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Diseases of Human Systems > Respiratory Disease > Flashcards

Respiratory Disease Flashcards

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1
Q

what is polycythaemia

A

this is when the bone marrow produces more red blood cells to carry more oxgyen

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2
Q

what does respiratory mean

A

designating, relating to, or affecting the organs involved in respiration, or of relating to respiration

of or relating to the processes of oxygen transport and respiration

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3
Q

what is respiration

A

the action of taking air into the lungs and expelling it again, especially as a continuous physiological process

a single act of breathing

the exchange of oxygen and carbon dioxide between an organism or cell and the environment, the process by which this occurs, also the process by which oxygen is distributed to the tissues of an organism

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4
Q

what is disease

A

sickness in a person, animal or plant, disturbance or impairment of the function and structure of the body, a part of the body, or the mind

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5
Q

normal respiratory rate for an adult

A

12-20 breaths a minute

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6
Q

normal respiratory rate for a newborn

A

30-40 breaths a minute

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7
Q

normal respiratory rate for a toddler

A

20-30 breaths a minute

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8
Q

normal respiratory rate for a 6-10 year old

A

18-25 breaths a minute

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9
Q

normal oxygen saturation

A

96-100%

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10
Q

what is the FEv1

A

the volume of air forcibly expired in the first second after a full inhalation
this is normally calculated based on age, weight and sex
the percentage of normal will be indication of disease severity

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11
Q

FEV1 in healthy adults is

A

greater than 3.5 litres for a male
greater than 2.5 litres for a female

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12
Q

what is the FVC

A

the maximum volume of air that can be expressed from the lungs forcibly

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13
Q

what are some rheumatological conditions

A

rheumatoid arthritis
systemic scelorosis
systemic lupus erythmatosis
myositis

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14
Q

what is obstructed sleep apnea

A

this is the most common disorder of breathing during sleep which affects 5-15% of the population
there is an upper airway obstruction but movement of the chest wall will persist.

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15
Q

which sleep zone is the most common for sleep apnoea to occur in and why

A

REM due to low muscle tone

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16
Q

what are the symptoms of OSA

A

snoring
apnoea periods
dry mouth
daytime fatigue
daytime somnolence
poor concentration
headaches
depression

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17
Q

what are the risk factors for OSA

A

male
obesity
type 2 diabetes
smoking
alcohol
down syndrome
craniofacial abnormalities
hypothyroidism
acromegaly

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18
Q

what is the STOP BANG questionnaire

A

used to diagnose OSA

S - do you snore loudly
T - do you often feel tired
O - has anyone observed you stop breathing or gasping during sleep
P - high blood pressure

B - BMI over 35
A - age over 50
N - neck circumference greater than 17 male or 16 female
G - gender, are you male

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19
Q

what are the methods used to diagnose OSA

A

STOP BANG questionnaire
epworth sleepiness scale
sleep studies
polysomnograph

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20
Q

how is OSA treated

A

lifestyle changes
continuous positive airway pressure (CPAP)
mandibular advancement devices

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21
Q

describe the common cold

A

a common, self limiting illness resolving without intervention in up to 10 days
predominantly viral (rhinovirus)
influenza, parainfluenza, adenovirus have been implicated

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22
Q

what is epiglottitis

A

localised swelling of the epiglottis caused by infection, obstructing the laryngeal inlet, leading to haemophilus influenzae

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23
Q

what does epligglotitis present as

A

unwell scared patients
muffled voices
quack cough in a child
increasing dysphagia
drooling
stridor

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24
Q

how does tonsillitis present as

A

patient c/o
- sore throat
- otalgia (earache)
- headache and malaise

on examination
- patient is pyrexial (raised body temperature)
- tonsils enlarged and exuding pus
- lymph nodes enlarged or tender
- foetar oris / halitosis (bad breath)

