respiratory Flashcards by Kirsty Magee

what is stertor?

hot potato speech due to nasopharyngeal or orophrarangeal blockage

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cause of biphasic stridor?

tracheal narrowing

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cause of inspiratory stridor?

narrowing at vocal cords

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what does wheeze on waking indicate?

COPD

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what is wheeze?

high pitched whistling from upper airways

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why is sputum green?

dead neutrophils release veroperoxidase

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what colour sputum will a patient with COPD and infection produce?

in the morning-green from dead stagnated neutrophils, it will become yellow throughout the day as more live ones are coughed up

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what is red sputum an indicator of

pneumococcal pneumonia

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causes of clubbing

cardiac-IE -congenital cyanotic disorders
respiratory-bronchiectasis -TB -neoplasm -sarcoidosis -IPF -empyema
GI-IDB -PBC -achalasia -liver cirrhosis
familial

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how might a patient describe dyspnoea?

hard to get enough air in
short of breath
tiredness

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what is dyspnoea?

unecessary awareness of breathing

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cardiac causes of dyspnoea

heart failure
MI
cardiomyopathy
constrictive pericardits
pericardial effusion

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respiratory causes of dyspnoea

asthma
COPD
bronchiectasis
fibrosis
tumour
sarcoidosis
alveolitis
pneumonia
PE
pulmonary HTN
pneumothorax
pleural effusion
ank spond
kyphoscoliosis
myasthenia gravis
Guillian Barre syndrome

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if dyspnoea was sudden onset (minutes), what is a likely diagnosis?

PE
pneumothorax
pleural effusion
asthma
inhaled foreign body

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what is orthopneoa often a sign of?

left ventricular failure and less commonly:
r muscle weakness
pleural eff
massive ascites
morbid obesity
GORD

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onset of dyspnoea from hours to days

asthma
pneumonia
COPD exacerbation

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dyspnoea onset weeks to months

anaemia
PE
neuromuscular disorders

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dyspnoea onset months to years

COPD
pulmonary fibrosis
pulmonary TB

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breathlessness RELIEVED by lying down

platypnoea from R>L PFO

ASD

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dyspnoea on waking is associated with?

asthma

left ventricular failure

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what is breathlessness on waking associated with?

COPD-SOB that wakes is more typical of asthma

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what symptoms should you ask about if someone presents with SOB?

chest pain
wheeze
cough

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where does pleural pain localise

if originates above 6th rib, it’s localised
if below 6th rib-referred to upper abdo
if over the diaphragm, it’s referred to shoulder tip or neck

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causes of pleuritic chest pain?

pneumonia
pleural effusion
pulmonary embolism
fractured ribs

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describe the chest pain in lung cancer

dull, aching, progressive, unrelated to breathing, disrupts sleep

what is Pancoast's tumour?

a tumour in the apex of the lung that compresses the brachial plexus and causes pain down medial side of arm

reterosternal, raw, burning pain, worse on coughing

mediastinum pain caused by irritants or infection of trachobronchial tree

central chest pain?

MI or massive PE causing increased pressure in RV

define tachypnoea

over 25 b/min

causes of tachypnoea

``` fever acute asthma COPD exac pneumonia pul oedema interstitial lung disease ```

define bradypnoea and give causes

under 10 b/min opioid toxicity hypothryoidism raised ICP

causes of painless breathlessness

``` PE pneumonia pneumothorax metabolic acidosis hypovolaemia acute left ventricular failure ```

what is Cheyne-Stokes respiration?

periodic breathing, increasing in depth and rate and then there's a 10-20s period of apnoea or hypopnea, it's due to altered CO2 sensitivity from congestive heart failure (bad prognosis), altitude sickness, encephalitis, brainstem lesions, raised ICP

causes of Kussmaul's breathing?

``` DKA AKI lactic acidosis methanol poisoning salicylate poisoning ```

reduced chest expansion is seen in?

lung cancer pneumonia IPF pleural effusion

hyperinflation seen in?

asthma | COPD

what areas does fibrosis affect?

starts basally

what respiratory diseases may cause ankle swelling?

COPD from cor pulmone | IPF

what would cause diminished vesicular breathing?

``` pleural effusion pleural thickening pneumothorax hyperinflation over an area of collapse ```

what will speech sound like over pleural effusion?

muffled

respiratory diseases in which there will be raised eosinophil count

allergic asthma pulmonary eosinophilia allergic bronchopulmonary aspergillosis churg strauss

what ion will severe pneumonia reduce?

sodium

what respiratory disease causes Ig deficiency?

bronchiectasis

what requires a high resolution CT scan?

bronchiectasis | interstitial lung disease

indications for bronchoscopy

? lung cancer ? foreign body aspiration specimens for microbiology

causes of respiratory acidosis

acute ventilatory failure from severe acute asthma, severe pneumonia, COPD exa, skeletal abnormality or neuromuscular disorder

respiratory alkalosis causes

hyperventilation (asthma, PE, pleurisy) | CNS-stroke; subarachnoid; early salicylate poisoning

causes of metabolic acidosis

- DKA - poisoning from alcohol, methanol, ethylene glycol, iron, salicylate - AKI - lactic acidosis-shock, cardiac arrest - loss of bicarb from renal tubular acidosis, severe diarrhoea, Addison's

metabolic alkalosis causes

- loss of acid from severe vomiting, NG suction | - loss of potassium from XS diuretic, hyperaldosteronism, Cushing's, liquorice, XS alkali ingestion

what does haemoptysis suggest?

PE | malignancy

Which organisms are most likely to cause COPD exacerbation?

Moraxella carrhalis, S. pneumoniae, H influenzae, rhinovirus, influenza

features of bronchiectasis on CXR?

tram track bronchi ring like shadows thick dilated airways

what is the faulty protein in CF?

CF transmembrane conductance regulator

GI complications of CF?

DIOS, autodigestion+malabsorption+steatorrhoea, cholesterol stones, cirrhosis, PUD, GI cancer

add to the list of: SOB, haemoptysis, bronchiectasis, steatorrhoea sx of CF

meconium ileus, nasal polyps, sinusitis, liver/kidney failure, GORD

how can you prove CFTR dysfunction?

nasal PD, sweat test and small bowel ion studies

how do you treat a CF exacerbation?

o2 support, antibiotics, control hyperglycaemia, increased physio and nutrition support

is bronchitis obstructive or restrictive?

obstructive

transudate PE causes?

liver cirrhosis, kidney failure, hypothyroidism, heart failure, low protein, a haemothorax

sx of PE?

atelectasis leading to PE, pleuritic chest pain, asymptomatic, stony dull to percussion, reduced breath sounds, reduced expansion

why does systemic bp fall in PE?

decrease in cardiac output because pulmonary artery pressure has increased

what is a massive PE?

both pulmonary arteries blocked

what would you hear on auscultating a PE?

coarse crackles, possibly a pleural rub

what might a PE CXR look like?

normal or blunting of the costophrenic angles or atelectasis

management of PEs?

high flow o2 adrenaline consider surgery if massive LMWH until INR over 2 then warfarin

respiratory Flashcards

(65 cards)