Pathology from learning outcomes Flashcards

1
Q

What are the signs and symptoms of COPD ?

A
Productive cough (every day, 3 consecutive months, 2 consecutive years)
Steady decline 
Dyspnoea 
Severe weigh loss and muscle mass loss 
Acute exacerbations
Others
Cyanosis 
fine tumour 
Flapping tumour
expiratory wheeze 
chest infections 
pursed lip breathing 
Peripheral oedema 
Raised JVP
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2
Q

Describe the complications of emphysema

A

Emphysema causes a reduced in gas exchange and so there is vasoconstriction.
Fibrosis can then occur on these vasoconstricted capillaries and reduce blood flow further.
If emphysema affects a large area then pressure builds up in the heart, this can cause cor pulmonale, this causes build up in the veins, leading to peripheral oedema and raised JVP.
Decrease in the flow of the blood increases its thickness of the blood also increased in all of this making it even harder to pump the blood around the body.
All of this results in hypoxia.

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3
Q

What happens to the body in COPD ?

A

There is loss of the surface area in the lungs (emphysema).

Effects on the large and small airways hyperplasia etc

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4
Q

What are the symptoms of asthma?

A

Variation of symptoms
Night disturbances
Wheeze
Feeling like you cant breath

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5
Q

How does Asthma affects alveolar oxygen levels ?

A

It is an obstructive condition so there are problems getting air out of the lungs. There is air in the lungs but there is a reduced in alveolar ventilation and alveolar dead space.

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6
Q

What is a shunt ?

A

When blood moves from the right side of the heart to the left side of the heart without participating in sufficient gas exchange.

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7
Q

What is cor pulmonale ?

A

right side heart failure

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8
Q

What is anatomical dead space ?

A

The air which sits in the conducting region of the lungs around 150 ml

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9
Q

What is alveolar dead space ?

A

Air which sits in the alveoli and doesn’t participate in gas exchange

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10
Q

What is physiological dead space ?

A

Total dead space found in the lungs

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11
Q

What is the defining features of COPD ?

A

-

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12
Q

What is the epidemiology of COPD ?

A

1.2 million living with a diagnosis of COPD
2% population
At least 50% undiagnosed

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13
Q

What is the aetiological (causes) factors of COPD ?

A

-

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14
Q

What is the main causes of a wheezing illness ?

A

-

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15
Q

What should you ask for in the clinical history of COPD

A

-

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16
Q

What investigations are done to find out if a person have COPD ?

A

-

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17
Q

How is the severity of COPD assessed ?

A

-

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18
Q

What are the differences in COPD and Asthma ?

A

-

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19
Q

What are the similarities in COPD and Asthma ?

A

-

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20
Q

What is the natural history of COPD (What will happen if COPD was untreated) ?

A

-

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21
Q

How does the natural history of COPD tie into realistic medicine ?

A

Realistic medicine is about having open and honest conversations about what the treatment and prognosis is for a patient and allowing the patient to be involved in that process

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22
Q

What is the aim of COPD management ?

A

Highest quality of life for as long as is possible i.e. preventing exacerbations,

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23
Q

What investigations are done when assessing a patient with a COPD exacerbation ?

A
ABG 
WBC + Hb
U&Es
Sputum culture 
CXR
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24
Q

What are the classes of drugs and there mode of delivery which are used to treat COPD and asthma ?

