Stridor and Sleep Apnoea Flashcards Preview

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Flashcards in Stridor and Sleep Apnoea Deck (26):
1

What are the two locations for inspiratory stridor?

Extrathoracic
Supraglottis/larynx

2

What 4 factors can affect the supraglottis/larynx and cause inspiratory stridor?

Laryngomalacia
Supraglottic mass
Glottic lesions
Vocal cord paralysis

3

What are the 4 main causes of stridor in children?

Infections
Foreign body
Anaphylaxis/angioneurotic oedema
Other (burns)

4

What do these infections all cause in children - croup, epiglottistis, pseudomembranous croup, retropharyngeal abscess, diphtheria and infectious mononucleosis?

Stridor

5

What are 4 causes of stridor in adults?

Neoplasms
Anaphylaxis
Goitre (retrosternal)
Trauma (e.g. strangulation, burns and irritant gases)

6

What are the three main neoplasms that cause stridor in adults?

Larynx
Trachea
Major bronchi

7

What do these conditions cause - bilateral vocal cord palsy, Wegener's granulomatosis, cricoarytenoid arthritis, RA and tracheopathia?

Stridor in adults

8

What are the 4 main investigations for stridor?

Laryngoscopy (beware of acute epiglottitis)
Bronchoscopy
Flow volume loop
CXR

9

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
3. Cricothyroidotomy
4. Tracheostomy

10

What is the name for a rapid upward thrust in epigastrium to force upward movement of diaphragm and force expiration?

Heimlich manoeuvre

11

What are 4 treatment methods for a malignant airway obstruction?

1. Tumour removal - laser, photodynamci therapy, cryotherapy
2. Tumour compression - intraluminal stent
3. Radiotherapy
4. Chemotherapy; corticosteroids

12

What type of reaction is acute anaphylaxis?

Type I (immediate) hypersensitivity (IgE)

13

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?

Acute anaphylaxis

14

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

15

What causes snoring?

Relaxatopm of pharyngeal dilator mjuscles during sleep

16

What is the term for a predominantly inspiratory wheeze due to large airways (larynx/trachea/major bronchi) obstruction?

Stridor

17

What causes obstructive sleep apnoea?

Intermittent upper airway collapse in sleep

18

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

19

What is sleep apnoea an indeopendent risk factor for?

Hypertension

20

What causes raised CRP?

Sleep apnoea

21

What two things does sleep apnoea impair?

Endothelial function and glucose tolerance

22

What could be suspected if a patient has snoring and EDS (raised Epworth score)?

Obstructiev sleep apnoea

23

What three investigations in an overnight sleep study could be used to diagnose obstructive sleep apnoea?

Oximetry
Domicillary recording (airflow, oximetry, thoracic/abdominal movement)
Full polysomnography

24

What does CPAP stand for?

Continuous positive airway pressure

25

What is the most effective therapy for sleep apnoea?

CPAP

26

What device is used in mild obstructive sleep apnoa, improves snoring and has a moderate reduction in AHI?

Mandibular advancement device