Respiratory Pathology

Question 1

What is type 1 respiratory failure

Answer 1

Failure of oxygen exchange function fie to acute disease of the lungs

Question 2

What is type 2 respiratory failure?

Answer 2

Hypercapnic respiratory failure- high CO2, low O2

Question 3

Common causes of Type 1 Respiratory failure

Answer 3

Cardiogenic pulmonary oedema (CHF)

Pneumonia

PE

Question 4

Common causes of Type 2 Respiratory failure

Answer 4

CO2 Retention:
Severe asthma

Chronic Bronchitis

Drug overdose

Neuromuscular disease

Chest wall abnormalities

Question 5

What is V/Q mismatch?

Answer 5

Inbalance between ventilation and perfusion

Question 6

What is atelectasis?

Answer 6

Collapsed alveoli

Question 7

What is respiratory shunt?

Answer 7

Venous blood returning to the heart without picking up its normal O2 quota

Question 8

Causes of shunt

Answer 8

Pneumonia

Atelactasis

Severe pulmonary oedema

Question 9

Cause of cardiogenic pulmonary oedema

Answer 9

LVF

Heart valve diseases

Reduced cardiac output

Reduced stroke volume

Question 10

Signs and Symptoms of pulmonary oedema

Answer 10

DIB
Anxiety
Pale Skin
Pink Frothy Sputum
Hpyoxia
Orthopnea
Oedema of ankles later

Question 11

What is Acute Respiratory distress syndrome

Answer 11

Non-cardiogenic pulmonary oedema

Question 12

Direct causes of ARDS

Answer 12

Pneumonia
Aspiration
Drowning
PE
Trauma
Inhalation injury

Question 13

Symptoms of pneumonia

Answer 13

Cough with green/yellow phlegm
Fever and chills
SOB
Chest pain worse on breathing and coughing

Question 14

What are the two branches of COPD

Answer 14

Chronic Bronchitis

Emphysema

Question 15

Risk factors of COPD

Answer 15

Smoking
Exposure to industrial pollution
Childhood respiratory infections
Genetic- Alpha-1-antitrypsin deficiency
Age

Question 16

Signs and Symptoms of Chronic Bronchitis

Answer 16

Chronic wet cough
SOB
Excess mucus
Wheezing
Tachycardia
Tachypnoea
Pulmonary Hypertension
Low SPO2
CO2 retention

Question 17

Signs and Symptoms of Emphysema

Answer 17

Chronic cough
SOB
Flushed skin
Tachycardia
Tachypnoea
Pursed lips
Barrel Chest
Hypertension
Cachexia

Question 18

Which cells produce mucus

Answer 18

Goblet cells

Question 19

Explain the term “blue bloaters” in relation to COPD

Answer 19

In chronic bronchitis, restriction of bronchioles leads to CO2 retention in alveoli. CO2 lead up causes cyanosis, and the air trapping gives bloated barrel chest impression

Question 20

Pathology of emphysema

Answer 20

Damage to alveolar walls, reduced surface area for gas exchange

Question 21

Define asthma

Answer 21

A chronic respiratory disorder which causes episodic airway obstruction

Question 22

What are the two types of asthma?

Answer 22

Atopic Asthma (Extrinsic)

No atopic Asthma (Intrinsic)

Question 23

What is the Atopid Triad of Asthma?

Answer 23

Childhood

Hayfever

Dermatitis

Question 24

What is Atopic Asthma?

Answer 24

Type 1 (IGe Mediated) hypersensitivity reaction of the immune system

Question 25

What is the main difference between Atopic and Nonatopic Asthma?

Answer 25

Atopic is an immune response to a known allergen, whereas non atopic is an inflammatory response to an irritant

Question 26

Triggers of Nonatopic Asthma

Answer 26

Smoke stress NSAIDs pollution chemicals

Question 27

Signs and Symptoms of SEVERE asthma

Answer 27

Tachycardia Cyanosis Reduced Air Entry Reduced Peak flow Unable to complete full sentences Tripoding Accessory muscle use

Question 28

What are the three severity classifications of asthma episodes

Answer 28

Mild Severe Life Threatening

Question 29

Signs and symptoms of LIFE THREATENING asthma

Answer 29

Silent Chest Exhaustion Lack of Respiratory Effort Hypotension Reduced GCS Arrhythmias

Question 30

First line treatments of Acute asthma episode

Answer 30

Nebulised salbutamol (5mg Adult/ 2.5mg Paeds) Ipatropium bromide (500mcg adult) Hydrocortisone IV/IM 100mg Supplemental Oxygen Prednisolone Rapid evacuation Adrenaline

Question 31

Pathology of acute atopic asthma

Answer 31

Allergen enters the body IGe released IGe causes mast cell degranulation of histamine Disproportionate inflammatory response Oedema and mucus production

Question 32

Is asthma an example of Type 1 or Type 2 respiratory failure?

Answer 32

Type 2- hyercapnic due to CO2 retention

Question 33

What is pulmonary oedema?

Answer 33

Excess fluid build up in the lungs interstitial and alveolar spaces

Question 34

Categories of Pulmonary Oedoema

Answer 34

Cardiogenic- result of heart disease Non-cardiogenic- damage to pulmonary capillaries or alveoli - Local pulmonary infections, Sepsis, low oncotic interstitial space

Question 35

Symptoms of Pulmonary Oed

Question 36

Mechanisms of Pulmonary oedema

Answer 36

Increased hydrostatic pressure Increased permeability of vessels Impaired lymphatic drainage Altered gas exchange

Question 37

What is HAPE

Answer 37

High altitude pulmonary oedema

Question 38

Diagnosis of Pulmonary Oedema

Answer 38

History and symptoms Chest X-ray CT Scan ECG Blood Tests SPO2 and ABG

Question 39

Emphysema leads to higher risk of:

Answer 39

Pneumonia Type 2 Respiratory failure - Hypercapnia and respiratory acidosis Secondary Spontaneous Pneumothorax Bullae

Question 40

In TB, live and dead bacilli form what in the lungs?

Answer 40

Granulomas