Flashcards in Stridor and Sleep Apnoea Deck (26):
What are the two locations for inspiratory stridor?
What 4 factors can affect the supraglottis/larynx and cause inspiratory stridor?
Vocal cord paralysis
What are the 4 main causes of stridor in children?
What do these infections all cause in children - croup, epiglottistis, pseudomembranous croup, retropharyngeal abscess, diphtheria and infectious mononucleosis?
What are 4 causes of stridor in adults?
Trauma (e.g. strangulation, burns and irritant gases)
What are the three main neoplasms that cause stridor in adults?
What do these conditions cause - bilateral vocal cord palsy, Wegener's granulomatosis, cricoarytenoid arthritis, RA and tracheopathia?
Stridor in adults
What are the 4 main investigations for stridor?
Laryngoscopy (beware of acute epiglottitis)
Flow volume loop
What are the 4 methods of treatment for laryngeal obstruction?
1. Treat underlying cause - foreign body removal/anaphylaxis
2. Mask bag ventilation with high flow oxygen
What is the name for a rapid upward thrust in epigastrium to force upward movement of diaphragm and force expiration?
What are 4 treatment methods for a malignant airway obstruction?
1. Tumour removal - laser, photodynamci therapy, cryotherapy
2. Tumour compression - intraluminal stent
4. Chemotherapy; corticosteroids
What type of reaction is acute anaphylaxis?
Type I (immediate) hypersensitivity (IgE)
What are these all a sign of - flushing, pruritus, urticaria, angioneurotic oedema, abdominal pain/vomiting, hypotension (vasodilatation and plasma exudation) - circulatory collapse (shock), stridor, wheeze and respiratory failure?
Give the 6 treatment steps for anaphylaxis
1. IM epinephrine (adrenaline)
2. IV anti-histamine
3. IV corticosteroid
4. High flow oxygen
5. Nebulised bronchodilators
6. Endotracheal intubation if necessary
What causes snoring?
Relaxatopm of pharyngeal dilator mjuscles during sleep
What is the term for a predominantly inspiratory wheeze due to large airways (larynx/trachea/major bronchi) obstruction?
What causes obstructive sleep apnoea?
Intermittent upper airway collapse in sleep
What are enlarged tonsils and adenoids, obesity, retrognathia, acromegaly, hypothyroidism, oropharyngeal deformities, stroke, MS, myesthenia gravis, myotonic dystrophy, benzodiazepines, opiates, alcohol?
Risk factors for sleep apnoea
What is sleep apnoea an indeopendent risk factor for?
What causes raised CRP?
What two things does sleep apnoea impair?
Endothelial function and glucose tolerance
What could be suspected if a patient has snoring and EDS (raised Epworth score)?
Obstructiev sleep apnoea
What three investigations in an overnight sleep study could be used to diagnose obstructive sleep apnoea?
Domicillary recording (airflow, oximetry, thoracic/abdominal movement)
What does CPAP stand for?
Continuous positive airway pressure
What is the most effective therapy for sleep apnoea?