Breathless Betty (REVISE) Flashcards

1
Q

How to differentiate physiological and pathological shortness of breath from exercise

A

It can be difficult but generally it is judged by comparing yourself to your past self or those around you

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2
Q

Significance of sputum colour (grey or green)

A

Grey or green generally indicates elevated WBCs; could be infection but not necessarily

But this is compared to the patient’s ‘norm’

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3
Q

Causes of cough

A
Coryza
Acute Bronchitis
Tracheitis
Pneumonia
COPD
Asthma
Anxiety
Foreign Body
TB
Bronchiectasis
CHD
Lung Cancer

Drug-induced: e.g. ACE Inhibitors

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4
Q

Pneumonia

A

Alveoli become full of fluid as a result of infection

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5
Q

Bronchiectasis

A

Can be genetic or acquired

Damage to bronchiole/alveoli sacs and so damage ciliary mucous elevator so mucous stagnates and does not clear

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6
Q

Differentiate between smoker’s cough and COPD cough

A

It is difficult to do so; smokers with a PERSISTENT smoker’s cough are suggested to present for further investigation

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7
Q

Percussion of COPD

A

Dull Percussion

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8
Q

Alerting symptoms regarding COPD or Lung Cancer - im not rly sure :’(

A

Cough > 3 weeks
Smoking history associated with Haemoptysis
Change in ‘smoker’s cough’

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9
Q

Haemoptysis

A

Coughing up blood

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10
Q

Sound heard during percussion of fluid in lungs

A

Dullness, unlike percussion of air which is more crisp

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11
Q

Symptoms OE of COPD patients

A

Prolonged Exhalation
Polyphonic Wheeze (multi note breath)
Unusual dull percussion of lungs
Reduced chest movements (I THINK)

REVISE

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12
Q

Polyphonic Wheeze

A

Whistling Like Breath Sound

Due to the varying changes in breathing of COPD

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13
Q

Monophonic Wheeze

A

Indicates tumour or something

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14
Q

What does a lowered PEF Indicate

A

A lot of very different things that are hard to diagnose

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15
Q

What do stained fingers on COPD indicate

A

Tar staining (indicate that they are a current smoker)

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16
Q

What does no ankle swelling tell us of a COPD patient

A

It indicates that the patient likely does not have chronic congestive heart failure

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17
Q

What is spirometry used for in COPD

A

It is not used to diagnose COPD but it does confirm it when other data and history is indicative of it

It also identifies those most at risk of complications

Just as a bonus, it also scares some patients straight if you tell them they have lungs of a 90 year old

18
Q

How to diagnose between COPD and Emphysema

A

COPD is an umbrella term for those with chronic bronchitis and emphysema; they are clumped together because usually one would include at least an element of the other

19
Q

Describe the FEV1:FVC in obstructive and restrictive lung disease

A

FEV1 is low in both but FVC is normal in obstructive while being lowered in restrictive

Obstructive: Low FEV1:FVC
Restrictive: Normal FEV1:FVC

20
Q

eGFR

A

Estimated Glomerular Filtration Rate

Measures Renal Function

eGFR must be kept in mind in certain prescriptions
(Declines during aging)

21
Q

Why is Haemoglobin elevated for those with COPD

A

Body’s response to hypoxia

22
Q

Polycythaemia

A

Having a high concentration of red blood cells in your blood

23
Q

Amoldipine

A

Calcium-channel blocker used for hypertension and angina

24
Q

Ramipril

A

Used for high blood pressure and congestive heart failure

25
Q

Atorvastatin

A

Statin

26
Q

Are beta blockers indicated for COPD patients with hypertension

A

Yes definitely, as long as a spirometer does not indicate asthma (but monitor their progress with spirometry)

27
Q

What are COPD patients vulnerable to

A

Winter infection and Covid

28
Q

In what way does the x-ray indicate COPD

A

Not really much - does not diagnose other things though

29
Q

Should a chest X-ray be done for COPD Patients and why

A

Yes for sure, to ensure that there are no other concurrent infections

30
Q

Fundamental Five COPD Interventions

A

Smoking Cessation (MOST IMPORTANT ASF)
Pulmonary Rehabilitation (VERY IMPORTANT AS WELL)
Vaccination
Self Management Plan
Assess Co-morbidities (including mental health)

31
Q

Recommended Vaccinations for COPD Patients

A

Covid
Flu Vaccine
Pneumococcal

32
Q

Dyspnoea

A

Shortness of Breath

33
Q

How is tiotropium taken up

A

It is taken via inhalation to prevent systemic muscarinic inhibition

34
Q

Mucolytics

A

Medicines that make the mucus less thick and sticky and easier to cough up

Often makes patients cough up copious amounts and almost feel like they’re drowing from how much there is

35
Q

Should we suggest e-cigarettes for smoking cessation

A

This is up to the doctor

Generally, use it with caution as a last resort if other methods of cessation do not work

36
Q

Fostair 100/6

A

LABA and Inhaled Steroid (Beclamethasone)

37
Q

What improvement is expected in COPD patients with medication

A

Usually the medication is not expected to solve the issue, instead just to improve lifestyle like allowing tying your shoes without breathlessness

38
Q

Pulmomary Rehabilitation

A

Getting COPD patients to do simpler movements to strengthen their lungs

39
Q

Referrals from the COPD Clinic Include:

A
Severe disease
Frequent exacerbators
Suspect genetic cause
Breathelssness doesn't match up with spirometry severity
Cor Pulmonale
Increasing palliative care needs
Paid decline
40
Q

Polyphonic Wheeze

A

Whistling Like Breath Sound

Due to the varying changes in breathing