TRI B VIVA Flashcards
(50 cards)
1
Q
5
signs/symptoms of COPD
A
- persistent cough that produces sputum
- shortness of breath (dyspnoea)
- wheezing
- difficulty performing physical activities
- chest tightness
2
Q
5
signs/symptoms of bronchiectasis
A
- chronic productive cough - foul-smelling, purulent sputum, blood stained mucus
- history of repeated, severe lung infections
- dyspnoea and wheezing
- fatigue and poor concentration
- clubbed fingers
3
Q
6
signs/symptoms of cystic fibrosis
A
- persistent cough
- excessive sputum production (thick mucus in bronchi)
- wheezing
- impaired mucocillary clearance
- recurrent respiratory infections (incl pneumonia)
- bronchiectasis in later stages
4
Q
7
signs/symptoms of pulmonary fibrosis
A
- persistent unproductive cough
- shortness of breath - especially when active
- fatigue
- low grade fevers
- muscular pain
- joint pain
- unexplained weight loss
5
Q
8
signs/symptoms of lung cancer
A
- cough lasting more than 3 weeks
- worsening cough
- recurrent chest infections
- coughing up blood
- ache/pain when breathing or coughing
- persistent breathlessness
- fatigue/lack of energy
- loss of appetite/unexplained weight loss
6
Q
9
signs/symptoms of pneumonia
A
- cough - may produce yellow/green mucus
- shortness of breath
- high temperature
- wheezing
- chest pain
- body ache
- fatigue
- loss of appetitie
- confusion - especially in older patients
7
Q
4
risk factors/causes of COPD
A
- history of smoking
- exposure to occupational dusts and chemicals
- air pollution and exposure to noxious fumes or particles
- genetic - anti-trypsin deficiency
8
Q
7
risk factors/causes of bronchiectasis
each answer has sub-answer
A
- post infection
- inhalation injury
- obstructive airway disease
- immunodeficiency
- bronchopulmonary fungal infection
- mucocillary clearance disorders
- bronchial obstruction
9
Q
1
risk factors/causes of cystic fibrosis
A
fault gene inherited by both parents
present from birth and cannot be caught from someone else with it
10
Q
8
risk factors/causes of pneumonia
pathogens
A
- streptococcus pnuemonia
- haemophilus influenzae
- pneumocystis jiroveci
- legionella
- moraxella catarrhalis
- staphylococcus aureus
- klebsella pneumonia
- pseudomonas aeruginosa
11
Q
7
risk factors/causes of pulomonary fibrosis
A
- autoimmune conditions
- radiation exposure
- infections
- inhaled toxic fumes
- dust
- cigarette smoke
- other lung diseases
there is a genetic predisposition that leads to abnormal wound healing
12
Q
3
risk factors/causes of lung cancer
A
- smoking
- radon - natural radioactive gas
- occupational exposure and pollution
70% of cases are caused by smoking
13
Q
one line
what is COPD
A
an airways disease where there is irreversible obstruction of airflow that deteriorates over time
14
Q
pathophysiology of COPD
include chronic bronchitis
A
- hyperinflation due to destruction of supporting tissue in emphysema, so airway collapses and increased resistance to expiratory flow
- decreased elastic recoil in emphysema, so increased air trapped in alveoli
- in chronic bronchitis, obstruction within the airway leads to reduced air leaving the lungs
15
Q
one line
what is cystic fibrosiss
A
an autosomal recessive inherited disorder
16
Q
pathophysiology of cystic fibrosis
A
- defective chloride ion transport
- affects exocrine glands in digestive tract, reproductive organs, and airways
- abnormal expression of CFTR protein
- this protein is found in membranes of epithelial cells e.g. airways, bile duct, pancreas, sweat glands, vas deferens
17
Q
one line
what is pneumonia
A
lung infection and inflammation where the alveoli and small airways form a solid mass called consolidation
18
Q
pathophysiology of pneumonia
A
- can be an acute (primary) infection or develop as a secondary infection, and can be viraal, bacterial or fungal
- lobar pneumonia can be unilateral, bilateral or involve more than one lobe - often associated with pleuritic pain and reduced tidal volume
- viral pneumonia can cause inflammation of intestinal tissue or alveolar septae
19
Q
pathophysiology of lung caancer
include SCLC and NSCLC
A
- repeated exposure to carcinagens e.g. cigarette smoke, leads to dysplasia of lung epithelium
- continued exposure leads to genetic mutations and affects protein synthesis
- most common genetic mutations for small cell lung cancer (SCLC) = MYC, BCL2 and p53
- most common for non small cell lung cancer (NSCLC) = EGFR, KRAS and p16
20
Q
one line
what is pulmonary fibrosis
A
an accumulation of fibrous scar tissue in lungs
21
Q
pathophysiology of pulmonary fibrosis
A
- lungs become stiffer (decreased compliance) and respiratory membrane is thicker than normal
- due to the presence of excess fibrous tissue
- more common in older males with comorbiditiess
- disease progression is variable, some slow, others more rapid decline
- high mortality rate - median = 3-4 yeaars after diagnosis
22
Q
treatments/maangement for COPD
A
- stop smoking
- positioning
- bronchodilators
- mucolytics
- pulmonary rehabilitation
- oxygen therapy
- breathing exercises
23
Q
treatments/management for bronchiectasis
A
- ACBT
- postural drainage
- PEP/flutter
- bronchodilators
24
Q
treatments/management for cystic fibrosis
A
- autogenic drainage
- positioning
- ACBT
- devices - PEP, flutter
25
treatment/management for lung cancer
* chemotherapy
* surgery
* other radiotherapies
26
treaatment/ management for pneumonia
* antiobiotics
* oxygen
* vaccination
27
treatment/management for pulmonary fibrosis
* oxygen
* pulmonary rehabilitation
* lung transplant
* stop smoking
28
what does ACBT do?
