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Respiratory System > Pathophysiology > Flashcards

Pathophysiology Flashcards

1
Q

What are the two different types of breathlessness that a patient can present with?

A

Acute and chronic

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2
Q

What are the 3 categories that can cause SOB?

A

Cardiac, Respiratory and “Other”

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3
Q

What are some of the associated features that come with SOB?

A

Cough, wheeze, haemoptysis and chest pain

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4
Q

What is the scale we use to quantify a patients breathlessness?

A

MRC scale

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5
Q

What is the range of the MRC scale?

A

1-5

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6
Q

What is interstitial lung disease?

A

A group of disorders that affect the lung interstitum

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7
Q

What happens to the lungs in interstitiual lung disease?

A

You have fibrosis (or scarring) of the lungs and this leads to a loss in elasticity of the lungs

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8
Q

Can scarred lungs increase or decrease the gas exchange in the tissues?

A

Decrease

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9
Q

What are the two main symptoms of interstitual lung disease?

A

SOB and a dry cough

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10
Q

Is there a cure for idiopathic pulmonary fibrosis?

A

No, we can only manage the disease

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11
Q

Name some ways that we can manage IPF?

A

Pulmonary rehab, medications, supplementary oxygen and a lung transplant

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12
Q

What is Sarcoidosis?

A

A multisystem chronic inflammatory condition

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13
Q

When do we usually find sarcoidosis?

A

When we carry out a chest x-ray and it is usually found accidentally

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14
Q

What are the symptoms that you should be looking out for to consider a sarcoidosis diagnosis?

A

Night sweats, SOB, cough, dry eyes, glaucoma, night fever

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15
Q

What can sarcoidosis progress onto?

A

Pulmonary fibrosis

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16
Q

What steroid do we usually prescribe patients that have sarcoidosis?

A

Pregnisolone

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17
Q

What is Bronchiectasis?

A

It is a chronic airway inflammation with dilation of the bronchi or their branches. It is an obstructive pulmonary defect

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18
Q

With Bronchiectasis do you get an increase or a decrease in mucus production?

A

Increase

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19
Q

In Bronchiectasis do you get an increase or decrease in cilla?

A

You get a decrease as you are loosing cillia in the airways.

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20
Q

What are patients with Bronchiectasis more prone to developing?

A

Chest infections

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21
Q

What is the “gold standard” clinical imaging that we would use to diagnose Bronchiectasis?

A

CT scan

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22
Q

Will a patient with Bronchiectasis present with a wheeze or not?

A

Yes they will

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23
Q

What is the management plan usually for patients with Bronchiectasis?

A

Respiratory rehab, antibiotics, inhalers.

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24
Q

What type of diagnosis is asthma?

A

A clinical diagnosis

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25
Q

What are some of the symptoms of asthma?

A

SOB, wheeze, cough, chest tightness

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26
Q

What is important to establish when giving an asthma diagnosis?

A

Whether they have any triggers or not

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27
Q

If a patient is not having an asthma attack, will their resp rates be normal or not?

A

They will be Normal

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28
Q

What will you have to carry out to confirm an asthma diagnosis?

A

~Peak flow and spirometers
~Positive response from a bronchodilator
~Convincing clinical history

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29
Q

What will you see with an obstructive defect?

A

~Reduced FEV 1, quite significantly
~Reduced FVC, but to a lesser extent that a reduced FEV1
~FEV1/FVC ration less than 0.7

30
Q

If someone has an obstructive defect will their spirometry graph look the same shape as a “normal” graph?

A

No, you will not have the same shape, but you will reach the same end volume, it just takes longer to get there

31
Q

Give examples of obstructive defects

A

Asthma, COPD, bronchiectasis

32
Q

If you have a restrictive defect will you see the same shaped graph seen an a spirometry graph?

A

Yes, the graph will be the same shape, but you will not reach the same end volume, it will be significantly reduced

33
Q

How can you diagnose a restrictive defect?

A

~Reduced FEC1
~Reduced FVC considerably
~FEV1/FVC ratio is either normal or elevated (over 0.7)

34
Q

Give examples of some restrictive defects?

A

Idiopathic pulmonary fibrosis, skeletal deformities, neuromuscular weaknesses and obesity

35
Q

What does a transfer factor DLCO measure?

