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MBCHB 1 > respiratory pathology 3 > Flashcards

respiratory pathology 3 Flashcards

1
Q

how does cigarette smoking contribute to emphysema

A

inactivation of alpha -1 antitrypsin
activates polymorphonuclear leukocytes to cause emphysema

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2
Q

inflammation of the ear drum

A

otitis media

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3
Q

inflammation of the larynx

A

laryngitis

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4
Q

inflammation of the epiglottis

A

epiglottitis

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5
Q

tonsillitis

A

inflammation of the tonsils at the back of the throat

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6
Q

croup

A

Laryngotracheobronchitis

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7
Q

factors to look for in upper respiratory tract infections in children

A

whether they are breathing fine , hydration and feeding

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8
Q

causes of the upper respiratory tract infections

A

viral
bacterial in some cases

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9
Q

effects of a bacterial infection

A

could be locally causing the cardinal roles of inflammation
could be systemic that is affecting other regions of the body

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10
Q

how do the pathogens invade the respiratory system

A

disruption of the epithelium will lead to entry of the microorganisms into the respiratory tract

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11
Q

diseases where there is local inflammation only

A

otitis media
tonsillitis

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12
Q

systemic effects of the disruption of the rep epithelium

A

Otitis media, tonsillitis (local)
Septicaemia (systemic)
Pneumonia (systemic)
Meningitis (systemic)

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13
Q

commensal bacteria

A

bacteria whose main habitat is in the human body and under normal conditions they do not lead to spread of disease.
for example the nose , mouth , lungs , stomach , colon , sexual organs and skin

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14
Q

pathogenesis in bacteria

A

viruses invasion are repelled quite quickly as compared to any other pathogen
bacteria type 1 cause the degradation of the epithelium but the immune cells can handle example pneumococcus , staphylococcus , moraxella and haemophilus

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15
Q

examples of bacteria that cannot be fully destroyed by the immune system

A

pertussis
TB

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16
Q

treatment of upper respiratory tract infections

A

treatment with analgesia /antipyretic to relieve the pain

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17
Q

is it better to use antibiotics in upper resp infections

A

no , more side effects
1.Diarrhoea
2.Oral thrush
3.Nappy rash
4.Allergic reaction
5.Multi resistance

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18
Q

natural history in predicting the pattern of a upper respiratory infection

A

pattern cannot be predicted as it is different with different individuals

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19
Q

rhinitis

A

could be a prodrome to other illnesses such as pneumonia , bronchiolitis , meningitis , septicaemia

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20
Q

duration of rhinitis

A

not all the same although 50% of children had a runny nose gone within 11 days after the start

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21
Q

otitis media

A

primarily a viral infection with a characteristic pink colour which causes the rupture of the ear drum

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22
Q

otitis media as a secondary infection

A

pneumococcus
influenza flu

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23
Q

duration of otitis media

A

50% of children recovered within 3 days ; upto 3 day s

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24
Q

treatment of otitis media

A

analgesia
amoxycillin if the child is less than 2 and has otitis media in both ears; however the disease will still be resolved with both the analgestics and antibiotics but antibiotics have many side effects

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25
Q

testing for bacterial or viral tonsillitis

A

throat swab

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26
Q

treatment for tonsillitis

A

either nothing or penicillin
no amoxycillin

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27
Q

duration of a sore throat

A

50% should be done within 3 days

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28
Q

group 1 strep A disease

A

more systemic effects
high fever
rashes
more unwell ( lol funny guy)

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29
Q
A
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29
Q

pathogen that causes croup ( infection of the trachea , bronchi , larynx)