can be viral or bacterial

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25
how to manage tonsillitis
analgesia soft diet if there is difficulty swallowing, refer to ent
26
what is COPD
chronic obstructive pulmonary disease airflow obstruction due to chronic inflammation
27
describe chronic bronchitis
inflammation and excess mucous chronic productive cough for over three months in two consecutive years
28
what is emphysema
an alveolar membrane degradation leading to recurrent inflammation, scarring and loss of parenchymal lung texture
29
how many people affected by COPD
1.2 million
30
is COPD curable
no
31
what is the pathology of COPD
mucous hypersecretion ciliary dysfunction airflow obstruction and hyperinflation gas exchange abnormalities pulmonary hypertension
32
describe mucous hypersecretion
increased goblet cells and size of bronchial submucosal glands
33
describe ciliary dysfunction
squamous metaplasia of epithelium dysfunction of the mucociliary escalator difficulty expectorating
34
describe airflow obstruction and hyperinflation
small airways inflammation and narrowing loss of lung elastic recoil progressive air trapping during expiration hyperinflation of the lungs
35
describe gas exchange abnormalities
hypoxaemia with or without hypercapnia abnormal distribution of ventilation and perfusion ratios
36
describe pulmonary hypertension
late COPD, loss of pulmonary capillary bed endothelial dysfunction remodelling of the pulmonary arteries
37
what are the symptoms of COPD
chronic cough fatique dyspnoea /difficulty breathing excess mucous shortness of breath chest discomfort
38
causes of COPD
smoking pollution occupational exposure genetics lung development asthma
39
deficiency in which gene leads to COPD
alpha 1.- antitrypsin
40
how to diagnose COPD
take a history spirometry chest radiograph full blood count SpO2
41
what is spirometry
most reproducible and objective measurement of airflow limitation measure the post bronchodilator spirometry to confirm diagnosis of COPD should be used to monitor disease progression
42
what is the function of a radiograph in diagnosing COPD
to exclude other pathologies
43
why is a full blood count taken to diagnose COPD
looking at anaemia or polycythaemia
44
what is the GOLD criteria for COPD diagnosis
persistent or worsening dyspnea chronic cough chronic sputum production exposure risk factors eg smoking, dust or chemicals family history
45
how to treat COPD
aim to prevent sequelae minimise the progression of disease minimise exacerbations lifestyle measures smoking cessation exercise end stage oxygen therapy
46
what are some after effects of COPD
reduced quality of life Cor Pulmonale frequent LRTI secondary polycythaemia pneumothorax respiratory failure lung cancer muscle wasting and cachexi
47
what is cor pulmonale
right side heart failure due to lung failure
48
what is pneumothorax
this is where air leaks into the pleural space between the lung and the chest wall
49
what is asthma
a chronic respiratory condition associated with airway inflammation and hyper responsiveness most common long term conditions worldwide higher in children than in adults more boys than girls, but more women than men have it
50
what is the asthma pathology
atopy airway hyperactivity
51
what is atopy
the genetic tendency to develop allergic diseases such as allergic rhinitis, asthma and atopic dermatitis susceptible individuals produce large amounts of IgE in response to trivial extrinsic allergens
52
describe airway hyperactivity in asthmatics
an increased responsiveness of the airways to non specific stimuli which may in part be due to inflammation of the bronchus
53
describe how a combination of atopy and airway hyperactivity can lead to airway limitation
bronchoconstriction which is contraction of the bronchial smooth muscle mucosal oedema an increased secretion of tenacious mucous
54
what is intrinsic asthma
late onset, unrelated to atopic conditions no evidence of IgE mediation no seasonal variation pathophysiology is unknown
55
what are the symptoms of asthma
coughing wheezing chest tightness shortness of breath variable expiratory airflow limitation varies over time and in intensity
56
what are the triggers of asthma
exercise allergen or irritant exposure changes in weather viral respiratory infections NSAIDs beta blockers
57
how is asthma diagnosed
history peak flow trial SABA blood tests
58
what does asthma lead to
death respiratory complications impaired quality of life
59
describe the respiratory complications arising from asthma
pneumonia pulmonary collapse (atelectasis caused by mucous plugging of the airways) leading to respiratory failure pneumothorax status asthmaticus
60
how does asthma impair quality of life
fatigue underperformance and time off school or work
61
what is atelectasis
collapse of a lung
62
how is asthma managed
aim to control the disease by avoiding exacerbations and reduce the risk of morbidity and mortality complete control of asthma as there is no daytime symptoms, no nigh time awakening due to asthma, no need for rescue medication, normal lung functions and minimal medication side effects
63
what are some asthma medications categorised into
controllers, which are taken daily on a long term basis relievers used as needed
64
what are some asthma control medications
systemic corticosteroids methotrexate leukotriene antagonists LABA inhaled corticosteroids
