Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Semester 2: Cardiorespiratory Fitness > PBL Topic 2 Case 3 Extra > Flashcards

PBL Topic 2 Case 3 Extra Flashcards

1
Q

Identify two conditions associated with COPD

A
  • Emphysema

- Chronic Bronchitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the main cause of COPD in developed countries?

A
  • Smoking

- Which accounts for 90% of cases in developed countries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the main cause of COPD in developing countries?

A
  • Smoke from biomass fuels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Outline the pathophysiology of COPD

A
  • Increased numbers of goblet cells
  • Inflammation with infiltration of CD8 cells
  • Scarring, thickening and fibrosis of the airways
  • Ulceration and squamous cell metaplasia replacing columnar cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is emphysema?

A
  • Loss of elasticity

- Air trapping (enlargement of air spaces)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Outline the two abnormalities of Va/Q in emphysema

A
  • Obstruction results in unventilated alveolar
  • Va/Q approaching zero
  • Resulting in serious physiologic shunt
  • Destruction of alveolar walls results in inadequate perfusion
  • Va/Q approaches infinity
  • Resulting in serious physiologic dead space
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Identify three types of emphysema

A
  • Centri-acinar emphysema
  • Pan-acinar emphysema
  • Irregular emphysema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe centri-acinar emphysema

A
  • Emphysema centred around the respiratory bronchioles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe pan-acinar emphysema

A
  • Emphysema that affects the entire acinus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which type of emphysema is associated with a1-Antitrypsin deficiency?

A
  • Pan-acinar emphysema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe the ‘pink puffer’

A
  • Individuals are breathless but not cyanosed
  • Individuals are typically thin
  • Normal PaCO2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe the ‘blue bloater’

A
  • Individuals are cyanosed but rarely breathless
  • Individuals are oedematous peripherally
  • High PaCO2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Explain why ‘blue bloaters’ are not typically breathless

A
  • Patients become insensitive to CO2

- Patients then become dependent on low O2 to drive their ventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Explain why oxygen administration should be avoided in ‘blue bloaters’

A
  • Patients are dependent on low O2 to drive their ventilation
  • Oxygen therapy increases O2
  • Thus reducing their respiratory drive
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Outline the symptoms of COPD

A
  • Productive cough with sputum
  • Frequent infective exacerbations with purulent sputum
  • Wheeze and breathlessness
  • All of which are worsened by cold, foggy weather and atmospheric pollution
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Outline the signs of COPD

A
  • Hyper-inflated ‘barrel’ chest
  • Pursed lip breathing
  • Raised JVP, peripheral oedema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Outline a sign of COPD that can be detected using auscultation

A
  • Reduced breath sounds

- Wheeze

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Outline a sign of COPD that can be detected using percussion

A
  • Cardiac apex not palpable

- Loss of cardiac dullness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Outline the pathophysiology of Cor Pulmonale

A
  • Fluid overload due to hypoxic kidney
  • Pulmonary valve incompetence
  • Tricuspid incompetence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Outline the clinical features of Cor Pulmonale

A
  • Elevated jugular venous pressure
  • Peripheral oedema
  • Ascites
  • Liver swelling
  • Parasternal heave
  • Loud pulmonary second sound
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

When is COPD diagnosed?

A
  • Spirometry demonstrating airflow obstruction
  • FEV1 is less than 80% predicted
  • FEV1/FVC ratio is less than 70%
22
Q

How is hyperinflation tested for in COPD?

A
  • Helium dilation technique

- Low gas transfer factor

23
Q

How is respiratory failure diagnosed?

A
  • PaO2 < 8 kPa

- PaCO2 > 7 kPa

24
Q

Explain why pulmonary hypertension occurs in respiratory failure

A
  • Constriction of pulmonary arterioles

- Due to alveolar hypoxia and hypercapnia

25
Q

What are the targeted oxygen saturations in respiratory failure? How do these differ in patients with COPD?

A
  • 94% - 98%

- In COPD: 88% - 92%

26
Q

In nocturnal hypoxia, during which phase of sleep is PaO2 particularly affected?