A

parainfluenza 3

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30
Q

symptoms of croup

A

quite common
the child is generally well
stridor , hoarse voice , barking cough

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31
Q

oral dexamethasone

A

treatment of croup

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32
Q

cause of epiglottitis

A

haemophilus influenza type B

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33
Q

symptoms of epiglottitis

A

very rare
child generally unwell
stridor breath sounds and drooling of saliva

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34
Q

management of epiglottitis

A

intubation and antibiotics

35
Q

duration of croup

A

mean population within 3 days

36
Q

recurrent croup

A

present in older population
related with malacia
commonly presented as asthma symptoms

37
Q

common bacterial agents

A

Strep pneumoniae,
Haemophilus influenzae,
Moraxella catarrhalis,
Mycoplasma pneumoniae

38
Q

common viral agents

A

Rhinovirus, RSV,
parainfluenza III,
influenza,
adenovirus,
coronavirus,
Human Meta Pneumo Virus

39
Q

tracheitis

A

croup that does not get better
fever and sick child

40
Q

cause of tracheitis

A

staphylococci
streptococcus

41
Q

symptoms of tracheitis

A

systemically unwell
tachycardia
narrowed tracheal lumen
swollen tracheal wall

42
Q

treatment and management of trachealis

A

antibiotics
steroids to be used at first

43
Q

bronchitis in children

A

common among ages 1 to 4
infection of the bronchi

44
Q

COPD

A

emphysema
chronic bronchitis - cough and sputum for at least 3 months present for at-least 2 consecutive years

45
Q

cause of COPD

A

inhalation of noxious particles and gases
which leads to the loss of alveolar attachments and thus decreased ability of the lungs to open up during expiration

46
Q

difference between COPD and asthma

A

asthma is reversible

47
Q

prevalence and incidence of COPD

A

1.2 million people living with a diagnosis of COPD everyday
with males having a greater number of prevalence than women

48
Q

copd and social deprivation

A

air pollutants exposure
poor nutrition
low socioeconomic status

49
Q

FEV -1 of people with COPD

A

smoking during gestation and childhood has the potential for increasing and increases the individual risks of developing COPD.

50
Q

known factors that increase the risk of COPD

A

age
sex

51
Q

Alpha-1 Antitrypsin Deficiency

A

rare inherited disease
manifested as COPD in childhood

52
Q

manufacture of alpha 1 trypsin inhibitor

A

liver
liver cirrhosis and liver fibrosis cause less production of the enzyme

53
Q

consequences of alpha -1 - antitrypsin inhibitor

A

alveolar damage and emphysema
basal predominance to emphysema

54
Q

symptoms of COPD

A

cough
breathlessness
sputum
frequent chest pains
wheezing
fatigue
weight loss
swollen legs

55
Q

factors that contribute to COPD

A

age
smoking history
onset and progression

56
Q

examination findings of COPD

A

peripheral oedema
hyperinflated chest
use of accessory muscles
cyanosis
cachexia
wheeze ( often a musical sound)

57
Q

mMRC dysponoea scale

A

scale that is used to measure levels of breathlessness
0-4

58
Q

diagnostic tests for COPD

A

post- bronchodilator spirometry to test for airflow obstruction
history and symptoms
chest x ray to show the severity

59
Q

spirometry tests results for COPD

A

diagnosed FEV1/FVC which is less than 0.7 post bronchodilator which shows no reversibility

60
Q

stages of COPD

A

Stage 1, mild — FEV1 80% of predicted value or higher. With these values, a diagnosis of COPD can only be made on the basis of respiratory symptoms.
◦Stage 2, moderate — FEV1 50–79% of predicted value.
◦Stage 3, severe — FEV1 30–49% of predicted value.
◦Stage 4, very severe — FEV1 less than 30% of predicted value.

