Week 3 - Allergic and Obstructive Respiratory Disease Flashcards
What is the medical term for deep breathing (i.e. breathing a greater than baseline level of ventilation?)
Hyperpnoea
What are the differentials for asthma?
What is the definition of acute and chronic bronchitis?
Both = inflammation of airways presenting with cough and mucus
Acute - usually due to acute infection that resolves in <3 weeks. Common in children and elderly. Not usually related to underlying disease.
Chronic - sputum for at least 3 months of the year - for at least 2 consecutive years. Associated with COPD.
Which disease involves destruction of alveoli distal to the terminal bronchial resulting in loss of elastic supporting tissue and reducing TLCO?
Emphysema
What are the differentials for COPD?
How is COPD managed?
Weight loss, exercise
Vaccination against common viral infections
Prompt Abx for infection
Pulmonary rehab essential
LTOT - if P hypoxic at rest or on exertion
Smoking cessation
Inhaled therapy
If a P has COPD and unexpected worsening breathlessness - what other diagnoses should you consider?
Lung cancer
CAP
CHF
What is ACOS?
Asthma and COPD Overlap Syndrome - for Ps who had childhood history of asthma and smoked, then developed COPD on top of asthma
What is a chronic condition resulting in destruction and dilatation of SMALL BRONCHI due to a cycle of recurrent infection and inflammation?
Bronchiectasis
What is bronchiectasis also known as?
Supperative lung disease
What are the three aetiologies of bronchiectasis?
Abnormal Cilia
Abnormal Mucus
Abnormal Immune System
What diseases can cause abnormal cilia?
Primary ciliary dyskinesia (PCD)
Smoking
Recurrent infections - esp pertussis and measles in childhood
How does bronchiectasis present?
Persistent productive cough - often yellow / green mucus
Recurrent respiratory infections - more than 4-5 per year (2-3 infections considered normal).
Can also get
- Breathlessness
- Wheezing
- Rhinosinusitis
- Haemoptysis
- Fatigue
- Coarse crackles
- Clubbing
- Recurrent pleurisy
- Anosmia
What are the differentials for bronchiectasis?
Asthma
COPD
CF
Allergic bronchopulmonary aspergillosis (ABPA)
Chronic TB
What investigations can be done for bronchiectasis?
What do the following images show?
How is bronchiectasis managed?
What causes allergic bronchopulmonary aspergillosis?
An exaggerated Th cell reaction to aspergillum fumigatus
When should ABPA (allergic bronchopulmlonary aspergillosis) be suspected in a P?
Long hx of “asthma” = SOB, productive cough, sputum plugs, recurrent infections
What tests can be done for ABPA?
HRCT - looking for central bronchiectasis
Bloods = IgE raised? Inc IgG to Aspergillus fumigatus?
What is the management of ABPA?
Antifungal medication - Voriconazole,, Itraconazole
LFTs
High dose oral corticosteriods
