Respiratory

Question 1

Acute bronchitis

Answer 1

Inflammation of lining of bronchial tube, which carries air from lungs

Question 2

Chronic bronchitis

Answer 2

Productive cough that lasts at least three months, with recurring bouts occurring at least two consecutive years
No cure, significantly improved through managing condition through medication and lifestyle changes

Question 3

Acute bronchitis cause

Answer 3

Usually caused by viruses, typically same as colds and flu (influenza)
Smoking
Air pollution
Dust
Toxic gas from enviro

Question 4

Acute bronchitis population

Answer 4

Can affect all ages, most common in children under 5
More commonly developed in winter

Question 5

Acute bronchitis risk

Answer 5

Smokers
Low resistance- may result from another acute illness such as a cold
Exposure to irritants at work- e.g., grain or textiles
Gastric reflux- repeated bouts of severe heartburn can irritate throat and inc chance of bronchitis

Question 6

Acute bronchitis S+S

Answer 6

Cough
Production of mucus=- clear, white, yellowish-grey or green, rarely may have streak of blood
Fatigue
Shortness of breath
Slight fever/chills
Chest discomfort
Potential body aches, mild headache

Question 7

Acute bronchitis prognosis

Answer 7

Usually improves within a week to 10 days without lasting effects, although cough may linger for weeks
Antibiotics won’t work as it won’t kill influenza virus

Question 8

Bronchiolitis

Answer 8

Common lung infection
Causes inflammation and congestion in bronchioles

Question 9

Bronchiolitis cause

Answer 9

Virus- influenza, rhinovirus, etc

Question 10

Bronchiolitis population

Answer 10

Young children and infants
Peal time is during winter

Question 11

Bronchiolitis risks

Answer 11

Premature birth
Underlying heart or lung conditions
Depressed immune system
Exposure to tobacco smoke

Question 12

Bronchiolitis presentation

Answer 12

Early- runny/stuffy nose, cough, slight fever (not always present)
After this may be a week or more of difficulty breathing or whistling of nose
Many infants have an ear infection (otitis media)

Question 13

Bronchiolitis prognosis

Answer 13

Most children get better with care at home
Small % hospitalised
See doctor if audible wheezing, breathing very fast, laboured breathing, lethargic appearance, refusal to drink, skin turning blue (cyanosis)

Question 14

Whooping cough

Answer 14

Highly contagious respiratory tract infection

Question 15

Whooping cough cause

Answer 15

Bacteria called Bordetella perussis
When infected person coughs or sneezes, tiny germ-laden droplets are sprayed into air and inhaled by others

Question 16

Whooping cough population

Answer 16

Before vaccine, considered childhood disease
Mainly affects children too young to finish full course of ABs or teens/adults whose immunity has faded

Question 17

Whooping cough risks

Answer 17

When vaccine wears off- leaves most teenagers and adults susceptible during outbreak
Infants under 12 months who are unvaccinated or haven’t received full set have highest risk for severe complications and death

Question 18

Whooping cough presentation

Answer 18

Once infected, takes about 7-10 days to show symptoms
Runny nose
Nasal congestion
Red, watery eyes
Fever
Cough
After week or two- provoke vomiting, red/blue face, extreme fatigue, end with high pitched ‘whoop’ sound during next breath of air

Question 19

Whooping cough prognosis

Answer 19

Deaths are rare but most commonly occur in infants
See doctor if prolonged coughing causes vomiting, face to turn red/blue, pauses in breathing, inhale with whooping sound
Complications- bruised/cracked ribs, abdominal hernias, broken vessels in skin or whites of eyes
Infant complications- pneumonia, slowed/stopped breathing, seizures
Make sure fully vaccinated and boosted

Question 20

Pneumonia

Answer 20

Infection that inflames air sacs in one or both lungs
Sacs may fill with fluid or pus, causing cough, fever, child, and difficulty breathing

Question 21

Causes of pneumonia

Answer 21

Variety of organisms, including bacteria, viruses and fungi
Community acquired
Hospital acquired
Health care
Aspiration

Question 22

Pneumonia community acquired cause

Answer 22

Bacteria- Streptococcus pneumoniae- occurs on its own once infected with a cold or flue
Bacteria like organisms- Mycoplasma pneumoniae- typically produces milder symptom’s
Fungi- most common in people with chronic health problems or weakened immune systems. Found in soil, bird droppings, etc
Viruses- most common in children younger than 5

