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PAR2012 - Respiratory > Week 9 > Flashcards

Week 9 Flashcards

1
Q

what is a pneumothorax?

A

the presence of air or gas in the pleural space caused by a disruption in the visceral/parietal pleura and the chest wall

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2
Q

what is a spontaneous pneumothorax?

A

pneumothorax that occurs without any obvious cause of trauma

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3
Q

what is the difference between a primary and secondary spontaneous pneumothorax?

A

primary - occur without recognised lung disease

secondary - occur due to a recognised lung disease

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4
Q

what pressure does the pleural space have in relation to atmospheric pressure?

A

4-8mmHg below atmospheric pressure

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5
Q

What are the characteristics of patients who get primary spontaneous pneumothorax?

A

usually 18-40

tall, thin and are often smokers

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6
Q

What are the risk factors of primary spontaneous pneumothorax?

A 
smoking
genetics
lung disease
mechanical ventilation
previous pneumothorax
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7
Q

What is the most common cause of secondary spontaneous pneumothorax?

A

COPD

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8
Q

What are the risk factors for secondary spontaneous pneumothorax?

A 
tall thin males
copd or asthma
smoking
family history
marfan syndrome
exposure to loud music in those at risk for SP
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9
Q

what are the signs and symtoms of spontaneous pneumothorax

A 
SOB
decreased breaths sound over affected area
pleuritic chest pain
increase WOB
Increase ETCO2 initially
Decrease ETCO2 late
Low SpO2
Lower LOC
Hypotension
Subcutaneous emphysema
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10
Q

how long does complete resolution of an uncomplicated pneumothorax take?

A

approx 10 days

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11
Q

when is recurrence of pneumothorax most likely?

A

within 6 months - 3 years of initial.

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12
Q

what is the most common cause of Pulmonary embolysm?

A

blood clot in a vein - DVT

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13
Q

What are risk factors for PE?

A
  • Varicose veins
  • oral contraceptive pill
  • Oestrogen therapy
  • Vasculitic syndromes (lupus, behcets syndroms)
  • pregnancy
  • haematological disease (polycythaemia)
  • Age
  • AF
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14
Q

WHat is the triad that indicates how a blod clot forms?

A

VIRCHOWS TRIAD

  • stasis
  • vessel wall injury
  • hypercoagulopathy
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15
Q

when should you consider a PE?

A

any patient with sudden onset of cardiovasular decompensation, syncope, unexplained hypoxia, shock and or PEA cardiac arrest

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16
Q

what does a PE lead to physiologically

A

hypoxaemia by increasing anatomical and phsiological dead space

  • increase in pulmonary vascular resistance leading to right ventricular wall ternsion
  • RV dysfunction or AMI
17
Q

what is a demarcation line?

A

cyanotic head and neck and chest from nipples only.

indicates PE

18
Q

what should you do when suspecting PE?

A

head to toe - check legs!

look for size, colour, temp and pain

19
Q

WHAT ARE SIGNS AND symptoms of PE?

A
  • chest pain (under breastbone, sharp/stabbing/burning/aching/dull/heavy
  • pain gets worse with deep inhalation
  • pt may bend over or hold chest during pain
  • cyanosis
  • poor Pa02 level
  • dizziness/lightheaded/fainting/coma
  • fast breathing and wheezing
  • tachycardia
  • anxiety
  • leg pain redness and swelling
  • low BP
  • sudden cough, possibly coughing up blood
  • SOB that starts suddenly
  • CPC skin
20
Q

what ECH changes do you see in PE?

A
  • Sinus tachy
  • complete or incomplete RBBB
  • Right axis deviation
  • RV strain pattern
  • S1 Q3 T3 - deep s wave in lead 1, large Q wave in lead 3, inverted T in lead 3.
21
Q

Explain S1 Q3 T3

A

S1 Q3 T3 - deep sluured s wave in lead 1, large Q wave in lead 3, inverted T in lead 3.

Sign of pulmonary embolism

22
Q

What leads do you use to look for RBBB and LBBB?

A

V1 and V6

William Marrlow

23
Q

What is the rule out criteria for PE?

A

HAD CLOTS

H - hormone - no oestrogen or progenancy
A - <50
D - DVT/PE - no previous history
C - coughing up blood
L - leg swelling
O - Sats >95%
T - tachycardia <100
S - surgery in last 28 days
24
Q

what is a pleural effusion?

A

abnormal build of fluid in the pleural space. resulting from excess production of fluid or decreased reabsorption of fluid.

25
Q

what are the 2 pulmonary effusion categories?

A

exudates - from pleural disease and increase secretion of fluid

transudates - imbalance in hydrostatic pressures drawing fluid into space

26
Q

what are the symptoms/features of Pulmonary effusion?

A
  • SOB
  • pain
  • percussion dullness
  • decreased breath sounds
  • hypoxia-

PAR2012 - Respiratory (13 decks)

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