Respiratory System Disorders

Question 1

Define asthma

Answer 1

Chronic inflammation of the airway, characterised by intermittent airway obstruction and hyper-reactivity - constriction of the bronchioles

Question 2

State 2 risk factors of asthma

Answer 2

Family history

Allergens/irritants

Question 3

Explain the pathophysiology of asthma

Answer 3

1. Insulting environment culprit
2. Genetic disposition
3. Hyperresponsive and inflammatory pathway
4. AW remodelling

Question 4

What is COPD

Answer 4

Caused by 2 main primary players - chronic bronchitis and emphysema

Question 5

Describe the pathophysiology of COPD

Answer 5

1. There’s a genetic susceptibility and environmental insult to lungs
2. Leads to lung inflammation
3. Branches to chronic bronchitis and emphysema
4. Increase of inflammatory cells and mucus
5. Becomes trapped in airway and a spot for infections to breed
6. Chronic bronchitis and emphysema = COPD

Question 6

Hypoxic drive - think hypercapnia

What is hypercapnia

Answer 6

Hypercapnia - build up of carbondioxide in the blood stream

1. VQ mismatch
2. Hypercapnia
3. Haldane effect

Question 7

How long should COPD patients be nebuliser for

Answer 7

6 mins on and 6 mins off

Question 8

Define pneumothorax

Answer 8

Accumulation of air in the pleural space

Question 9

What are the risk factors of a pneumothorax

Answer 9

Smokers
Tall and slender 
Asthma 
COPD 
Chest trauma 
TB 
Cystic fibrosis

Question 10

Explain lung pressures

Answer 10

Intrapleural pressure is always negative/lower

This is important because when there is an opening from lungs to intrapleural space there is a change in pressure, gases move from high to low so gas would move into intrapleural space and measures will become equal –> this will then cause symptoms of pneumothorax

Question 11

Explain the pathophysiology of a pneumothorax

Answer 11

1. Communication is developed between alveolar and pleural space
2. There is initial pressure different, pressure in always negative in intrapleural space compared to the pressure in alveoli
3. Gas then enters the space and there’s a pressure increase
4. As a result there’s symptoms of a pneumothorax
5. Decreased lung compliance thus increased breathing

Question 12

What is the pathophysiology of a tension pneumothroax

Answer 12

Air enters the space but cannot leave and this causes increased pressure in the injured lung

Question 13

What are the signs and symptoms of a pneumothorax

Answer 13

Hypotension
Tachycardia
Low sp02
Tachypnoea

Question 14

What is pneumonia

Answer 14

Inflammation of the lungs usually caused by an infection

Question 15

What are the signs and symptoms of pneumonia

Answer 15

Cough
DIB
Pyrexia
Chest pain

Question 16

How is pneumonia treated?

Answer 16

Anti-biotics, severe pneumonia may need to be treated in hospital

Question 17

What is a pulmonary embolism

Answer 17

Blood clot that develops in a blood vessel in the body, it then travels to a lung artery where it blocks blood flow

Question 18

What is Virchow’s triad?

Answer 18

Helps us to identify the 3 main factors to understand why a blood clot develops in the deep veins

We can look at the risk factors in virchows triad and take preventative measures

Question 19

What are the 3 main factors of Virchows triad

Answer 19

1. Vessel wall injury - endothelial cell damages - thrombus formation
2. Stasis - poor blood flow and stasis promote the formation of thrombi - vascular damage
3. Hypercoagulability - cancer, high-oestrogen states, inflammatory bowel disease, sepsis, blood transfusion

Question 20

State risk factors of a pulmonary embolism

Answer 20

Recent surgery
Obstetrics
Lower limb
Malignancy 
Immobilisation
Age

Question 21

Describe the pathophysiology of a PE

Answer 21

1. Virchows triad
2. Forms a thrombus
3. A thrombus then gets dislodged
4. Then migrates up to the inferior vena cava
5. Finds itself in pulmonary vasculature
6. Signs and symptoms - decrease of perfusion leads to ischaemia