Question 23

Pneumonia hospital acquired

Answer 23

can be serious because bacteria causing it may be more resistant to ABs

Question 24

Pneumonia healthcare

Answer 24

occurs in people who live in long-term care facilities, similar to hospital

Question 25

Pneumonia aspiration

Answer 25

occurs when you inhale food, drink, vomit or saliva into lungs. More likely if something disturbs normal gag reflex, such as brain injury or swallowing problems

Question 26

Pneumonia risks

Answer 26

Most serious for infants and young children (under 2) People over 65 Health problems/weakened immune system Being hospitalised Smoking

Question 27

Pneumonia presentation

Answer 27

Mild to severe Chest P when coughing or beathing Confusion (65+) Cough, may produce phlegm Fatigue Fever, sweating and shaking chills Lower body temp Nausea, vomiting, diarrhoea New-borns may not show signs

Question 28

Pneumonia prognosis

Answer 28

Ranges from mild to life-threatening Get vaccinated to prevent

Question 29

TB

Answer 29

Potentially serious disease that mainly affects lungs Bacterial infection Inc prevalence in 1985 post HIV outbreak as HIV weakness immune system

Question 30

TB cause

Answer 30

Spread through droplets Bacteria Contagious, but not easy to catch 2 weeks of treatment= no longer contagious

Question 31

TB risks

Answer 31

HIV/AIDS Diabetes Severe kidney disease Very young or advanced age Some drugs with treat rheumatoid diseases

Question 32

TB presentation

Answer 32

Latent TB- have Tb but bacteria in body are inactive and cause no symptoms, treatment important to prevent it becoming active Active TB- show symptoms, can spread to others, can occur weeks or years after TB bacteria infection Soughing for 3 or more weeks Coughing up blood or mucus Night sweats Loss of appetite Chest P especially when coughing or breathing

Question 33

TB prognosis

Answer 33

Any TB strains are resistant to drugs Multiple medication needed to be taken for months to get rid of infection and prevent AB resistance

Question 34

Emphysema

Answer 34

Lung condition causing shortness of breath Alveoli damaged, over time inner walls of air sacs weaken and rupture- creating large air spaces instead of small ones Reduces SA of lungs  reduced oxygen to bloodstream During exhalation, damaged alveoli don’t work properly and old air is trapped, leaving no room for oxygen-rich air to enter

Question 35

Emphysema cause

Answer 35

Long-term exposure to airborne irritants e.g., tobacco smoke, air pollution, chemical fumes and dust

Question 36

Emphysema risks

Answer 36

Smoking Age- 40-60 Exposure to second-hand smoke Occupational exposure to fumes or dust

Question 37

Emphysema presentation

Answer 37

Can have it many years without noticing Main symptom is shortness of breath, so doesn’t become a problem until it interferes with daily life Causes shortness of breath whilst at rest

Question 38

Emphysema prognosis

Answer 38

Complications include- collapsed lungs, heart problems, large holes in lungs (bullae)

Question 39

Asthma

Answer 39

Airways narrow and swell and may produce extra mucus Minor-major

Question 40

Asthma cause

Answer 40

Not clear, thought to be due to combination of enviro and genetic factors Triggers: 1. Airborne allergens- e.g., pollen, dust mites 2. Respiratory infections 3. Physical activity 4. Cold air 5. Air pollutants 6. Strong emotion/stress

Question 41

Asthma population

Answer 41

Female= inc risk Younger population 1/12 adults- late onset asthma On the inc due to pollution

Question 42

Asthma risks

Answer 42

Blood relative with asthma Overweight Smoker Exposure to second hand smoke Exposure to exhaust fumes/occupational triggers

Question 43

Asthma presentation

Answer 43

Variable May have infrequent asthma attacks Shortness of breath Chest tightness or P Wheezing when exhaling, common in children Trouble sleeping caused by shortness if breath Worsening signs- more frequent and bothersome, inc difficulty breathing, need to use quick-relief inhaler

Question 44

Asthma flare ups in certain situations

Answer 44

Exercise induced- may be worsened by cold or dry air Occupational asthma- triggered by workplace irritants Allergy induced asthma- triggered by airborne substances (pollen, cold spores)

Question 45

Asthma prognosis

Answer 45

Can be minor or major Can’t be cured but symptoms can be controlled Important to work with doctor to track signs and symptoms and adjust to changes Metered dosed Dry powder inhaler Soft mist inhaler -inhale corticosteroids- reduce inflammation in lungs, prevent attacks -short-acting bronchodilators- use during attack

