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JL Respiratory > Stridor and Sleep Apnoea > Flashcards

Stridor and Sleep Apnoea Flashcards

1
Q

What are the two locations for inspiratory stridor?

A

Extrathoracic

Supraglottis/larynx

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2
Q

What 4 factors can affect the supraglottis/larynx and cause inspiratory stridor?

A

Laryngomalacia
Supraglottic mass
Glottic lesions
Vocal cord paralysis

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3
Q

What are the 4 main causes of stridor in children?

A

Infections
Foreign body
Anaphylaxis/angioneurotic oedema
Other (burns)

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4
Q

What do these infections all cause in children - croup, epiglottistis, pseudomembranous croup, retropharyngeal abscess, diphtheria and infectious mononucleosis?

A

Stridor

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5
Q

What are 4 causes of stridor in adults?

A

Neoplasms
Anaphylaxis
Goitre (retrosternal)
Trauma (e.g. strangulation, burns and irritant gases)

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6
Q

What are the three main neoplasms that cause stridor in adults?

A

Larynx
Trachea
Major bronchi

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7
Q

What do these conditions cause - bilateral vocal cord palsy, Wegener’s granulomatosis, cricoarytenoid arthritis, RA and tracheopathia?

A

Stridor in adults

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8
Q

What are the 4 main investigations for stridor?

A

Laryngoscopy (beware of acute epiglottitis)
Bronchoscopy
Flow volume loop
CXR

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9
Q

What are the 4 methods of treatment for laryngeal obstruction?

A
  1. Treat underlying cause - foreign body removal/anaphylaxis
  2. Mask bag ventilation with high flow oxygen
  3. Cricothyroidotomy
  4. Tracheostomy
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10
Q

What is the name for a rapid upward thrust in epigastrium to force upward movement of diaphragm and force expiration?

A

Heimlich manoeuvre

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11
Q

What are 4 treatment methods for a malignant airway obstruction?

A
  1. Tumour removal - laser, photodynamci therapy, cryotherapy
  2. Tumour compression - intraluminal stent
  3. Radiotherapy
  4. Chemotherapy; corticosteroids
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12
Q

What type of reaction is acute anaphylaxis?

A

Type I (immediate) hypersensitivity (IgE)

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13
Q

What are these all a sign of - flushing, pruritus, urticaria, angioneurotic oedema, abdominal pain/vomiting, hypotension (vasodilatation and plasma exudation) - circulatory collapse (shock), stridor, wheeze and respiratory failure?

A

Acute anaphylaxis

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14
Q

Give the 6 treatment steps for anaphylaxis

A
  1. IM epinephrine (adrenaline)
  2. IV anti-histamine
  3. IV corticosteroid
  4. High flow oxygen
  5. Nebulised bronchodilators
  6. Endotracheal intubation if necessary
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15
Q

What causes snoring?

A

Relaxatopm of pharyngeal dilator mjuscles during sleep

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16
Q

What is the term for a predominantly inspiratory wheeze due to large airways (larynx/trachea/major bronchi) obstruction?

A

Stridor

17
Q

What causes obstructive sleep apnoea?

A

Intermittent upper airway collapse in sleep

18
Q

What are enlarged tonsils and adenoids, obesity, retrognathia, acromegaly, hypothyroidism, oropharyngeal deformities, stroke, MS, myesthenia gravis, myotonic dystrophy, benzodiazepines, opiates, alcohol?

A

Risk factors for sleep apnoea

19
Q

What is sleep apnoea an indeopendent risk factor for?

A

Hypertension

20
Q

What causes raised CRP?

A

Sleep apnoea

21
Q

What two things does sleep apnoea impair?

A

Endothelial function and glucose tolerance

22
Q

What could be suspected if a patient has snoring and EDS (raised Epworth score)?

A

Obstructiev sleep apnoea

23
Q

What three investigations in an overnight sleep study could be used to diagnose obstructive sleep apnoea?

A 
Oximetry
Domicillary recording (airflow, oximetry, thoracic/abdominal movement)
Full polysomnography
24
Q

What does CPAP stand for?

A

Continuous positive airway pressure

25
Q

What is the most effective therapy for sleep apnoea?

A

CPAP

26
Q

What device is used in mild obstructive sleep apnoa, improves snoring and has a moderate reduction in AHI?

A

Mandibular advancement device

JL Respiratory (27 decks)

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