Respiratory disease: Asthma, bronchitis and respiratory failure & Carcinoma of the bronchus

Question 1

What is dyspnoea?

Answer 1

Shortness of breath

Question 2

What is orthopnoea?

Answer 2

When people get short of breath but only when lying flat

Question 3

What is the name given to the condition if a person is awakened by their shortness of breath when they are asleep?

Answer 3

Paroxysmal nocturnal dyspnoea

Question 4

Orthopnoea and paroxysmal nocturnal dyspnoea indicate what type of issue?

Answer 4

Cardiovascular problem (particularly left ventricular failure)

Rather than a primary resp disease

Question 5

If a cough or shortness of breath has come on quickly/suddenly - what may this be indicative of?

Answer 5

May be inhalation of foreign body, pulmonary embolism or bursting of lung inside the chest

Question 6

What is pleural effusion?

Answer 6

It is a collection of fluid between the chest wall and the lung itself (aka water on the lungs)

Question 7

If a cough/SOB has developed over the course of a few hours- what could be the cause? (4)

Answer 7

Asthma
Pulmonary odema
Pneumonia
Allergy

Question 8

If a cough/SOB has developed over days - what may be the cause? (2)

Answer 8

Pleural effusion

Irritation of slowly-developing lung cancer

Question 9

If SOB/cough develops over months - what may this indicate?

Answer 9

It indicates a scarring process, such as pulmonary fibrosis or chronic airflow limitation diseases

Question 10

Which condition is a wheeze a characteristic symptom?

Answer 10

Asthma - noise caused by air trying to escape small capillaries of lungs

Question 11

What is Stridor, and what does this suggest?

Answer 11

Stridor is a high pitch noise that is made during the inspiratory phase of respiration.

It can indicate larynx swelling or upper airway obstruction/narrowing

Question 12

What is it called when your are coughing up blood?

Answer 12

Haemoptysis

Question 13

In what conditions may you see haemoptysis?

Answer 13

TB, pneumonia, pulmonary oedema, lung cancer

Question 14

What 2 volumes are you interested in when looking at a lung function test?

Answer 14

Forced vital capacity

Forced expiratory volume

Question 15

What is the FEV1?

Answer 15

It is the amount of air you can force from your lungs in one second

Question 16

What is peak expiratory flow rate?

Answer 16

It is the volume of air forcefully expelled from the lungs in one quick inhalation - it is a reliable indicator of ventilation adequacy as well as airflow obstruction.

Easy to monitor using peak flow meter at home

Question 17

Name the 7 upper respiratory tract infections

Answer 17

Common cold 
Sinusitis
Rhinitis
Pharyngitis
Laryngo-tracheo-bronchitis
Influenza
Inhalation of foreign body

Question 18

Outline the main characteristics of the common cold (6 points)

Answer 18

80-90% viral 
12 hours incubation 
Malaise
Pyrexia
Mucopurulent (mucus and pus)
Resolves in 1/52

Question 19

Outline the main characteristics of the sinusitis (3 points)

Answer 19

Obstructed antral ostia due to mucosal oedema - leads to increasing pressure.
Pressure = pain
Toothache by antral floor irritation

Question 20

Outline the main characteristics of rhinitis

How is this treated?

Answer 20

Sneezing and congested/blocked nose
Perennial (long lasting) asthma-type allergens (e.g. hayfever)

Tx: antihistamines, decongestants, nasal topical steroid spray

Question 21

Outline the main characteristics of pharyngitis

Answer 21

Typical viral sore throat
occasionally bacterial (e.g. strep pneumoniae, h. influenzae, staph aureus)

Question 22

Which type of upper resp infection can result in the swelling of the throat

Answer 22

Haemophilus influenzae bacteria can cause epiglotittis, is life threatening and rapidly advancing, could need tracheotomy to save life

Question 23

What does AIR RAID stand for when considering epiglottitis?

Answer 23

Airway inflammation - leading to obstruction
Increased pulse
Restlessness

Retractions (when inhaling can see tissue retracting into rib cage as struggling for air)
Anxiety increased
Inspiratory stridor
Drooling (cant swallow liquid easily)

Question 24

What should you not do if you suspect someone has epiglotittis?

Answer 24

Do not put anything down the throat or near the epiglottis, because as soon as it’s touched it can swell - which will mean that the pt needs a surgical airway immediately.

Question 25

Outline the main characteristics of laryngo-tracheo-bronchitis (7 points)

How is this treated? (3)

Answer 25

Typically parainfluenza or measles viruses
Laryngeal odema (especially children) = hoarse voice, croup, stridor, tracheitis - this can lead to burning retrosternal chest pain

Tx: oxygen, steam inhalations, tracheotomy

Question 26

Outline the main characteristics of influenza (6 points)

Answer 26

3 day incubation
Fever, myalgia, headache, sore throat, dry or productive cough
Vulnerable to secondary infection (e.g. pneumonia)

Tx: prophylaxis

Question 27

Outline the main characteristics of inhalation of a foreign body-

When may this occur?
What is the treatment for this?

Answer 27

Children, drunken, dental exam or endo file

Tx: back blows, Heimlich manoeuvre