Stridor, Obstructive Sleep Apnoea, Orthopnoea, and Pickwickian Syndrome Flashcards
What is stridor?
Predominantly inspiratory sounds caused by large airway obstruction
What are possible causes of stridor in children?
Infection
Foreign body
Anaphylaxis or Angioneurotic oedema
Others e.g. burns
What are possible causes of stridor in adults?
Neoplasm Anaphylaxis Goitre Trauma Other
What are investigations of stridor?
Larnygoscopy Bronchoscopy Flow volume loop spirometry CXR CT (thyroid scan)
Acute anaphylaxis is an example of which kind of hypersensitivity?
Type I hypersensitivity
What are symptoms/signs of anaphylaxis?
Flushing Pruritis Urticaria Angioneurotic oedema (lips, tongue, face, larynx, bronchi) Abdominal pain, vomiting Hypotension Circulatory collapse - shock Strioder, wheeze and respiratory failure
How is acute anaphylaxis treated?
IM adrenaline (within minutes IV antihistamines within 0.5 hrs IV corticosteroids within 1 hour High flow O2 Nebulised bronchodilators Endotracheal intubation if necessary
What is obstructive sleep apnoea?
Intermittent closure/collapse of the pharyngeal airway causing apnoea episodes during sleep - terminated by partial arousal
What are risk factors for obstructive sleep apnoea?
Enlarged tonsils Adenoids Post-op after anaesthesia Drugs Obesity
Which drugs are risk factors for OSA?
benzodiazepines
Opiates
Alcohol
What are symptoms of OSA?
Excessive daytime sleepiness Personality change Cognitive or functional impairment Poor sleep quality Morning headache Decreased libido
What are signs of OSA?
Snoring
Raised Epworth score
What are physiological features of OSA?
Activated sympathetic system
Raised CRP
Impaired endothelial function
Impaired glucose tolerance
What are tests/investigations for OSA?
Polysomography (sleep study is diagnostic)
Pulse oximetry
Eppworth score
What are possible complications of OSA?
Pulmonary hypertension
Type II respiratory failure
