Respiratory Medicine - 2 Flashcards by Z M

What are the two diseases that cause COPD?

Bronchiectasis & emphysema component - non-reversible

How well did you know this?

Not at all

Perfectly

What causes bronchiectasis and what happens to the lungs?

recurrent infections
causing consistent damage to the bronchial walls
increased mucus
thickened walls due to scarring

How well did you know this?

Not at all

Perfectly

What is the main symptom of bronchiectasis?

productive cough with green sputum

How well did you know this?

Not at all

Perfectly

What causes emphysema and what happens to the lungs?

smoking and exposure to toxic chemicals
* Destruction of alveoli - less alveoli
* dilatation of some sacs to ‘fill space’
less surface area, increased cardiac load

How well did you know this?

Not at all

Perfectly

What are the causes of COPD?

smoking
air pollutants
genes (AAT deficiency)
age
asthma
chemical exposure

How well did you know this?

Not at all

Perfectly

What are the symptoms of COPD?

chronic cough
production of mucus
fatigue
shortness of breath
chest tightness

How well did you know this?

Not at all

Perfectly

What is the biggest preventative cause of COPD?

smoking

How well did you know this?

Not at all

Perfectly

What medications can be used to treat COPD?

long acting beta agonists = for reversible patients

steriods

oxygen support

How well did you know this?

Not at all

Perfectly

What can excerbate COPD?

environmental factors
noncompliance with medications
bacterial pathogens
viral infections
atypical bacteria

How well did you know this?

Not at all

Perfectly

What can COPD lead to without management?

progress to respiratory failure - type 1/2

How well did you know this?

Not at all

Perfectly

Type 1 VS Type 2 respiratory failure?

Type 1 - hypoxemia
Impaired gas exchange
Normal CO2
Caused by V/Q mismatch, alveoli descruction/ thickening
Treat with oxygen

Type 2 - hypercapnia
Hypoventilation
Normal O2
Caused by muscle disorders, increased airway resistance
Treat with ventilatory support (bronchodilators)

How well did you know this?

Not at all

Perfectly

Symptoms of Type 1 VS Type 2

Type 1 (blue bloaters)
- cyanosis
- confusion

Type 2 (pink puffers)
- pink skin
- barrel chest
- pursed lips

How well did you know this?

Not at all

Perfectly

When should oxygen be used and what should be done during?

In the acute stage use Oxygen until medical help arises
Watch - under medical supervision
respiratory rate
SaO2
In the CHRONIC stage, use oxygen with care – fixed percentage delivery

How well did you know this?

Not at all

Perfectly

What is a risk of home oxygen therapy?

oxygen can suppress the respiratory drive, leading to lower ventilatory effort and inability to exhale CO2 efficiently

How well did you know this?

Not at all

Perfectly

What is the risk of inhaled steriods dentally and what can be used to prevent this?

Use of inhaled steroids - candida risk
* rinse mouth after device use
* use spacer device for MDI ‘puffers’

How well did you know this?

Not at all

Perfectly

What increased risk do smokers have?

oral cancer

How well did you know this?

Not at all

Perfectly

In dental surgery, what may a patient that requires home oxygen need?

supplemental oxygen during treatment

How well did you know this?

Not at all

Perfectly

What type of disease is cystic fibrosis?

genetic disease

How well did you know this?

Not at all

Perfectly

What is the systemic failure in cystic fibrosis?

inherited defect in cell chloride channels
produces excess mucous in all body systems

How well did you know this?

Not at all

Perfectly

Which organs are mostly affected by cystic fibrosis?

lung and pancreas

How well did you know this?

Not at all

Perfectly

What gene does the cystic fibrosis mutation occur in?

CFTR gene (cystic fibrosis transmembrane conductance regulator)
chromosome 7

How well did you know this?

Not at all

Perfectly

What type of gene is the CFTR mutation?

Study These Flashcards

recessive
both parents need to have the gene

What mutation is the commnest defect?

Study These Flashcards

F508del

How is cystic fibrosis diagnosed?

