• Archive for May, 2013

    Emphysema

    by  • 23/05/2013 • Respiratory

    Emphysema (‘pink puffer’):  p/c: thin, barrel chested, no cough, pursed lip breathing, accessory muscle use, tripod sitting position, hyper-resonant chest, wheeze, wasted and cachexic.  Pathology: o Alveolar septal damage (distal to terminal bronchiole) leaving empty spaces in lung = reduced vascular bed/alveolar contact = minor hypoxia (still perfusing=pink) o Elastic damage of...

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    Asthma

    by  • 22/05/2013 • Respiratory

    Asthma Definition Asthma is a common chronic inflammatory lung disease of the airways characterised by variable, reversible and recurring symptoms, airflow obstruction and bronchospasm. Severity Symptom frequency Nighttime symptoms %FEV1 of predicted FEV1 Variability Intermittent <1 per week ≤2 per month ≥80% <20% Mild persistent >1 per week but <1 per day >2 per...

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    Influenza

    by  • 20/05/2013 • Respiratory

    Influenza Belongs to orthomyxovirus group and exists in two main forms, A and B (e.g. influenza A) Human immunity develops against the haemagglutinin antigen and the neuraminidase antigen on the viral surface (e.g. H1N1 = swine flu) Presentation  Incubation period is usually 1-3 days.  Illness starts with fever, shivering and generalised aching...

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    Pulmonary Hypertension

    by  • 18/05/2013 • Respiratory

    Pulmonary hypertension Definition Mean pulmonary arterial pressure >25mmHg at rest OR >30mmHg during exercise. Increase in blood pressure in the pulmonary vessels. Presentation May present spontaneously with no apparent underlying disease association, then known as primary pulmonary hypertension. More common in women Pulmonary venous HTN: similar to LHF = orthopnoea, PND… PAH: similar to...

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    Rhinitis

    by  • 18/05/2013 • Respiratory

    Rhinitis Definition Present if sneezing attacks, nasal discharge or blockage occur for more than an hour on most days for:  A limited period of the year = Seasonal rhinitis (‘Hayfever’): allergic, 2-20% incidence, most common in teens, p/c: nasal irritation, sneezing, rhinorrhoea, itching eyes/soft palate.  Throughout the whole year = Perennial rhinitis:...

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    Respiratory Failure

    by  • 16/05/2013 • Respiratory

    Respiratory Failure: PaO2 <8kPa (60mmHg).. and.. PaCO2 <6kPa (low) = Type 1 RF o Seen in: o Hypoventilation (arterial-alveloar PO2 difference >2.5kPa) o PAO2 = PIO2 – PACO2/R o Starts as Type 1 RF, but over time maintain low O2, but start to retain CO2 – progress to Type 2 RF. o Diffusion impairment...

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    Respiratory Overview

    by  • 15/05/2013 • Respiratory

    Respiratory function tests Test Use Peak Expiratory Flow Rate – ranges: o Male 440-670L/min o Female 300-460L/min   Monitoring changes in airflow limitation in asthma (diurnal change) – COPD fixed obstruction. Spirometry: FEV, FVC, FEV1/FVC Assessment of airflow limitation (constrictive/restrictive). The gold standard. Flow-volume curves Assessment of flow at lower lung volumes. Detection of...

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    Metabolic and Alcoholic Liver Disease

    by  • 14/05/2013 • Gastroenterology • 0 Comments

    Alcoholic liver disease: o Relationship between chronic liver disease and alcohol use is complex o Excess alcohol = chronic liver disease o However personal susceptibility varies and alcohol-related pathology is increasingly seen in individuals who drink minimal amounts of alcohol (=non-alcoholic steatohepatitis = NASH) o Of all the people who drink excess alcohol –...

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    Hepatitis

    by  • 13/05/2013 • Gastroenterology • 0 Comments

    Viral Hepatitis Hep A virus (HAV): o Common cause of transient hep, no long term carriage, often occurs in epidemics o Faeco-oral transmission o After 5/52 infection = IgM peaks and IgG continues to rise o 50% are subclinical (=have IgG to HAV without jaundice) o Jaundice: most common presentation in an acute hep....

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