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1st/2nd Year Revision > Resp Conditions > Flashcards

Resp Conditions Flashcards

1
Q

What is the pathology of asthma?

A

Reversible airway narrowing:
Bronchial muscle contraction
Mucosal swelling
Increased mucous production

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2
Q

What are the symptoms of asthma?

A 
Dyspnoea
Wheeze
Cough
Diurnal variation – typically worse at night
Episodic
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3
Q

What investigations would be done if asthma was suspected?

A

Spirometry

Peak flow

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4
Q

How is asthma treated?

A 
SABA (short acting beta agonist) – salbutamol
ICS low dose
Add LTRA (leukotriene receptor antagonist) – Montelukast
Add LABA
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5
Q

What are the two types of COPD?

A

Emphysema

Chronic bronchitis

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6
Q

What is the pathology of COPD?

A

Emphysema - pink puffers, increased alveolar ventilation, breathless but not cyanosed
Bronchitis - blue bloaters, decreased alveolar ventilation, cyanosed, not breathless

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7
Q

What causes COPD?

A

Smoking

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8
Q

What are the symptoms of COPD?

A 
Cough
Sputum
Dyspnoea
Wheeze
Chest – wheeze, reduced expansion and air entry
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9
Q

What investigations would be done if COPD was suspected?

A 
Spirometry – FEV1/FVC ratio <0.7
CXR – lung hyperinflation 
Sputum culture
ABG – high CO2
ECG
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10
Q

How is COPD managed?

A 
Stop smoking
1 – SABA/SAMA
2 – LABA + LAMA if no asthmatic / steroid response, if they are responsive then LABA + ICS
3 – LABA + LAMA + ICS
4 – nebulisers, oral theophylline
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11
Q

What are the complications of COPD?

A

Acute exacerbations of condition
Respiratory failure
Lung cancer

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12
Q

What is the pathology of pneumonia?

A

Inflammation of lung parenchyma caused by LRTI

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13
Q

What are the different types of pneumonia?

A

Community acquired
Hospital acquired – develops >48hrs after hospital admission
Aspiration

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14
Q

What are the causes of pneumonia?

A

Community – strep pneumoniae, haemophilus influenzae, morexalla catarrhalis
Hospital – staph aureus

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15
Q

What are the symptoms of pneumonia?

A 
Fever
SOB
Cough
Sputum
Haemoptysis
Pleuritic pain
Chest – reduced expansion, consolidation, dull percussion
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16
Q

What investigations would be done if pneumonia was suspected?

A

Sputum culture
CXR – consolidation
Bloods – FBC, U&Es, LFT, CRP

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17
Q

How is pneumonia treated?

A

Antibiotics
Oxygenation
Hydration

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18
Q

What are the complications of pneumonia?

A 
Pleural effusion
Empyema
Lung abscess
Respiratory failure 
Septicaemia
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19
Q

How is the severity of pneumonia assessed?

A 
CURB 65 - 1 point for each
Confusion
Urea >7mmol/l
Respiratory rate >30/min
BP <90/60 mmHg
Age > 65
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20
Q

Type 1 respiratory failure

A

Low PO2, normal PCO2

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21
Q

Type 2 respiratory failure

A

Low PO2, raised PCO2

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22
Q

What are the histological subtypes of lung cancer?

A 
Small cell – 25%
Non-small cell:
Squamous – 35%
Adenocarcinoma – 25%
Large cell – 10%
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23
Q

What are the symptoms of lung cancer?

A 
Cough
Haemoptysis
Dyspnoea
Chest pain
Lethargy
Weight loss
Clubbing
Hoarse voice
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24
Q

What investigations would be done if lung cancer was suspected?

A

CXR – hilar enlargement, peripheral opacity, pleural effusion (unilateral), collapse
Contrast enhanced CT
Biopsy
PET