* loosens and clears secretion from the lungs - reduce risk of chest infections
* improve ventilation inn the lungs
* improve effectiveness of a cough
29
how would you teach ACBT
**breathing control**
- in/out through nose, at their own rate (slow) - pursed lip?
**thoracic expansion exercises**
- relax upper body, long, slow, deep breath in through nose, hold for 2-3secs at end of inhalation before exhaling, focusing on emptying lungs fully
- repeat 3-5 times
**forced expiratory techniques**
- huffing. medium = normal breath in and active long breath out until lungs feel empty (steaming up mirror). high = deep breath in, open mouth wide, breathe out quickly
- 1-2 huffs at a time
**coughing**
- only if huffing does not clear all sputum
## Footnote
NHS UK
30
# one line
what do bronchodilators do
relax and widen airway
| short-acting and long-acting
31
how would you teach the use of bronchodilators
* take steaady breath in and seal lips around mouthpiece
* actuate device while continuing to inhale
* hold for briefly before exhaling
32
what does positioning do
helps alleviate pressure making it easier to breathe
33
how would you teach positioning
| for breathing
- forward leaning
- hands on knees or table
- add pillow for comfort
- can also be done against wall or sitting on wall
34
what does the flutter do
allows pressure to build up in lungs that helps keep airways open and allows air to get behind any sputum and help move it upwards
the vibration of the flutter loosens any sputum against airway walls
35
what does postural drainage do
uses gravity to help guide sputum out of airways/lungs
36
how do you teach postural drainage
- certain positions help more depending on location of affected lungs
- most involve lying down with slight incline to encourage sputum
- can also be accompanied by chest percussion etc to aid mobilisation
37
normal ABG values
pH = 7.35 - 7.45
H+ = 35-35 mmol/l
PaCO2 = 4.7-6 kPa
PaO2 = 10-13.3 kPa
SaO2 = 94-98%
HCO3 = 22-26 mmol/l
BE = -2 - +2 mEq/L
38
# all three different
respiratory acidosis
| uncompensated
pH = decreased
PaO2 = increased
HCO3 = normal
39
# 1 different, 2 same
respiratory acidosis
| partial compensation
pH = decreased
PaCO2 = increased
HCO3 = increased
40
# 1 different, 2 same
respiratory acidosis
| fully compensated
pH = normal/decreased
PaCO2 = increased
HCO3 = increased
41
# all 3 different
respiratory alkalosis
| uncompensated
pH = increased
PaCO2 = decreased
HCO3 = normal
42
# 1 different, 2 same
respiratory alkalosis
| partial compensation
pH = increased
PaCO2 = decreased
HCO3 = decreased
43
# 1 different, 2 same
respiratory alkalosis
| fully compensated
pH = normal/increased
PaCO2 = decreased
HCO3 = decreased
44
# 2 same, 1 different
metabolic acidosis
| uncompensated
pH = decreased
PaCO2 = normal
HCO3 = decreased
45
# all same
metabolic acidosis
| partial compensation
Ph = decreased
PaCO2 = decreased
HCO3 = decreased
46
# all same ~
metabolic acidosis
| fully compensated
pH = normal/decreased
PaCO2 = decreased
HCO3 = decreased
47
# 2 same, 1 different
metabolic alkalosis
| uncompensated
pH = increased
PaCO2 = normal
HCO3 = increased
48
# all same
metabolic alkalosis
| partial compensation
pH = increased
PaCO2 = increased
HCO3 = increased
49
# all same ~
metabolic alkalosis
| fully compensated
pH = normal/increased
PaCO2 = increased
HCO3 = increased
50
soap
name
chi/dob
date/time
subjective - convo/questions
objective - case stuyd/test results
Rx - treatment plan
Assessment/analyis - what was done in session
Plan - for next session
each page - number, signature
