Respiratory system2

Question 1

about respiratory diseases

which one is generelize and localize in lungs?

Answer 1

1_Asthma, chronic obstruction pulmonary d

2_Bronchogenic carcinoma, bronchoctasis

Question 2

what’s the most common bronchial disease?

Answer 2

Asthma with 8-10% of population

Question 3

what is Asthma?

Answer 3

it’s a chronic airway disease, which can occur in childhood “early onset”, or in middle age” late onset”.

Question 4

what causes Asthma?

Answer 4

broncho constriction of bronchi and bronchioles, inflammation leading to mucoid odema, over secretions, all of them make narrowing of bronchi.

Question 5

what is the main cause for Asthma?

and what is the predisposing factors?

Answer 5

Allergy “Atopy”
obesity is a risk factor.

exposure to allergins

Question 6

what’s the complain in patients with B. A?

Answer 6

1_wheesing
2_dyspnae
3_chest tightness
4_productive cough “viscous white graish mucoid sputum”
5_A history of Allergic disease “high fever
6_allergic dermatitis
7_eczema

Question 7

Mention the risk factors of B. A.

Answer 7

CDTREE
1_cold
2 dust, drugs"Aspirin, non steroid antiinflammatory drugs "NSAID" Trophine, voltarin"
3 Tobacco, smoking
4 RT infection "flue" 
5 excersie
6 emotional stress
 7 occupatiomal hazards "textiles, glutaraldehyde".

Question 8

mention the physical signs you can see in Asthmatic patients.

Answer 8

1_ deffuse wheesing when ausculating the chest bilaterally.
at first prolonged expi phase +expi wheesing
in severe cases ins, expi wheesing
in life threating B.A scilent chest.
2_pulse: tachycardia
3b. p, pulsus paradoxes “dropping of systolic pressure less than 10 mmhg during inspiration.
4 activation of accessory muscles of inspiration
5_pectus carniatum” pigeon chest in early onset B. A

Question 9

How to manage a case with life threating B. A?

Answer 9

give 200 mg hydrocortisone

high flow oxygen.

Question 10

What’s the possible complications of Asthma?

Answer 10

1_Dehydration 
2_respiratory infection 
3_pneumothorax
4_syncope
5_headache

Question 11

How to differentiate between B. A and Cardiac Asthma?

Answer 11

B. A.           
no respiratory crackles
no pulmanry congestion 
no lower limb oedema
no engorgement of jagular v
not inproved by furosemide

C. A
in congestive heart failure patient develop dyspnea
there is wheesing and fine basal respiratory crackles
+pulmonary congestion
+liwer limb oedema
+ engorgment of jagular v
symptoms relieved by lasix “furosemide.

Question 12

Why do we hear wheesing more in peripheral?

Answer 12

becuase the small bronchioles are more in periphery.

Question 13

what’s the disease that cause nocturnal wheezy cough and why?

Answer 13

B. A
because of the bronch motor tone espi”3-4”A. m
so more brocho spasm

Question 14

what’s the types of bronchitis and which one is the commener

Answer 14

acute, commoner

chronic

Question 15

when dose acute bronchitis occurs?

and what is the symptoms?

Answer 15

in post upper respiratory tract infection specially in winter.
1_flue symptoms
2_after few days “productive cough, mucoid yellow sputum.(presenting manifistaion)
3_slight dyspnea
4_chest tightness

Question 16

How can you treat acute bronchitis?

Answer 16

it relieves spontaneously after treating the underlying cause, which is the U. R. T infection

Question 17

what’s chronic bronchitis? and caused by what?

Answer 17

It’s a chronic productive cough for more than three months for two successive years.
most common cause is smoking and air pollution.

Question 18

what’s the time related relation of caugh with chronic bronchitis?

Answer 18

the patient wakes from sleep every morning with chronic productive cough with mucoid yellow sputum and exertional dyspnea

Question 19

How to diagnose C. B clinically?

Answer 19

By Ausculatation

“wheezing and early inspi crackles

Question 20

what’s the most common Bacteria causing acute bronchitis?

Answer 20

1_S. pneumonia
2_H. influenza
3_M. cataralis

Question 21

Mention the possible complications of C. B.

Answer 21

1_respiratory failure 
2_pulmonary hypertension 
3_cor pulmonale"right sided heart failure "
4_empyma
5_pneumonia 
6_polycythemia
7_increase carboxic hemoglubin.
8_emphysema
9_combination of cyanosis and odema resulting in blue bloater syndrome.

Question 22

Define bronchoctasis.

Answer 22

It’s a a chronic disease of the bronchi, in which there is a permenent abnormal broncho dilatation with distruction of the wall

Question 23

Explain the pathogenesis of bronchactasis.

Answer 23

when there is a destruction in the bronchial wall, a large amount of secretions form, with the dialation secretions will accumulate there, so with out drinage it will lead to secondary bacterial infection which cause more damage.

Question 24

Mention the causes of bronchoctasis.

Answer 24

most common: genetic Cystic fibrosis
attack of pneumonia or acute bronchitis
infection specially in children “measls, TB, whooping cough, forign body.

Question 25

what’s Katagener syndrom, young syndrome?

Answer 25

1_bronchoctasis, dextracardia, sinusitis.

2_yellow nails, some Autoimmune disease, allergic bronch_pulmonary aspergillosis.

Question 26

What’s the manifistaions of bronchoctasis?

Answer 26

1_productive caugh with large amount of greenish purulent sputum with an offensive odor.
2_dyspnea and chest pain in end stage
3_haemoptosis
4_clubbing fingers and amyloidosis in advanced cases.
5_marked decrease in weight, cachexia
6_in Ausculation, insp+expi coarse localized crackles.
7_pallor.

Question 27

What’s the most common area for bronchoctasis?

Answer 27

lower left lobe and lingula

Question 28

Mention the possible complications of bronchoctasis.

Answer 28

1_pneumonia 
2_plueral effusion
3_pneumothorax
4_Empyma
5_metastatic brain abcess
6_pulmunary hypertension 
7_cor pulmonale
8_recurrent pleurisy
9_fibrosis in the surrounding lung.

Question 29

What’s the only lung disease in which crackles don’t disappear or decrease after coughing?

Answer 29

fine crackles of lung fibrosis

Question 30

What’s the causes of bronchogenic carcinoma?

Answer 30

main is smoking
heavy metals: iron, arsenic, cadmium.
Asbestos

Question 31

Mention the common manifestations of B. G. C?

Answer 31

1_most common: cachexia
2_clubbing fingers, painful swelling of hands and legs due to osteoarthropathy.
3_massive haemorragic plueral effusion
4_dyspnea
5_chest pain
6_chronic productive cough>4 months with serous sputum.
7_daily heamoptosis
8_hoarsness of the sound and bovin cough
9_anemia
10_myoneuropathy

Question 32

What’s the underlying cause of recurrent pneumonia in the same side?

Answer 32

B. G. C

Question 33

What is the results of Ausculating the chest of a BGC patient?

Answer 33

1_coarse creptations
2_bronchophony
3_localize wheezing

Question 34

Mention the possible complications of B. G. C.

Answer 34

1_cushing syndrome due to high ACTH
2_inappropriate secretion of antidiuertic hor. 
3_hypercalcemia
4_thyrotoxicosis
5_neuropathy