Study These Flashcards

Prenatal screening - sibling has it
Perinatal testing - ALL children now screened at day 5 – blood spot test
‘Sweat test - greater salt in CF patients
CTFR Gene testing

Why is diabetes a symptom of CF?

build up causes inflammation and damage to B cells in pancreas

What are the main symptoms of CF in children?

* Troublesome cough * Repeated Chest infections * Pseudomonas, Staphylococci * Prolonged Diarrhoea * Poor weight gain

What are the consequences of CF?

* Liver dysfunction in some * Prone to osteoporosis * Diabetes symptoms * Prolonged pancreas disease * Reduced fertility (mainly male)

How is physiotherapy used to treat CF?

* Used to help remove the mucous secretions from the lungs * Performed at home by parents

What medications are used to treat CF in lungs?

* Bronchodilators to open the airways * Antibiotics to reduce Chest infection frequency * Steroids to reduce airway inflammation

What can resistance to antibiotics cause?

pneumonia leading to respiratory failure (1)

What medications are used to treat CF in the digestive system?

* Pancreatic Enzyme replacement * Nutritional Supplements

What full body system medications can also be used to treat CF?

* CFTR Modulators * Stem Cell treatments

What are example of CFTR moedulators and what mutation are they used for? | for F508del patients

* ivacaftor, tezacaftor and elexacaftor * triple-combination therapy

What can taking CFTR modulators from an early age do?

allows patient to produce a more normal secretion for a larger part of their life avoiding much damage

How is stem cell therapy used to treat CR and what is the different between adult and immature stem cells?

* Replace the bad gene with a new copy * If given to stable cells (‘adult’ cells) the therapy needs repeated every time the cells are replaced * If given to Stem Cells then ‘adult’ cells will all be made with the correct gene = cure

Why is exercise important for CF?

* Necessary to keep lung function optimal * Necessary to build physical bulk & strength

What is tranplantation used for in CF?

* Not a cure! * End stage lung disease * Also affects heart (cor pulmonale) * Heart-lung transplant * Not much survival after due to immunosuppressive drugs

What is the location of a visible mass in the lungs usually?

periphery

What happens if the mass is more central and blocks the bronchus?

allows secretions to build up leading to infection such as pneumonia causing occlusion of the lung

What is the biggest cause of lung cancer?

smoking

What are causes of lung cancer? (not smoking)

radon workplace chemicals (asbestos, arsenic, nickel) air pollution genetics radiation therapy other lung diseases (COPD, fiborosis)

What are the two groups of lung tumours?

small cell (25%) non-small cell (75%)

What are the 3 types of non-small cell lung tumors?

* Squamous Cell carcinoma - most common, central location * Large cell * Adenocarcinoma

What are the signs and symptoms of lung tumours?

* Cough * Haemoptysis (blood stained sputum) * Pneumonia * Obstruction of structures near lungs

What are biomarkers and what do they allow?

genetic mutations the tumour has they allow physicians to classify patients by their probable diseases, prognosis and their response to treatment

In locally advanced NSCLC, what are the treatment steps?

chemoradiation watch and wait

What is the role of the dentist in cancer?

ask about smoking advise on quitting act on patient's response (refer, build confidence)

What is sleep apnoea?

* Airway obstruction whilst asleep (blocked preventing patient from breathing normally) * 10 secs or more duration * Airway muscle tone drops (causes tongue to fall back and occlude the airway)

What can sleep apnoea cause?

Daytime sleepiness/drowsiness (dangerous while driving) Higher risk of heart disease/stroke due to low oxygen

What are the two types of sleep apnoea?

obstructive sleep apnoea (most common) central sleep apnoea

How is the severity of sleep apnoea measured?

via apnoea/hypopnoea index (AHI)

What score and less indicates few problems in AHI?

<10

What are the two treatments for OSA and how do they work?

Mandibular Advancement Devices Oral appliance that pulls jaw forward to open airway Continuous Positive Airway Pressure (CPAP) Machine providing constant air pressure to splint airway open

What is positional therapy used for in sleep apnoea?

prevent patient sleeping on their back

Respiratory Medicine - 2 Flashcards

(54 cards)