stridor & sleep apnoea Flashcards
what is stridor?
inspiratory wheeze due to large airway obstruction
what are the main causes of stridor in children?
infections, foreign bodies, anaphylaxis/angioneurotic oedema, burns
what are the main infective causes of stridor in children?
(pseudomembranous) croup, epiglottitis, diptheria, retropharyngeal abscess
what are the main causes of stridor in adults?
cancer, anaphylaxis, goitre, trauma,
what investigations do we do for stridor?
laryngoscopy, bronchoscopy, spirometry, CXR, CT, thyroid scan
how might we treat stridor?
treat underlying cause, mask bag ventilation with high flow oxygen, cricothyroidotomy, tracheostomy, heimlich
how do we treat a malignant obstruction?
resection/removal, intraluminal stent, radiotherapy, chemotherapy
what is anaphylaxis?
an acute type one hypersensitivity reaction
what are the symptoms and signs of anaphylaxis?
flushing, pruritis, oedema, abdominal pain, vomiting, hypotension, stridor, wheeze, respiratory and/or circulatory failure
what are some common causes of anaphylaxis?
food, insect venom, drugs
how do we treat anaphylaxis?
IM epinephrine (adrenaline), IV antihistamine, IV corticosteroids, high flow oxygen, nebulised bronchodilators, endotracheal intubation, allergen avoidance, immunotherapy
how do we score daytime sleepiness?
epworth sleepiness scale
why do we snore?
pharyngeal dilator muscles relax during REM sleep. upper airway narrows and turbulent flow vibrates soft palate and tongue base
what is obstructive sleep apnoea?
intermittent upper airway collapse during sleep resulting in recurrent arousals and sleep fragmentation (+- hyperaemia)
what are the risk factors of OSA?
enlarged adenoids/tonsils, obesity, retrognathia, acromegaly, drugs (opiates & alcohol), post-op (anasthesia), neurological dysfunction