61
Q

chest x ray interpretation of COPD

A

small heart - that is squashed by the hyperinflated lungs
flat diaphragm
hyperinflation - more than 6 anterior or 10 posterior ribs in the mid -clavicular line at the diaphragm level
vascular hila

62
Q

differentiating between asthma and COPD

A

history of smoking or occupational gas particles .
obesity causes decreased airflow into the lungs which can be displayed as anormal spirometry when it is indeed COPD

63
Q

differences between COPD and asthma

A

1.Reversibility, asthma spirometry should be normal out with exacerbations
2.PEFR little value in COPD and not used to stratify exacerbation severity

64
Q

is still not sure about whether it is COPD

A

pulmonary function test that is measure the lung volumes
1.there is is increased residual volume and total lung capacity
2.there is reduced gas transfer with carbon dioxide levels
3.radiology that is high resolution computed tomography.

65
Q

acute exacerbation of COPD

A

1.following a bacterial or a viral infection
2.air pollution
3.stopping treatments
4.poor nutrition
5.drugs such as diuretics
6.inappropriate oxygen administration
7.heart failure pulmonary embolus pneumothorax

66
Q

symptoms of acute exacerbation of COPD

A

worsening symptoms of shortness of breath , chest tightness , sputum that is increased volume and purulence and coughing.

67
Q

signs of a severe exacerbation

A

breathless that is increased respiratory rate of more than 25
accessory muscle at use
purse lip breathing
cyanosis
signs of sepsis
fluid retention
confusion

68
Q

management of acute exacerbations

A

change in inhaler ( technique , device , bronchodilator , increase or add inhaled steroid)
prednisolone tablets ( oral steroids )
antibiotics
self managements

69
Q

differential diagnosis of acute exacerbation
of COPD

A

pneumonia
pulmonary embolism
myocardial infarction
left ventricle failure
pleural effusion
pneumothorax

70
Q

deciding whether to admit someone with COPD or not

A

social aspects that is care of who is at home
comorbidity and background of the disease

71
Q

acute exacerbation diagnosis in secondary care

A

chest x ray
blood gases
FBC 9 full blood count )
sputum culture
VTS( viral throat swab )

72
Q

treatment of COPD in acute exacerbation in secondary care

A

oxygen
oral and IV corticosteroid and antibiotic
nebulised bronchodilator ( beta-2 and antimuscarinic )

73
Q

measuring severity of COPD

A

1.spirometry
2.nature and magnitude of symptoms MRC breathlessness scale
3.history of moderate and severe exacerbations and future risk
4.presence of co-morbidity

74
Q

in severe disease

A

respiratory failure which is caused by
ventilation perfusion mismatch
in type 1 there is reduced oxygen in type 2 there is increased CO2
this leads to flapping tremor when there is increased carbon dioxide retention

75
Q

severe COPD

A

cor-pulmonale
secondary polycythaemia
respiratory failure

76
Q

cor pulmonale in COPD

A

Tachycardic, oedematous, raised JVP, congested liver
ECG features: Right axis deviation, P pulmonale, T wave inversion V1-V4
Echo: pulmonary hypertension, tricuspid regurgitation

77
Q

secondary polycythaemia

A

increased production of erythropoietin in response to low oxygen .
increased haemoglobin , increased haematocrit and increased blood viscosity which leads to strokes

78
Q

deaths from lung diseases in UK

A

lung cancer
COPD

79
Q

admission of COPD in the UK

A

females is greater than in the UK

80
Q

Public measures to prevent COPD

A

public ban
sale of tobacco from vending machines
age of tobacco products purchase

81
Q

non pharmacological management of COPD

A

smoking cessation
vaccinations that is pneumococcal and annual flu vaccine
pulmonary rehabilitation
nutritional assessment
psychological support

82
Q

vaccinations for COPD management

A

annual flu vaccine
pneumococcal vaccine

83
Q

treatment for COPD with predominant breathlessnes

A

SABA
SABA AND LAMA

84
Q

COPD with exacerbations

A

SABAand lama

85
Q

oxygen therapy for COPD patients

A

partial pressure of less than 7.3 and for only a short duration with the following symptoms
polycythaemia
nocturnal hypoxia
peripheral oedema
pulmonary hypertension

86
Q
A

MBCHB 1 (27 decks)

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