25
How is lung cancer treated?
Non-small cell – surgery (typically lobectomy), radiotherapy if early enough, chemotherapy if later Small cell – combination radiotherapy and chemotherapy
26
What are the complications of lung cancer?
``` Recurrent laryngeal nerve palsy Phrenic nerve palsy SVC obstruction Horner’s syndrome (Pancoast tumour) Syndrome of inappropriate ADH ```
27
How is lung cancer staged?
TNM staging
28
Where does lung cancer commonly metastasise to?
Bone Brain Liver Adrenal glands
29
What is the pathology of pulmonary embolism?
Thrombus in the pulmonary arteries
30
What typically causes a pulmonary embolism?
``` Deep vein thrombosis Risk factors: Pregnancy Recent flight Immobility Recent surgery Thrombophilia ```
31
What are the symptoms of pulmonary embolism?
``` Sudden onset: Breathlessness Pleuritic chest pain Haemoptysis Dizziness Syncope ```
32
What investigations would be done if a pulmonary embolism was suspected?
CT pulmonary angiogram V/Q scan D-dimer
33
How is a pulmonary embolism treated?
LMWH – dalteparin Long-term anticoagulation – warfarin, NOAC (apixaban) Massive PE – thrombolysis
34
What score is used to assess someones risk of a pulmonary embolism?
Wells score
35
What is the pathology of a pneumothorax?
Air in the pleural space separating the lung from the chest wall
36
What are the causes of a pneumothorax?
``` Spontaneous Chronic lung disease Infection Traumatic Carcinoma Connective tissue disorders ```
37
What are the symptoms of a pneumothorax?
Sudden onset: Breathlessness Pleuritic chest pain Chest – hyper-resonant percussion, reduced expansion
38
How is a pneumothorax investigated?
CXR - not if a tension pneumothorax is suspected
39
How is a pneumothorax treated?
If no SOB and <2cm rim air then will resolve spontaneously If SOB and/or >2cm rim air then aspirate If aspiration fails twice – chest drain Tension – insert large bore hole cannula into 2nd intercostal space, mid-clavic line then chest drain
40
What is a common finding of a tension pneumothorax?
Tracheal deviation
41
What is the pathology of a pleural effusion?
Fluid in the pleural space Transudates <25g/L Exudates >25g/L
42
What causes a pleural effusion?
Transudate (fluid moving across into pleural space) – congestive heart failure, hypothyroidism, hypo-albuminaemia Exudate (inflammation, protein leaks into space from tissue) – lung cancer, pneumonia, RA, TB
43
What are the symptoms of a pleural effusion?
SOB Pleuritic chest pain Chest – reduced air entry, dull percussion, diminished breath sounds Tracheal deviation if massive
44
What investigations would be done if a pleural effusion was suspected?
CXR – blunting of costophrenic angle Ultrasound Diagnostic aspiration Pleural biopsy
45
How is a pleural effusion treated?
Conservative if small effusion Drainage – aspiration, drain Pleurodesis – recurrent effusions
46
Haemothorax
Blood in the pleural space
47
Empyema
Pus in the pleural space
48
What are the risk factors for contracting tuberculosis?
Known contact with active TB Immigrants from areas of high TB prevalence Immuno-suppressed
49
What is the causative agent of tuberculosis and how is it stained?
Mycobacterium tuberculosis (rod shaped) – Zeihl-Neelsen stain, turns bacteria red on blue background
50
What are the symptoms of tuberculosis?
``` Asymptomatic Fever Weight loss Night sweats Clubbing Cough Pleurisy Haemoptysis ```
51
How is tuberculosis investigated?
``` Mantoux test – intradermal injection Interferon-gamma release assays CXR Sputum culture Nucleic acid amplification test (NAAT) Biopsy ```
52
How is tuberculosis treated?
``` (RIPE) 4 for 2 months: Rifampicin Isoniazid Pyrazinamide Ethambutol 2 for 4 months: Rifampicin Isoniazid ```
53
What are the complications of tuberculosis?
R – irn bru urine, tears, hepatitis, oral contraceptive pill ineffective I – hepatitis, peripheral neuropathy P – gout E – optic neuropathy
54
How is cystic fibrosis inherited?
Autosomal recessive
55
What is the pathology of cystic fibrosis?
Mutation in CF transmembrane conductance regulator (CFTR) gene on chromosome 7 leading to defective Cl secretion and increased Na absorption across the epithelium
56
What are the symptoms of cystic fibrosis?
Neonate – failure to thrive, meconium ileus, rectal prolapse Children – cough, wheeze, thick sputum production, recurrent infections, pancreatic insufficiency, male infertility, clubbing
57
How is cystic fibrosis investigated?
Screened at birth – newborn blood spot test Sweat test – sweat Na and Cl >60mmol/L Genetic testing during pregnancy – amniocentesis Faecal elastase – pancreatic enzyme deficiency
58
How is cystic fibrosis treated?
``` Chest physiotherapy Treat infections where they arise Prophylactic flucloxacillin Bronchodilators CREON tablets if pancreatic insufficiency ```
59
What are common colonisers of cystic fibrosis?
Staph aureus | Pseudomonas aeruginosa

1st/2nd Year Revision (15 decks)

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