Respiratory

Question 1

main respiratory symptoms

Answer 1

breathlessness
wheeze
cough
sputum production
chest pain

Question 2

what is sputum?

Answer 2

Mucus and other matter brought up from the lungs by coughing

Question 3

what is pneumonia?

Answer 3

inflammation of the lungs, usually caused by an infection

Question 4

symptoms of pneumonia

Answer 4

cough
sputum production
sometimes haemoptysis
pleuritic chest pain
breathlessness
fever, sweats, rigors
malaise

Question 5

what is haemoptysis?

Answer 5

Sometimes there is blood in the sputum and that symptom is called haemoptysis

Question 6

causative organisms of pneumonia

Answer 6

streptococcus pneumoniae
haemophilus influenzae
mycoplasma pneumoniae

Question 7

how would you manage pneumonia?

Answer 7

ABDCE approach
CRB65 score
Antibiotics

Question 8

what is the CRB65 score?

Answer 8

CRB 65 - C - confusion
R - respiratory rate
B - blood pressure

This is to find out the risk of patient having pneumonia

Question 9

what score in the CRB 65 states low risk?

Answer 9

0

Question 10

what score in the CRB 65 states intermediate risk?

Answer 10

1 or 2

Question 11

what score in the CRB 65 states high risk?

Answer 11

3 or 4

Question 12

what is obstructive sleep apnoea?

Answer 12

breathing stops and starts during sleep due to obstruction of pharynx
sleep interrupted many times during the night
unrefreshing sleep, headaches, poor memory

Question 13

risk factors of obstructive sleep apnoea

Answer 13

male>female
overweight/obesity
small airway, small lower jaw, large tonsils

Question 14

diagnosis of obstructive sleep apnoea

Answer 14

symptom assessment - epworth sleepiness scale
sleep study

Question 15

what is pneumothorax?

Answer 15

when the lung lining punctures and air escapes into the pleural space

Question 16

symptoms of pneumothorax

Answer 16

pleuritic chest pain
breathlessness
may cause collapse and cardiac arrest

Question 17

management of pneumothorax

Answer 17

admission for assessment
may need chest drain to allow lung reinflation

Question 18

what is interstitial lung disease?

Answer 18

a group of about 100 chronic lung disorders characterized by inflammation and scarring that make it hard for the lungs to get enough oxygen.

Question 19

examples of interstitial lung disease

Answer 19

idiopathic pulmonary fibrosis
extrinsic allergic alveolitis

Question 20

what can interstitial lung disease lead to?

Answer 20

lung scarring and fibrosis

Question 21

symptoms of interstitial lung disease

Answer 21

breathlessness, often progressive
cough

Question 22

treatment for interstitial lung disease

Answer 22

depends on cause
specialist respiratory clinic for management

Question 23

what is cystic fibrosis?

Answer 23

Autosomal recessive genetic disease in which the lungs and digestive system can become clogged with thick, sticky mucus

Question 24

what is pulmonary embolus

Answer 24

occurs when a blood clot gets stuck in an artery in the lung, blocking blood flow to part of the lung

Question 25

what is Deep Vein Thrombosis (DVT)?

Answer 25

Deep vein thrombosis (DVT) is a condition in which a blood clot develops in the deep veins, most commonly in the lower extremities

Question 26

treatment for pulmonary embolus

Answer 26

anticaogulants

Question 27

what is asthma?

Answer 27

Asthma is a common lung condition that causes occasional breathing difficulties. inflammatory and allergic condition

Question 28

symptoms of asthma

Answer 28

wheeze breathlessness cough

Question 29

peak flow recording (PEFR) for moderate acute asthma

Answer 29

50-75%

Question 30

peak flow recording (PEFR) for acute severe asthma

Answer 30

33-50%

Question 31

peak flow recording (PEFR) for life threatening asthma

Answer 31

<33%

Question 32

how would you treat moderate acute asthma?

Answer 32

give salbutamol and reassess

Question 33

how would you treat acute severe asthma?

Answer 33

phone 999 give salbutamol give oxygen

Question 34

how would you treat life threatening asthma?

Answer 34

phone 999 give salbutamol give oxygen

Question 35

In detail how would you manage a medical emergency acute asthma attack in your surgery?

Answer 35

ABCDE approach give salbutamol inhaler - 2 puffs with spacer - if patient does not respond satisfactorily phone 999 high flow oxygen send someone for AED give salbutamol 5mg nebuliser or 2-10 puffs via spacer if part of an anaphylactic reaction, give IM adrenaline repeat salbutamol every 10 mins write a handover note to hospital

Question 36

how could unstable asthma be managed

Answer 36

steroids

Question 37

oral side effects of inhaled therapy

Answer 37

candidiasis altered taste dry mouth

Question 38

what are the markers of acute severe asthma?

Answer 38

PEFR 33-50% respiratory rate >25 per minute heart rate >110 inability to complete sentences in one breath

Question 39

what dose of salbutamol inhaler should you give in an acute asthma attack in your dental surgery?

Answer 39

initially 2 puffs via MDI If does not respond satisfactorily then call 999, high oxygen flow, salbutamol 5mg nebulized or 2-10 puffs via MDI

Question 40

Oral side effects of salbutamol

Answer 40

oral and throat irritation

Question 41

oral side effects of inhaled corticosteroids

Answer 41

oral candidiasis, altered taste, altered voice

Question 42

oral side effects of leukotriene receptor antagonists (montelukast)

Answer 42

dry mouth

Question 43

oral side effects of long acting muscarinic agonists (tiotropium)

Answer 43

dry mouth, dysphonia, altered taste

Question 44

oral side effects of oral corticosteroids

Answer 44

oral candidiasis

Question 45

what is COPD?

Answer 45

Chronic Obstructive Pulmonary Disease airway obstruction that is not fully reversible progressive overtime caused by smoking mostly or air pollution

Question 46

how is COPD diagnosed?

Answer 46

history exam spirometry

Question 47

symptoms of COPD

Answer 47

breathlessness wheeze chronic cough and sputum production frequent infections (stagnant mucous)

Question 48

COPD management

Answer 48

smoking cessation pulmonary rehabilitation vaccination - reduce chance of flu etc

Question 49

what are the 4 main medications used for COPD?

Answer 49

SABA LABA LAMA ICS

Question 50

what is SABA?

Answer 50

salbutamol or terbutaline

Question 51

what is LABA?

Answer 51

formoterol, salmeterol, vilanterol

Question 52

what is LAMA?

Answer 52

tiotropium, glycopyrronium, aclidinium

Question 53

what is ICS?

Answer 53

Beclomethasone, fluticasone

Question 54

how would you manage acute breathlessness in a person with COPD in your surgery?

Answer 54

ABCDE approach salbutamol 2 puffs via spacer oxygen to maintain sats 88-92 may need to be hospitalised

Question 55

how is COPD different to asthma?

Answer 55

irreversible airway obstruction chronic cough is common persistent and progressive breathlessness over time aetiology is usually inhalation of toxins (smoking, air pollution)