Flashcards in Respiratory Medicine Deck (63)
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1
what are the three main disturbances that can happen to the respiratory system?
reduced transfer of oxygen
reduced ventilation of lungs
reduced perfusion of lungs
2
what are some respiratory symptoms?
breathlessness dyspanea - b/c 3 main disturbances
wheeze - airways narrowing
cough - protective reflex
sputum production
chest pain - pleuritic pain
3
what is asthma?
reversible small airways obstruction
affects all ages
4
percent of children affected?
adults?
5-10% children
2-5% adults
5
is asthma a benign condition?
benign but life threatening
6
what is the pathophysiology of asthma?
an inflammatory allergic condition
7
symptoms of asthma?
wheeze
breathles - not always related to exerise, triggered by cold or emotion
cough - nocturnal, exercise induced, cold induced
8
how to assess asthma?
peak flow readings - plotted by age sex height
classically poorer in mornings - diurnal variation
9
asthma precipitated by?
allergens - house dust mite, pet dander
irritants - dust smoke
exertion
NSAIDS
emotion
10
indications of severity of chronic asthma?
restriction of activities b/c symptoms
increased inhaler use
keep peak flow readings
11
how to manage chronic asthma?
inhaled beta antagonists - salbutamol - short, salmeterol - long activity
inhaled steroids - beclamethasone
combo inhalers - seretide
other - antileukotrienes - montelukast
12
what is acute asthma?
sudden worsening of symptoms. patients can tire
13
what is unstable asthma caused by?
recent infections
poor compliance
14
symptoms of unstable asthma?
using inhaler more frequently
reduced exercise limit
15
management of unstable asthma?
GP - short course of oral steroidss
prednisolone
alteration to regular inhalers if gradual worsening
16
avoid what meds in a dental practice with asthmatic patients?
NSAIDs
17
what might be seen orally with a asthmatic patient?
oral candidiasis, altered taste, dry mouth, side
18
what should you advise to an asthmatic patient after taking their inhalers?
gargle vigorously after use
19
what is COPD?
irriversible obstruction of airways
degenerative
20
pathophysiology of COPD?
damage to lung parenchyma
main process = emphysema = alveolar destruction and reduced area for gas exchange
21
what is bronchitis?
airway inflammation
increased mucous
reduced ventilation
22
symptoms of COPD?
breathless on exertion
consistent wheeze
chronic cough and sputum production
frequent infections - stagnant mucous
23
what are some pulmonary function tests?
lung function
spirometry
FEVL = forced expiratory volume in one second
FVC = forced vital capacity
24
chronic COPD management?
progressive addition of oral inhaled therapies depending on symptoms - tiotropium - spiriva
stop smoking
exercise training
if severe - home = oxygen
25
drug management of copd?
increase inhalers or nebulisers
steroids
antibiotics
26
how to manage a COPD patient in the dentist?
how capable is patient to lie flat
do not treat when unstable
avoid NSAID's
avoid sedation - diminished respiratory reserve
27
how to manage acute exacerbation in the chair?
stop tx and sit pt up
ABCDE
avoid high flow oxygen unless v unwell
bronchodilator - spacer/nebuliser if possible
28
what is pneumonia?
an infection of the lung tissue
may be diffuse or affect the lobes
causative agents
29
symptoms of pneumonia?
acute illness
cough and green sputum
breathlessness
fever
pleuritic chest pain
30
