THE NATURE OF AIRWAY OBSTRUCTION Flashcards

Question

how do we treat a near fatal asthma exacerbation?

Answer 1

``` oxygen non-rebreater mask SABA with nebulizer or metered dose inhaler ipratropium bromide oral or IV systemic corticosteoids a ```

Answer 2

smoking cessation weight loss in overweight patients breathing exercises

Answer 3

a group of lung conditions that cause breathing difficulties. It includes chronic bronchitis and emphysema

Answer 4

``` exertional breathlessness cough sputum production wheezing frequent chest infections ```

Answer 5

patient sitting up, pursed lip breathing, using accessory muscles barrel chest loss of weight percussion shows hyperresonance

Answer 6

chronic hypoxemia causes hypoxic vasoconstriction which can cause pulmonary hypertension over time. This puts strain on the right side of the heart = failure

Answer 7

JVP distention peripheral oedema hepatomegaly

Answer 8

acute worsening of symptoms

Answer 9

chronic bronchitis | emphysema

Answer 10

inflammation of the airways which increases mucus production, causes smooth muscle hypertrophy, golblet cell hyperplasia, etc

Answer 11

a continuous cough for >3 months a year for at least 2 consecutive years phlegmy cough, wheeze, chest discomfort

Answer 12

an inflammatory response leading to excess elastases being produced which causes excessive destruction of alveolar cell walls this causes a loss in elastin so a loss in elastic recoil = alveoli colapse when we exhale. air becomes trapped in alveoli causing them to puff up, impairing gas exchange

Answer 13

alpha-1 antitrypsin deficiency

Answer 14

an autosomal dominant disorder where alpha-1 antitrypsin isnt exported out of the liver so it cannot inhibit elastase. Elastase therefore accumulates in the lung parenchyma, causing damage enzyme accumulates in liver so may get liver cirrhosis

Answer 15

suspicion and relevant exposure FEV1:FVC <70% remeasure pulmonary function tests after giving an inhaled bronchodilator - results should be <12% change because its irreversible

Answer 16

``` smoking cessation oxygen broncodilators corticosteroids vaccines - dont want infections to trigger COPD excerbations ```

Answer 17

because we want to maintain a level of hypoxaemia as this is stimulating the respiratory drive

Answer 18

COPD usually presents in >40s whilst asthma in childhood but can be any age COPD is chronic and continuous whilst asthma varies with triggers asthma patients will often have FHx of atopy COPD patients will often have had exposure to cigarette smoke changes are seen on an xray in COPD but not asthma

Answer 19

eosinophils

Answer 20

neutrophils

Answer 21

An obstructive lung disease caused by chronic inflammation leading to bronchi and bronchiole damage and dilation. This inflammation causes mucus plugs to form in the airways and obstruct airflow.

Answer 22

``` CF severe pneumonia infection COPD asthma whooping cough TB fungal infections ```

Answer 23

chronic inflammation causes damage to ciliated epithelial cells and elastin fibres in airways. fibroblasts trying to repair the damage actually deposit more collagen, making the lungs less elastic and more stiff. The stiff, mucus filled lungs make it diffiuclty for air to flow smoothly

Answer 24

``` wheezing coughing SOB foul smelling mucus digital clubbing ```

Answer 25

treat the recurrent pneumonias with antiboitics and remove excess mucus with percussion or postural drainage remove any physical obstructions

Answer 26

``` allergic asthma seasonal asthma occupational asthma non-allergic asthma exercise-induced asthma diffiuclt asthma severe asthma brittle asthma ```

Answer 27

mucus plugs that block air exchange and prevent inhaled medications from reaching the site of inflamamtion seen in asthma

Answer 28

crystals formed from the breakdown of eosinophils - seen in asthma