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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
testing for bacterial or viral tonsillitis
throat swab
26
treatment for tonsillitis
either nothing or penicillin no amoxycillin
27
duration of a sore throat
50% should be done within 3 days
28
group 1 strep A disease
more systemic effects high fever rashes more unwell ( lol funny guy)
29
29
pathogen that causes croup ( infection of the trachea , bronchi , larynx)
parainfluenza 3
30
symptoms of croup
quite common the child is generally well stridor , hoarse voice , barking cough
31
oral dexamethasone
treatment of croup
32
cause of epiglottitis
haemophilus influenza type B
33
symptoms of epiglottitis
very rare child generally unwell stridor breath sounds and drooling of saliva
34
management of epiglottitis
intubation and antibiotics
35
duration of croup
mean population within 3 days
36
recurrent croup
present in older population related with malacia commonly presented as asthma symptoms
37
common bacterial agents
Strep pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Mycoplasma pneumoniae
38
common viral agents
Rhinovirus, RSV, parainfluenza III, influenza, adenovirus, coronavirus, Human Meta Pneumo Virus
39
tracheitis
croup that does not get better fever and sick child
40
cause of tracheitis
staphylococci streptococcus
41
symptoms of tracheitis
systemically unwell tachycardia narrowed tracheal lumen swollen tracheal wall
42
treatment and management of trachealis
antibiotics steroids to be used at first
43
bronchitis in children
common among ages 1 to 4 infection of the bronchi
44
COPD
emphysema chronic bronchitis - cough and sputum for at least 3 months present for at-least 2 consecutive years
45
cause of COPD
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
difference between COPD and asthma
asthma is reversible
47
prevalence and incidence of COPD
1.2 million people living with a diagnosis of COPD everyday with males having a greater number of prevalence than women
48
copd and social deprivation
air pollutants exposure poor nutrition low socioeconomic status
49
FEV -1 of people with COPD
smoking during gestation and childhood has the potential for increasing and increases the individual risks of developing COPD.
50
known factors that increase the risk of COPD
age sex
51
Alpha-1 Antitrypsin Deficiency
rare inherited disease manifested as COPD in childhood
52
manufacture of alpha 1 trypsin inhibitor
liver liver cirrhosis and liver fibrosis cause less production of the enzyme
53
consequences of alpha -1 - antitrypsin inhibitor
alveolar damage and emphysema basal predominance to emphysema
54
symptoms of COPD
cough breathlessness sputum frequent chest pains wheezing fatigue weight loss swollen legs
55
factors that contribute to COPD
age smoking history onset and progression
56
examination findings of COPD
peripheral oedema hyperinflated chest use of accessory muscles cyanosis cachexia wheeze ( often a musical sound)
57
mMRC dysponoea scale
scale that is used to measure levels of breathlessness 0-4
58
diagnostic tests for COPD
post- bronchodilator spirometry to test for airflow obstruction history and symptoms chest x ray to show the severity
59
spirometry tests results for COPD
diagnosed FEV1/FVC which is less than 0.7 post bronchodilator which shows no reversibility
60
stages of COPD
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
chest x ray interpretation of COPD
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
differentiating between asthma and COPD
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
differences between COPD and asthma
1.Reversibility, asthma spirometry should be normal out with exacerbations 2.PEFR little value in COPD and not used to stratify exacerbation severity
64
is still not sure about whether it is COPD
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
acute exacerbation of COPD
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
symptoms of acute exacerbation of COPD
worsening symptoms of shortness of breath , chest tightness , sputum that is increased volume and purulence and coughing.
67
signs of a severe exacerbation
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
management of acute exacerbations
change in inhaler ( technique , device , bronchodilator , increase or add inhaled steroid) prednisolone tablets ( oral steroids ) antibiotics self managements
69
differential diagnosis of acute exacerbation of COPD
pneumonia pulmonary embolism myocardial infarction left ventricle failure pleural effusion pneumothorax
70
deciding whether to admit someone with COPD or not
social aspects that is care of who is at home comorbidity and background of the disease
71
acute exacerbation diagnosis in secondary care
chest x ray blood gases FBC 9 full blood count ) sputum culture VTS( viral throat swab )
72
treatment of COPD in acute exacerbation in secondary care
oxygen oral and IV corticosteroid and antibiotic nebulised bronchodilator ( beta-2 and antimuscarinic )
73
measuring severity of COPD
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
in severe disease
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
severe COPD
cor-pulmonale secondary polycythaemia respiratory failure
76
cor pulmonale in COPD
Tachycardic, oedematous, raised JVP, congested liver ECG features: Right axis deviation, P pulmonale, T wave inversion V1-V4 Echo: pulmonary hypertension, tricuspid regurgitation
77
secondary polycythaemia
increased production of erythropoietin in response to low oxygen . increased haemoglobin , increased haematocrit and increased blood viscosity which leads to strokes
78
deaths from lung diseases in UK
lung cancer COPD
79
admission of COPD in the UK
females is greater than in the UK
80
Public measures to prevent COPD
public ban sale of tobacco from vending machines age of tobacco products purchase
81
non pharmacological management of COPD
smoking cessation vaccinations that is pneumococcal and annual flu vaccine pulmonary rehabilitation nutritional assessment psychological support
82
vaccinations for COPD management
annual flu vaccine pneumococcal vaccine
83
treatment for COPD with predominant breathlessnes
SABA SABA AND LAMA
84
COPD with exacerbations
SABAand lama
85
oxygen therapy for COPD patients
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

MBCHB 1 (62 decks)

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