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Jason's Respiratory Block > Resp Depression, Breathlessness > Flashcards

Resp Depression, Breathlessness Flashcards

1
Q

At Rest respiratory system clears how much O2 and CO2 per minute?

A 
O2 = 250ml
CO2 = 200ml
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2
Q

How many horsepower can the aerobic&anaerobic metabolism sustain?

A

0.1 horse power

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3
Q

What PaO2, PaCO2 and pH are the chemoreceptors trying to maintain?

A

PaO2 = 100mmHg
PaCO2=40mmHg
pH =7.4

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4
Q

How many litres/minute can the alveolar capillary membrane exchange?

A

4L/min

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5
Q

Central chemoreceptors respond to what chemical? versus peripheral chemoreceptors?

A

Central: H+
Peripheral: CO2, O2, H+

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6
Q

Name 3 sensors for respiratory control?

A

Chemoreceptors
lung receptors
stretch/joint receptors

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7
Q

What’s the major output nerve of the brainstem for respiration?

A

phrenic nerve

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8
Q

Can the cortex override the brainstem re: respiration?

A

Yes.

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9
Q

Where are the peripheral chemoreceptors?

A

carotid bodies and aortic arch

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10
Q

T/F? small increase in O2 = increase ventilation?

A

False. Small CO2 = rapid increase ventilation

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11
Q

At what point would you start hyperventilating re: PaO2 levels?

A

<60mmHg

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12
Q

During exercise, what happens to PaO2?

A

Stays same

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13
Q

During exercise, what happens to PaCO2?

A

decreases slightlty due to increased ventilation

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14
Q

During exercise, what happens to pH?

A

drops slightly due to lactic acid

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15
Q

Hypoventilation is what in terms of PaO2 and CO2?

A

decreased PaO2

increased PaCO2

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16
Q

Acute hypoventilation causes respiratory what?

A

acidosis

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17
Q

Chronic hypoventilation causes metabolic what?

A

alkalosis

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18
Q

5 causes of hypoventilation?

A 
Central (drive, suppression)
Neuromusular
chest wall
obesity
sleep disorder
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19
Q

3 kinds of sleep apnea:

A

obstructive sleep apnoea
central
obesity hypoventilation syndrome

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20
Q

do all snorers have OSA?

A

Nope

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21
Q

Mechnism for snoring?

A

airway relaxes>throat narrowed>tongue falls backwards>turbulant flow = snoring

22
Q

OSA cycle results in what kind of sleep?

A

fragmented sleep/deprivation

23
Q

6 reasons to suspect OSA?

A 
snoring
witnessed apnoeas
arousals
disturbed sleep
persistent HTN/unexplained resp failure
24
Q

what is paradoxical movement on polysomnogram mean?

A

no airflow but still trying to breath

25
Q

Management of OSA?

A

CPAP
surgery
mandibular splint
lie on side

26
Q

what happens to the brain after chronic hypoventilation due to OSA?

A

brain accepts higher levels of CO2, you wake less but then it spills over into daytime and normally have lower O2 and higher CO2 in your body

27
Q

Resetting of respiratory centre happens with what other conditions?

A

severe COPD, pulmnoary fibrosis, neuromuscular disease

28
Q

If patients have chronic hypercapnoea, what do you do about supplemental oxygen?

A

You don’t have large amounts (only until they reach their ‘normal’) or else they’ll die as they are breathing re: O2 levels rather than CO2 levels

29
Q

4 key words for breathlessness?

A

recognition
inappropriate
respiratory work
total body work

30
Q

When is most of the respiratory work done?

A

inspiratory

31
Q

Two other things make up respiratory work besides inspiration

A

stretching work - elastic

airflow work - resistive

32
Q

Dyspnea is sensation of increased what? and what?

A

load and drive

33
Q

Besides repiratory and cardiac causes, name 4 other causes of dyspnea?

A

muscle weakness
metabolic
anaemic
psychogenic

34
Q

Does phrenic nerve palsy cause dyspnea?

A

yes

35
Q

What is usually the cause of SOB, cough, sputum, wheeze/stridor? what tests to do?

A

affected airways, (upper or lower) bronchiectasis, most likely obstructive
test with spirometry

36
Q

68 yr old with SOB, cough, sputum, tobacco, hyperinflation and wheezes, what imaging? what tests?

A

CT scan
spirometry
most likely COPD

37
Q

SOB, cough and crepitations, where are problems most likely?

A

alveolar, could also be bronchiectasis

38
Q

Someone with normal chest examination, haemoptysis, pleuritic pain, look out for?

A

PE, or pulmonary hypertension/vasculitis

39
Q

What is the Wells Score?

A

To help dx a PE

40
Q

If Wells score is >4 what to do?

A

rule in with pulmonary angiogram

41
Q

If Wells Score is <4 then what?

A

D dimer to rule out

42
Q

How many % of dyspnoea are diagnosed with symptoms, signs and special tests?

A

80%

43
Q

what is MUD?

A

medically undiagnosed dyspnoea?

44
Q

Types of MUD include?

A

psychogenic/anxiety?
other disease/new? MI, DM2
increased awareness of maximum effort

45
Q

Breathlessness in young athletes in 12-15% of Australians are usually diagnosed with this?

A

atopic asthma

46
Q

Breathlessness in young athletes, 30-40% have what? how treat?

A

exercise induced bronchoconstriction

treat with asthma treatments

47
Q

What can be confused with Breathlessness in young athletes and responds to speech therapy and CBT?

A

vocal cord dysfunction/laryngeal dysfunction

48
Q

If there are no ECG, BP of SaO2 abnormalities but have have steep heart rate, exceeive Ve max, early anaerobic threshold, what could it be?

A

De-conditioning

49
Q

How to confirm deconditioning?

A

3 months of aerobic training then remeasure

50
Q

What is a key marker for if dyspnoea is psychogenic?

A

If you have it at rest, but goes away during exercise

Jason's Respiratory Block (20 decks)

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