Respiratory Pathology Flashcards
What is type 1 respiratory failure
Failure of oxygen exchange function fie to acute disease of the lungs
What is type 2 respiratory failure?
Hypercapnic respiratory failure- high CO2, low O2
Common causes of Type 1 Respiratory failure
Cardiogenic pulmonary oedema (CHF)
Pneumonia
PE
Common causes of Type 2 Respiratory failure
CO2 Retention:
Severe asthma
Chronic Bronchitis
Drug overdose
Neuromuscular disease
Chest wall abnormalities
What is V/Q mismatch?
Inbalance between ventilation and perfusion
What is atelectasis?
Collapsed alveoli
What is respiratory shunt?
Venous blood returning to the heart without picking up its normal O2 quota
Causes of shunt
Pneumonia
Atelactasis
Severe pulmonary oedema
Cause of cardiogenic pulmonary oedema
LVF
Heart valve diseases
Reduced cardiac output
Reduced stroke volume
Signs and Symptoms of pulmonary oedema
DIB
Anxiety
Pale Skin
Pink Frothy Sputum
Hpyoxia
Orthopnea
Oedema of ankles later
What is Acute Respiratory distress syndrome
Non-cardiogenic pulmonary oedema
Direct causes of ARDS
Pneumonia
Aspiration
Drowning
PE
Trauma
Inhalation injury
Symptoms of pneumonia
Cough with green/yellow phlegm
Fever and chills
SOB
Chest pain worse on breathing and coughing
What are the two branches of COPD
Chronic Bronchitis
Emphysema
Risk factors of COPD
Smoking
Exposure to industrial pollution
Childhood respiratory infections
Genetic- Alpha-1-antitrypsin deficiency
Age
Signs and Symptoms of Chronic Bronchitis
Chronic wet cough
SOB
Excess mucus
Wheezing
Tachycardia
Tachypnoea
Pulmonary Hypertension
Low SPO2
CO2 retention
Signs and Symptoms of Emphysema
Chronic cough
SOB
Flushed skin
Tachycardia
Tachypnoea
Pursed lips
Barrel Chest
Hypertension
Cachexia
Which cells produce mucus
Goblet cells
Explain the term “blue bloaters” in relation to COPD
In chronic bronchitis, restriction of bronchioles leads to CO2 retention in alveoli. CO2 lead up causes cyanosis, and the air trapping gives bloated barrel chest impression
Pathology of emphysema
Damage to alveolar walls, reduced surface area for gas exchange
Define asthma
A chronic respiratory disorder which causes episodic airway obstruction
What are the two types of asthma?
Atopic Asthma (Extrinsic)
No atopic Asthma (Intrinsic)
What is the Atopid Triad of Asthma?
Childhood
Hayfever
Dermatitis
What is Atopic Asthma?
Type 1 (IGe Mediated) hypersensitivity reaction of the immune system
What is the main difference between Atopic and Nonatopic Asthma?
Atopic is an immune response to a known allergen, whereas non atopic is an inflammatory response to an irritant
Triggers of Nonatopic Asthma
Smoke
stress
NSAIDs
pollution
chemicals
Signs and Symptoms of SEVERE asthma
Tachycardia
Cyanosis
Reduced Air Entry
Reduced Peak flow
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Tripoding
Accessory muscle use
What are the three severity classifications of asthma episodes
Mild
Severe
Life Threatening
Signs and symptoms of LIFE THREATENING asthma
Silent Chest
Exhaustion
Lack of Respiratory Effort
Hypotension
Reduced GCS
Arrhythmias
First line treatments of Acute asthma episode
Nebulised salbutamol (5mg Adult/ 2.5mg Paeds)
Ipatropium bromide (500mcg adult)
Hydrocortisone IV/IM 100mg
Supplemental Oxygen
Prednisolone
Rapid evacuation
Adrenaline
Pathology of acute atopic asthma
Allergen enters the body
IGe released
IGe causes mast cell degranulation of histamine
Disproportionate inflammatory response
Oedema and mucus production
Is asthma an example of Type 1 or Type 2 respiratory failure?
Type 2- hyercapnic due to CO2 retention
What is pulmonary oedema?
Excess fluid build up in the lungs interstitial and alveolar spaces
Categories of Pulmonary Oedoema
Cardiogenic- result of heart disease
Non-cardiogenic- damage to pulmonary capillaries or alveoli
- Local pulmonary infections, Sepsis, low oncotic interstitial space
Symptoms of Pulmonary Oed
Mechanisms of Pulmonary oedema
Increased hydrostatic pressure
Increased permeability of vessels
Impaired lymphatic drainage
Altered gas exchange
What is HAPE
High altitude pulmonary oedema
Diagnosis of Pulmonary Oedema
History and symptoms
Chest X-ray
CT Scan
ECG
Blood Tests
SPO2 and ABG
Emphysema leads to higher risk of:
Pneumonia
Type 2 Respiratory failure
- Hypercapnia and respiratory acidosis
Secondary Spontaneous Pneumothorax
Bullae
In TB, live and dead bacilli form what in the lungs?
Granulomas
