Respiratory

Question 1

What is asthma?

Answer 1

Chronic inflammation disorder of airways

Question 2

What are the signs/symptoms of asthma?

Answer 2

PWCB

Paroxysmal bronchospasm
Wheeze
Cough
Variable bronchoconstriction with may be variable

Question 3

What is the pathological features of asthma?

Answer 3

Mucosal inflammation and oedema
Hypertropic mucus glands and mucus plugs in bronchi
Hyperinflated lungs

Question 4

What are the clinical classifications of asthma?

Answer 4

Atopic
Non-atopic
Aspirin-induced
Allergic-bronchopulmonary aspergillosis (ABPA)

Question 5

Type 1 hypersensitivity reaction

Answer 5

Allergens, cold, exercise, resp infections
Different cell types and mediators involved
Degranulation of IGE bearing mast cells
Histamine initiated bronchoconstri ction and mucus production and eosinophil chemotaxis

Question 6

What are the persistent/irreversible changes of asthma?

Answer 6

H H B

Bronchial wall smooth muscle HYPERTROPHY
Mucus gland HYPERPLASIA
Bronchilitis > centrilobular emphysema

Question 7

Epidemiology of asthma?

Answer 7

Children and young adults
COMMON - 33.9% 12-14 - wheeze
1/10 diagnosed w asthma
9-15% adult onset asthma = OCCUPATIONAL

Question 8

What is OPD?

Answer 8

Obstructive pulmonary disorder - obstruction can be localised/diffuse

Question 9

What is localised OPD

Answer 9

Tumour/foreign body causing obstruction

Distal alveolar collapse (total)/over expansion (valvular obstruction)

Distal retention pneumonitis (endogenous lipid pneumonia) and bronchopneumonia

Distal bronchiectasis = dilation

Question 10

What is bronchiectasis and what causes it?

Answer 10

Permanent dilation of bronchi/bronchioles caused by destruction of muscle and elastic tissue

Question 11

What does bronchiectasis result from?

Answer 11

Chronic necrotising infection

Question 12

What are the predisposing conditions, signs and symptoms and complications of bronchiectasis?

Answer 12

Predisposing conditions: CF, primary ciliary dyskinesia, Kartager syndrome, lupus, RA, IBC, GVHD (graft vs host disease), tumour/foreign body

Signs: cough, fever, copious foul smelling sputum (rare as have abx), may be localised so resectable

Complications: pnemonia, septicaemia, metazoic infection, amyloid

Question 13

What is Kartagers Syndrome?

Answer 13

A triad of features: situs inverses, abnormal frontal sinuses and primary ciliary dyskinesia