65
what are some asthma reliever medications
SABA short acting theophylline inhaled anticholinergics
66
describe cystic fibrosis
rare autosomal recessive condition multisystem disorder affecting the lungs, pancreas, liver and intestine impairs the normal clearance of mucous from the lungs which facilitates the colonisation and infection of the lungs by bacteria
67
which chromosome is mutated in cystic fibrosis
7 CTRF
68
how to diagnose cystic fibrosis
sweat tests, where if the chloride levels are higher than 60mmol/L is suggestive of CF gene tests
69
how to manage cystic fibrosis
antibiotics airway clearance techniques such as active cycle of breathing techniques or use of airway clearance devices regular exercise to improve lung function and overall fitness heart lung transplant
70
lung cancer stats
71
which lung cancer types are non small cell carcinomas
adenocarcinoma squamous cell carcinoma large cell carcinoma
72
which categories can lung cancer types be put into
non small cell carcinoma and small cell carcinoma
73
describe adenocarcoma
located peripherally in the smaller airways of the lungs glandular differentiation histology more common in non smokers and asian females metastasise early responds well to immunotherapy
74
describe squamous cell carcinoma
located centrally in the bronchi of the lungs squamous differentiation and keratinisation is the histology more common smokers secretes PTHrP causing hypercalcaemia metastisise late via the lymph nodes
75
describe large cell carcinomas
these are located peripherally and centrally large and poorly differentiated more common in smokers and will metastisise early
76
describe small cell carcinoma
located centrally poorly differentiated histology more common in older smokers metastisise early secretes ACTH leading to cushings syndome and ADH associated with Lambert eaton syndrome
77
what are the symptoms of lung cancer
50% of cases are symptomatic unexplained cough for over three weeks unintended weight loss new onset shortness of breath pleuritic chest pain bone pain fatigue
78
what are the signs of cancer
cachexia finger clubbing cervical lymphadenopathy wheeze
79
what is cachexia
a condition that causes muscle and fat tissue to waste away
80
what are some investigations for lung cancer
chest x ray ct chest abdomen and pelvis bronchoscopy and biopsy PET CT for staging
81
describe non small cell lung cancer treatment
surgery targeted therapy immunotherapy chemotherapy palliative care
82
what are the treatment options for small cell lung cancer
chemo and radiotherapy
83
what is the pathogen that causes community acquired pneumonia
streptococcus pneumoniae
84
what are the symptoms and signs of pneumonia
cough breathlessness pleuritic pain pyrexia tachypnoea tachycardia
85
which groups have greater severity of pneumonia
older age groups cardiorespiratory comorbidities low socioeconomic group new eight loss or cachectic state immunocompromised - should consider atypical organisms
86
describe tuberculosis
this causes more deaths than any other infectious disease most cases were in Southeast Asia Africa and the western pacific
87
what are the signs and symptoms of tuberculosis
asymptomatic malaise weight loss fever night sweats productive cough shortness of breath Chet pain extra pulmonary disease
88
what causes the tuberculosis
mycobacterium tuberculosis
89
describe the course of tuberculosis
can reactivate when the immune system is impaired there is destructive caveatting in the upper zone pneumonia, and multiplication of organisms within these cavities airway communication with cavities leads to endobronchial spread within the lungs and airborne spread to others
90
describe military tuberculosis
this is when the disseminated disease begins to spread through the blood causing tuberculosis in the brain kidney and bone this leads to tuberculosis meningitis and may follow primary or post primary infection poor prognosis
91
how to diagnose tuberculosis
chest x ray sputum sample blood tests HIV serology brain MRI for miliary tuberculosis lumbar puncture
92
describe the use of sputum sampling in the diagnosis of tuberculosis
ziehl nelson stain for acid fast bacilli culture for confirmation of diagnosis and sensitivity testing
93
describe the blood testing used to diagnose tuberculosis
interferon gamma release assay geneXpert nucleic acid amplification test and antibiotic sensitivity
94
describe the use of lumbar puncture
investigation for tuberculosis meningitis
95
describe pulmonary embolus
this is when a clot form a vein, originating in the venous sinuses of the calf of the femoral vein or the pelvis detaches and becomes lodged in the pulmonary arterial tree
96
what are the risk factors for a pulmonary embolism
age obesity previous venous thromboembolism malignancy hrt pregnancy immobility hospitalisation cancer atrial fibrillation factor v leiden deficiency
97
describe acute pulmonary embolus treatment
thrombolysis percutaneous catheter removal of clot
98
describe what can be used for anticoagulation in pulmonary embolus treatment
DOAC LMWH warfarin
99
describe use of corticosteriods
inhaled pressurised metered dose inhalers with spacer oral for severe disease and intravenous when emergency
100
how are muscarinic antagonists taken
inhaledd

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