A

-

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25
What are the non-pharmacological management methods for COPD ?
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26
Why is patient education important in the management of COPD ?
-
27
How is the management of asthma and COPD different ?
-
28
What other treatments are important in the palliative care of a COPD patient ?
Oxygen therapy | Treatment of symptoms (Making as comfortable as possible)
29
What are the defining features of Asthma ?
Variation in symptoms Wheeze Exacerbations
30
What is the epidemiology of asthma ?
Affects 10-15% of children Affects 5-10% of adults Largest pulmonary disease in the UK
31
What are the aetiological factors of asthma ?
Atopic gene Occupation Smoking (maternal smoking)
32
What are the pathological features of asthma ?
-
33
Why does the prevalence of respiratory disease change to rapidly in children as they grow?
-
34
What should be included in the history of an asthma patient ?
Family history - Atopic gene and smoking in family | Social history - Triggers and occupation
35
What investigations should be carried out to help diagnose asthma ?
``` Spirometry Bronchodilator reversibility test FeNO test Allergen test PEFR ```
36
How should the severity of asthma be assessed ?
-
37
How is the severity of acute asthma assessed ?
-
38
How is acute asthma managed ?
-
39
How is chronic asthma managed using the step up step down approach ?
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40
Name some of the common organisms which cause upper respiratory tract infections
Bacteria (Strep.) | Viruses (rhinoviruses, adenoviruses, parainfluenza, influence, EB virus)
41
What are some defence mechanisms of the body against infection ?
-
42
What is the pathogenesis of pneumonia ?
-
43
What are the complications of pneumonia and other LRTIs
-
44
What are the clinical features of acute bronchitis ?
-
45
What are the clinical features of pneumonia ?
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46
What is recurrent pneumonia ?
-
47
What is bronchiectasis ?
-
48
What is lung abscess ?
-
49
What is empyema ?
-
50
What happens to gas exchange during a respiratory tract infections ?
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51
What is the clinical presentation of tonsillitis / pharyngitis ?
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52
What are the clinical presentations of the common cold ?
-
53
What are the clinical presentations of the EB virus glandular fever ?
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54
What are the clinical presentations of otitis media ?
-
55
What are the clinical presentations of sinusitis ?
-
56
What is supportive therapy in respiratory tract infections ?
-
57
What is the difference between community and hospital acquired pneumonia ?
-
58
What is another name for hospital acquired pneumonia ?
nosocomial
59
How is pneumonia treated ?
-
60
How is bronchiectasis treated ?
-
61
How is a lung abscess treated ?
-
62
How is empyema treated ?
-
63
How is secondary and primary care different in how they treat reparatory tract infections ?
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64
Describe the global distribution of tuberculosis ?
-
65
What is the pathogenicity of primary TB ?
-
66
What is the pathogenicity of post-primary TB ?
-
67
What is the pathogenicity of fibrocaseous TB ?
-
68
What is the histopathology of TB ?
-
69
What is the typical presentation of TB ?
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70
How is TB treated ?
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71
What are the public health duties of a doctor when managing a TB case ?
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72
What is the typical clinical presentation of lung cancer ?
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73
What causes localised opacity on the chest X-ray ?
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74
What are the different types of lung cancer ?
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75
What is the epidemiology of lung cancer ?
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76
What is the pathogenesis of lung cancer ?
-
77
How does lung cancer spread?
-
78
What investigations are carried out into lung cancer?
-
79
How is lung cancer staged ?
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80
How is inoperable non-small cell lung cancer managed ? what are the side effects and the likely outcomes ?
Radiotherapy | Chemotherapy
81
What is the epidemiology of smoking ?
-
82
What is the economics of smoking ?
-
83
What is the politics of smoking ?
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84
What are some strategies used to reduce smoking ?
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85
What are the causes of pleural effusion ?
-
86
What are the clinical features of pleural effusion ?
-
87
How are the differential diagnosis of pleural effusion ?
-
88
What is the pathology of malignant mesothelioma ?
-
89
How do you manage pleural effusion ?
-
90
What are pleural plaques ?
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91
Names and describe some congenital respiratory conditions
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92
What is 'tracking' of pulmonary function from early life to adulthood ?
-
93
What is the term remodelling in relation to the developmental aspects of lung disease ?
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94
How does sleep apnoea present ?
-
95
What conditions are associated with sleep apnoea ?
-
96
What is the natural history of sleep apnoea?
-
97
How is sleep apnoea managed ?
-
98
What is another condition which causes excessive daytime sleepiness ?
Narcolepsy
99
What are some conditions which cause congenital respiratory muscle weakness ?
muscular dystrophy, | motor neurone disease
100
What are the clinical symptoms of restrictive lung disease ?
-
101
What are the major classes of restrictive lung disease?
occupational, | granulomatous lung disease (sarcoidosis), idiopathic pulmonary fibrosis
102
What is the natural history of restrictive lung disease?
-
103
What are the functional effects of interstitial lung disease?
-
104
What is the aetiology of diffuse alveolar damage syndrome
-
105
What is the pathogenesis of diffuse alveolar damage syndrome
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106
What is the aetiology of sarcoidosis syndrome
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107
What is the pathogenesis of sarcoidosis syndrome
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108
What is the pathogenesis of hypersensitivity pneumonitis syndrome
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109
What is the aetiology of hypersensitivity pneumonitis syndrome
-
110
What is the aetiology of idiopathic pulmonary fibrosis syndrome
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111
What is the pathogenesis of idiopathic pulmonary fibrosis syndrome
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112
What is the end stage effects of idiopathic pulmonary fibrosis ?
lung fibrosis/honeycomb lung.
113
How is restrictive lung disease investigated ?
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114
How is restrictive lung disease managed ?
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115
What is the pathogenesis of deep vein thrombosis
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116
What is the pathogenesis of pulmonary embolism ?
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117
What is the pathogenesis of pulmonary infarction?
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118
What is pulmonary hypertension ?
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119
What causes pulmonary hypertension ?
-
120
How is pulmonary vascular disease investigated ? (I.e. Hypertension, embolism)
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121
How is pulmonary vascular disease Managed ? (I.e. Hypertension, embolism)
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122
Describe the genetics of cystic fibrosis
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123
Describe the presenting features of cystic fibrosis
-
124
Define the possible complications of cystic fibrosis
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125
Outline the management of pancreatic insufficiency (Cystic fibrosis)
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126
Outline the management of chest infections (Cystic fibrosis)
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127
Explain the options available for antenatal and post natal screening for cystic fibrosis
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128
What are the differing issues associated with the management of adult and paediatric patients with CF?
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129
What are the social, educational and economic impact of cystic fibrosis on the child and the family
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130
What is the the role of transplantation in CF?
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131
What are emerging CFTR modulator therapies ?
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