A
  • During the REM phase of sleep

- PaO2 may fall as low as 2.5 kPa

27
Q

Outline the pathophysiology of nocturnal hypoxia

A
  • Inhibition of intercostal and accessory muscles
  • Shallow breathing in REM sleep
  • An increase in upper airway resistance because of a reduction in muscle tone
28
Q

Explain why patients with nocturnal hypoxia suffer from daytime sleepiness

A
  • Each episode is terminated by arousal of sleep
  • This occurs hundreds of times per night
  • So the amount of sleep is reduced
29
Q

Explain why sleeping tablets should never be given in patients with nocturnal hypoxia

A
  • Sleeping tablets will further reduce respiratory drive
30
Q

Identify the treatment used in nocturnal hypoxia

A
  • Non invasive positive pressure ventilation

- Administered with BiPAP

31
Q

Outline how BiPAP works

A
  • Inspiratory to provide inspiratory assistance
  • Expiratory to prevent alveolar closure,
  • Improves ventilation during sleep
  • Allows respiratory muscles to rest at night.
32
Q

Outline the treatment of COPD

A
  • Smoking cessation
  • Pulmonary rehabilitation
  • Bronchodilators e.g. salbutamol and ipratropium
  • Corticosteroids
  • Antibiotics
  • Oxygen therapy
33
Q

Outline three examples of surgery used as additional measures in COPD

A
  • Surgical bullectomy
  • Lung volume reduction
  • Single lung transplantation
34
Q

How is prognosis of COPD calculated?

A
  • BODE Index
  • B = BMI
  • O = Airflow obstruction
  • D = Dyspnoea
  • E = Exercise capacity
35
Q

What is bronchiectasis?

A
  • Mucociliary transport is impaired
  • Resulting in frequent infections
  • Resulting in dilated airways that are inflamed, thickened and irreversibly damaged
36
Q

Identify two different causes of bronchiectasis

A
  • Congenital defect such as cystic fibrosis

- Destructive infection such as tuberculosis

37
Q

Identify 6 clinical features of bronchiectasis

A
  • Clubbing
  • Crackles
  • Breathlessness
  • Sputum
  • Halitosis
  • Haemoptysis
38
Q

What will a CXR show in bronchiectasis?

A
  • Thickened, dilated bronchi

- Cysts containing fluid

39
Q

What will a sputum culture show in bronchiectasis?

A
  • Staphylococcus aureus
  • Pseudomonas aeruginosa
  • H. influenza
  • Anaerobes
40
Q

Why are sinus x-rays carried out in bronchiectasis?

A
  • 30% of bronchiectasis patients have rhinosinusitis
41
Q

Why are serum immunoglobulins investigated in bronchiectasis?

A
  • 10% of patients have IgA deficiency
42
Q

Outline the treatments used in bronchiectasis

A
  • Postural drainage
  • Flucloxacillin for Staphylococcus aureus
  • Ceftazidime for Pseudomonas aeruginosa
  • Blood transfusion, embolisation and surgical resection for haemoptysis
43
Q

Identify three complications of bronchiectasis

A
  • Pulmonary Tuberculosis
  • Pneumonia
  • Pneumothorax
44
Q

What is Pneumonia?

A
  • Inflammation of the substance of the lungs
45
Q

Outline the three classifications of Pneumonia

A
  • Community-Acquired
  • Hospital-Acquired
  • Immunocompromised Hosts
46
Q

What type of person is most likely to be affected by CAP?

A
  • Those at the extremities of age
47
Q

Which organism is responsible for causing CAP?

A
  • Pneumococcus
48
Q

Identify two examples of drugs given in mild CAP infections

A
  • Amoxicillin

- Clarithromycin

49
Q

What is Roflumilast?

A
  • Phosphodiesterase Type 4 Inhibitor
50
Q

What is Carbocysteine?

A
  • Antimucolytic

Semester 2: Cardiorespiratory Fitness (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions