Flashcards in Resp Basics Deck (39)
Features of an inspiratory wheeze?
Features of expiratory wheeze?
What is obstructive lung disease?
Narrowing of airways that prevents outflow from the lungs for gas exchange
Types of obstructive lung disease? Features?
Asthma - reversible airway obstruction - mast cell degranulation of histamine
CODP - Irreversible airway obstruction, long term smoking damage
What is SOB?
Difficulty breathing - use of accessory muscles and increased breathing rate
What make SOB worse?
Ventilation problem - Choking
Causes of SOB?
- Pulmonary fibrosis
- Interstitial lung disease
- Failure = inadequate O2 supply
- Anaemia (low Hb = low O2)
- Diabetic ketoacidosis = fast breathing = retention of metabolic acid from ketones
Joint cardiac and resp problems:
- Anxiety - fight/flight, hyperventilation, tachycardia
- PE - ventilation/perfusion problem
What is the normal respiratory rate?
What resp rate indicates tachypnoea?
Criteria of an acute severe asthma attack?
Resp rate over 25/30 per min
Peak flow is 50% below expected
Cannot complete sentences
When does an asthma attack become life threatening?
What is FEV1?
Forced expiratory volume over the 1st second of breathing out
What is FVC?
Forced vital capacity = vol of air that can be forcibly blown out after a full insp
What is the normal FEV1/FVC?
0.8 or more
What is the FEV1/FVC for obstructive disease?
What indicates asthma?
0.7 or less
Asthma needs to demo reversibility - give bronchodilator and repeat (if improves FEV1/FVC = asthmatic)
How to measure breathing?
Spirometer = measures volume breathed out in one forced breath (FVC)
Peak flow meter = breath out as far as you can as fast (how fast you breathe)
How does an asthmatic's breathing differ?
Cannot breathe out fast = peak flow (and FEV1) is lower but FVC is same
What is a spirometer?
Measures volume of air breathed out in one forced breath (FVC)
(how much air)
Helps diagnose and monitor lung conditions
Compare results to someone their age, height and sex
What is a peak flow meter?
Measures how fast someone can breathe out (PEF)
Helps diagnose asthma
Use at home twice daily when trying to diagnose asthma
Characteristics of a restricted disease?
Lower FVC (lower vol)
FEV1 = same
Inhalers: What do relievers do? Examples?
Dilate bronchi to normal
Short acting beta agonists
Inhalers: What do preventers do? Examples?
Do not relieve attacks
Decrease number of attacks
Long acting beta agonists
Steroids - Beclometasone, budesonide, fluticasone
What disorders require inhalers?
COPD and asthma
What is resp failure I?
Caused by pneumonia, asthma
Tx - give O2
What is resp failure II?
Caused by overdose, trauma, COPD, neuromuscular
Tx - give O2, care in chronic
What drives normal breathing?
CO2 as adapting receptor (increase CO2 = breathe faster)
What drives breathing in COPD?
O2 = non-adapting factor = lack of O2 to tissues
Airway obstruction as bronchial tubes inflamed = trapped air in lungs = decrease FVC and low FEV1
= FEV1/FVC = less than 70%
How to calculate if smoking is significant?
Cigarettes a day x number of years
Divided by 20
If more than 10PYH = significant