A

The uptake of carbon monoxide into the cells

36
Q

When may you see a reduced CO gas transfer?

A

Emphysema, acute asthma, anaemia, interstitial lung disease

37
Q

When may you see an increased CO gas transfer?

A

Chronic asthma, left heart failure, polycythaemia and exercise

38
Q

What are the 4 different classifications of acute asthma?

A

Moderate, severe, life-threatening and near-fatal

39
Q

If a patient having a severe acute asthma attack has normal or increased CO2 levels then should you be concerned?

A

Yes, you should be VERY concerned and refer you patient to ICU as they are not “blowing off” the CO2 so they could then go on to develop acidosis

40
Q

If a patient has oxygen sats of less than 92% what classification of asthma do they have?

A

Life-threatening asthma

41
Q

If a patient has a resp. Rate of over 25 what classification is their asthma?

A

Severe

42
Q

If an asthmatic patient presents with a silent chest is this a good or a bad symptom?

A

Very bad symptoms, this is a sign that they have life-threatening asthma

43
Q

What type of reaction will you see in asthma patients?

A

Type 1 hypersensitivity reactions

44
Q

What immunoglobulin is involved in a type 1 hypersensitivity reaction?

A

IgE

45
Q

What type of respiratory disease is asthma?

A

Obstructive

46
Q

What is released when mast cells begin to degranulate?

A

Histamine and other pro-inflammatory mediators

47
Q

What helps the attraction between T lymphocytes and eosiniphils?

A

Th2 cells

48
Q

What is hypoxaemia?

A

Low oxygen levels in the blood

49
Q

What would happen if a lung had a pressure difference of zero?

A

The lung would collapse

50
Q

What are the 4 ways that hypoxaemia can occur?

A
  1. Hypoventilation
  2. Diffusion
  3. Shunt
  4. Ventilation - Perfusion mismatch
51
Q

What are the two different types of shunts that can occur to cause hypoxaemia?

A

True shunt and a disease shunt

52
Q

In patients with COPD and asthma will you see an increase or a decrease in V/Q?

A

Decrease as theres a problem with their airways

53
Q

What is type 1 respiratory failure?

A

When you have low oxygen levels (hypoxia). You have one issue

54
Q

What is type 2 respiratory failure?

A

When you have high CO2 levels (hypercapnia), you usually also have low oxygen levels too (hypoxia). You have 2 issues

55
Q

In a healthy lung if you double Fi02 what will happen to PaO2?

A

It will also double, they are directly proportional

56
Q

What changes in CO2, O2 and pH will cause an increase in resp rate and tidal volume?

A

Increase in CO2
Increase in pH
Decrease in O2

57
Q

What is worse acidemia or alkalaemia?

A

Acidemia

58
Q

What is cor pulmonale?

A

It is a disorder of the lungs that leads to a disorder of the heart

59
Q

What is the knock on effect of cor pulmonale?

A

You get right-sided heart disease

60
Q

What causes cor pulmonale?

A

Pulmonary hypertension

61
Q

What are the 3 main things that can cause cor pulmonale?

A
  1. Lung tissue damage
  2. Damage to pulmonary vessels
  3. Altered anatomy
62
Q

Can left-sided heart disease cause cor pulmonale?

A

No, because its a problem with the heart and not the lungs

63
Q

What might you see on an ECG that signifies cor pulmonale?

A

Inverted T waves

64
Q

What might the ABGs of a patient with cor pulmonale show?

A

Hypoxia and hypocapnia

65
Q

Will a patient with COPD and cor pulmonale have frequent exacerbations of their disease or not?

A

Yes they will

66
Q

What can right ventricular strain cause?

A

An increase in muscle mass which squashed the coronary arteries, causing right ventricular ischaemia which can lead to an MI

67
Q

What is the gold standard diagnostic test for cor pulmonale?

A

Right-heart catheterisation

68
Q

What type of bundle branch block may you see on an ECG for a patient that has cor pulmonale?

A

Right bundle branch block (RBBB)

69
Q

What are the 4 main ways that we can treat cor pulmonale?

A
  1. O2 therapy (consider LTOT)
  2. Diuretics
  3. Vasodilators
  4. Venesection
70
Q

Is the prognosis for cor pulmonale good or bad?

A

Bad

Respiratory System (3 decks)

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