Question 46

Cystic fibrosis

Answer 46

Inherited disorder that causes severe damage to lungs, digestive system and other organs Affects cells that produce mucus, sweat and digestive juices- usually thin and slippery, people with CF have a defective gene causing secretions to be sticky and thick Instead of acting as a lubricant it plugs up tubes, ducts and passageways especially in lungs and pancreas

Question 47

Cystic fibrosis cause

Answer 47

Mutation in a gene- cystic fibrosis transmembrane conductance regulator (CFTR) gene- changes protein that regulates movement of salts in and out of cells Results in sticky mucus in respiratory, digestive and reproductive systems as well as inc salt in sweat Children need to inherit one copy of the gene from each parent in order to have disease If children develop one copy they won’t develop CF, however they will be carriers and could pass it one to their children

Question 48

Cystic fibrosis population

Answer 48

Northern Europeans

Question 49

Cystic fibrosis risks

Answer 49

Family Hx Most common in Northern European ancestry

Question 50

Cystic fibrosis presentation

Answer 50

Variable May not experience symptoms until teenage years or adulthood Tend to have higher salt in sweat, parents can tell when kissing their children Respiratory- persistent cough that produces thick mucus, wheezing, exercise intolerance, repeated lung infections, recurrent sinusitis Digestive- thick mucus can block rubes that carry digestive enzymes from pancreas to small intestines- without these unable to absorb nutrients from food resulting in foul smelling stools, poor weight gain and growth, intestinal blocks particularly in new-borns, chronic or severe constipation

Question 51

Cystic fibrosis prognosis

Answer 51

Requires progressive treatment/daily care, but usually able to attend school or work Improvements in screening treatments mean people with CF now may live into mid-late 30s or 40s, some into 50s Genetic screening

Question 52

Lung cancer

Answer 52

Leading cause of cancer deaths worldwide Types: 1. Small cell- almost exclusively in heavy smokers 2. Non-small cell- umbrella term for several types, includes squamous cell carcinoma, adenocarcinoma and large cell carcinoma

Question 53

Lung cancer cause

Answer 53

Smoking- both smokers and those exposed to second hand o Damage to cells which line lungs o Inhalation of carcinogens changes kung tissue immediately Other than smoking, no clear cause

Question 54

Lung cancer population

Answer 54

65+

Question 55

Lung cancer risks

Answer 55

Smoking Exposure to second hand Previous radiation therapy Family Hx of lung cancer

Question 56

Lung cancer presentation

Answer 56

Rarely symptoms in early stages New cough that doesn’t go away Coughing up blood Chest P Shortness of breath Hoarseness Losing weight Bone P Headache

Question 57

Lung cancer prognosis

Answer 57

Many complications- coughing up blood, shortness of breath, P, fluid in chest, cancer that spreads 2/5 live for a year after diagnosis 1/10 live for ten years

Question 58

Pneumothorax

Answer 58

Collapsed lung Occurs when air leaks into space between lung and chest wall Air pushes on outside of lung and it collapses

Question 59

Pneumothorax cause

Answer 59

Chest injury- blunt or penetrating Lung disease- damage inc likelihood, e.g., CF Ruptured air blisters- develop at top of lung, occasionally burst allowing air to leak into space that surrounds lungs Mechanical ventilation- severe type, imbalance of air pressure created within chest by ventilator

Question 60

Pneumothorax population

Answer 60

Tall, thin people Smokers

Question 61

Pneumothorax risks

Answer 61

Smoking Genetics Previous pneumothorax

Question 62

Pneumothorax presentation

Answer 62

Sudden chest P Shortness of breath Severity depends on how much lung is collapsed

Question 63

Pneumothorax prognosis

Answer 63

Insert needle or chest tube between ribs to remove excess air Can heal on its own

Question 64

General S+S

Answer 64

- Dyspnoea - Cough - Chest px - Wheeze - Weight loss - Fatigue - Chest infections - Mucus production coughing up blood

Question 65

Causes of breathlessness

Answer 65

- Asthma - Chest infection - Being overweight - Smoking - Panic attack - COPD - Idiopathic pulmonary fibrosis - Heart failure - Lung cancer

Question 66

CVS causes of breathlessness

Answer 66

- Angina - Heart attack - Heart failure - Some abnormal heart rhythms o Atrial fibrillation

Question 67

GI causes for breathlessness

Answer 67

- Any condition that leads to the build up of air or foodstuffs could cause both bloating anf breathlessness - Stool inside the intestines - IBS - Celiac disease - Lactose intolerance - Constipation - Ileus - Bowel obstruction - Gastroparesis