophy or failure
What is ACO
Asthma-COPD overlap syndrome
Raised eosinophils
What are the symptoms of rhinitis (4)
Rhinorrhoea
Sneezing
Itching
Nasal congestion and obstruction
What causes swelling of the nasal cavity
Dilation of blood vessels
What causes difficulty breathing in rhinitis (3)
increased mucosal blood flow
Increased blood vessel permeability
Increased volume of nasal mucosal
How can drugs be transported across the nasal epithelium (4)
Transcellular diffusion
Paracellular diffusion
Carrier mediated transport
Vesicle mediated transport
What is stridor
an inspiratory wheeze caused by obstruction of large airways
What are possible causes of stridor
infection
Foreign bodies
Anaphylaxis/angioneurotic oedema
Neoplasms
Goitre
Trauma
What investigations can be used for stridor (5)
laryngoscopy
Bronchoscopy
Flow volume loops
CXR
CT scan (thyroid)
How is stridor treated (4)
Treat underlying cause
Mask ventilation with high flow oxygen
Cricothryoidotomy
Tracheostomy
How can malignant airway obstruction be treated (5)
removal of tumour
Tumour compression
Radiotherapy
Chemotherapy
Corticosteroids
What type of hypersensitivity is involved in anaphylaxis
type 1 (immediate, IgE mediated)
What are the signs of anaphylaxis
flushing
Itching
Hives
Angioneurotic oedema
Abdominal pain + vomiting
Hypotension (circulatory collapse)
Stridor
Wheeze
Respiratory failure
How can anaphylaxis be treated (5)
IM epinephrine
IV antihistamine
High flow oxygen
Nebulised bronchodilators
Endotracheal intubation
How can anaphylaxis be treated long term (3)
avoiding allergen
Desensitisation
Self-administration of epinephrine
Describe obstructive sleep apnoea (2)
intermittent upper airway collapse in sleep
Resulting in recurrent arousals/sleep fragmentation
What are some risk factors for obstructive sleep apnoea
enlarged tonsils
Obesity
Retronathia
Acromegaly, hypothyroidism
Oropharyngeal deformity
Stroke/MS
Drugs
Post-operation
What are consequences of obstructive sleep apnoea (3 day-to-day, 4 biochemical)
excessive daytime sleepiness
Cognitive/function impairment
Personality change
Activated sympathetic system
Raised CRP
Impaired endothelial function
Impaired glucose tolerance
How can obstructive sleep apnoea be diagnosed (3)
raised Epworth score
Overnight sleep study (oximetry and domiciliary recording)
Polysomnography
how can obstructive sleep apnoea be treated (4)
removal of cause
CPAP
Mandibular advancement devices
Surgery
