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Respiratory > Stridor and Sleep apnoea > Flashcards

Stridor and Sleep apnoea Flashcards

1
Q

what is stridor

A

predominantly inspiratory wheeze due to large airways obstruction

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2
Q

what are the large airways

A

larynx, trachea, major bronchi

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3
Q

what type of wheeze is associated with asthma

A

expiratory wheeze as asthma is obstruction of small airways

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4
Q

narrowing where in the airways will give you inspiratory stridor

A

extrathoracic, supraglottis/larynx

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5
Q

what can cause narrowing of the supraglottis/larynx

A

tumour (supraglottic mass), laryngomalacia (softening of the larynx tissue), glottic regions, foreign body, vocal chord paralysis, collapse of bone/cartilage

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6
Q

what stridor occurs when there is unilateral vocal chord paralysis

A

none

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7
Q

what are causes of stridor in children

A

infections, forgein body, anaphylaxis/angioneurotic oedema (swelling), others e.g burns

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8
Q

what infections cause stridor in children

A

group (RSV), epiglottis, diphtheria

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9
Q

what pathogen causes epiglottis in children

A

haemophilus influenzae

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10
Q

where are sites of tumours in adults that cause stridor

A

larynx, trachea, major bronchi,

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11
Q

what causes stridor in adults

A

NEOPLASMS, anaphylaxis, goitre, trauma, other

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12
Q

what side of the airway does inhaled food tend to go down

A

right as more vertical

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13
Q

what is tacheomalacia

A

when the airway collapses

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14
Q

how is stridor investigated

A

laryngosccopy, bronchoscopy, flow volume loop, CXR, other imaging- CT, thyroid scan

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15
Q

when should you be cautious of doing a laryngoscopy

A

in acute epiglottitis as can make swelling worse and cause respiratory arrest

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16
Q

how is laryngeal obstruction treated

A

treat underlying cause (removal of foreign body/anaphylaxis), mask bag ventilation with high flow O2, cricothyroidotomy, tracheostomy

17
Q

how is malignant airway obstruction treated

A

tumour removal, tumour compression (stent), radiotherapy, chemotherapy

18
Q

what is acute anaphylaxis

A

type 1 (immediate) hypersensitivity (IgE)

19
Q

what are the symptoms of acute anaphylaxis

A

flushing, pruritus (itch), urticaria (hives), angioneurotic oedema (swelling), abdominal pain, vomiting, hypotension (vasodilatation and plasma exudation), circulatory collapse (shock), stridor, wheeze and resp failure

20
Q

how is anaphylaxis treated

A

IM (NOT IV) epinephrine, IV antihistamine, IV corticosteroid, high flow O2, nebulised bronchodilators, endotracheal intubation if necessary

21
Q

what cells release histamines

A

mast cells

22
Q

what effect do steroids have when treating anaphylaxis

A

immunosuppressants

23
Q

what causes a rash in anaphylaxis

A

swings in intrapleural pressures

24
Q

what is the later treatment for anaphylaxis

A

allergen avoidance, desensitisation, self administered epinephrine

25
Q

what is snoring

A

relaxation of the pharyngeal dilator muscles during sleep causing airway narrowing, turbulent airflow and vibration of soft palate and tongue base

26
Q

what is obstructive sleep apnoea

A

intermittent upper airway collapse in sleep

27
Q

what effect does obstructive sleep apnoea have on patients

A

recurrent arousals/ sleep fragmentation

28
Q

what are the risk factors for sleep apnoea

A

enlarged tonsils, obesity, neurological, drugs, post-op, deformity

29
Q

what are the resulting social consequences of sleep apnoea

A

excessive daytime sleepiness, personality change, cognitive/ functional impairment

30
Q

what are the physiological consequences of sleep apnoea

A

independent risk factor for hypertension, activated sympathetic system, raised CRP, impaired endothelial function and glucose tolerance

31
Q

how are all the physiological consequences of sleep apnoea improved

A

CPAP machine- continuous positive airway pressure

32
Q

how is sleep apnoea diagnosed

A

snoring and raised epworth score, overnight sleep study

33
Q

how is sleep apnoea treated

A

remove underlying cause, CPAP

34
Q

what are other treatments for sleep apnoea

A

mandibular advancement device, surgery

Respiratory (26 decks)

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