Respiratory Diseases Notes and Short Question and Answers

Diseases Of The Respiratory System Important Notes

1. Sputum and its associated pathology
2. Pleural effusion
   • It is excess fluid that accumulates in the pleural cavity that surrounds the lungs
   • It can impair breathing by limiting the expansion of the lungs during ventilation
   • It is uncommon in children
   • Transudative seen in
     • Congestive cardiac failure
     • Nephrotic syndrome
     • Cirrhosis
     • Heart, liver, and renal failure
   • Exudative is seen in
     • Pneumonia
     • TB
     • Malignant disease
     • Rheumatoid disease
     • SALE
3. Transudate v/s exudate
4. Pulmonary tuberculosis
   • Primary tuberculous comprises of
     • Ghon’s focus
     • Hilar lymphadenopathy
5. DOTS
   1. It is directly observed treatment short course
   2. In this anti-tubercular drugs are administered under the direct supervision of peripheral health staff or through voluntary workers
   3. Category
   4. Category 1 – new patients
   5. Category 2 – previously treated patients
6. Drugs used for tuberculosis
7. Asthma
   • It is a disorder characterized by chronic airway obstruction and increased airway responsiveness
   • Features
     • Wheeze
     • Breathlessness
     • Cough
     • The sensation of chest tightness
   • Features of status asthmaticus
     • Silent chest
     • Bradycardia
     • Pulsus paradoxes
     • Exhaustion
     • Confusion
     • Reduced conscious level
8. Diseases of the respiratory tract
   
9. Lung abscess
   • It is a collection of purulent material in a localized necrotic area of lung parenchyma
   • Clinical features
     • Fever with chills
     • Pleuritic chest pain
     • Dry cough
     • The presence of copious purulent discharge
     • Hemoptysis
     • Weight loss
     • Anorexia
     • Emphysema
10. Drug of choice in different pneumonia
    

Diseases Of The Respiratory System Short Answers

Question 1. Clubbing

Answer:

Clubbing

• It is an enlargement of the distal segment of fingers and toes due to an increase in soft tissues

Grades:

• Grade 1- Softening of nail bed due to hypertrophy of the tissue at that site
• Grade 2- In addition to grade 1 changes, there is the obliteration of the angle between the nail base and the adjacent skin of the finger
• Grade 3- In addition to grade 2 changes, the nail itself loses its longitudinal ridges, becomes convex from above downwards as well as from side to side
  • The nails assume the shape of a “parrot’s beak” or the terminal segment may become bulbous like a “drumstick”
• Grade 4- Tire finger changes are associated with hypertrophic pulmonary osteoarthropathy

Question 2. Bronchiectasis

Answer:

Bronchiectasis

• It is defined as an abnormal and irreversible dilatation of bronchi

Etiology:

1. Infective causes
   • Bacterial- H. influenzae, staphylococcus aureus, E. coli, Tuberculosis, mycoplasma
   • Viral- measles, adenovirus, influenza virus
   • Fungal
2. Obstructive causes
   • Endobronchial benign neoplasm
   • Foreign body aspiration
   • Chronic bronchitis
   • Enlarged lymph nodes
3. Noninfective causes
   • Allergic
   • Cystic fibrosis
   • Clinical Features:
   • Chronic cough with massive expectations
   • Haemoptysis
   • Recurrent pulmonary infection
   • Dyspnoea
   • hover, weight loss, anemia, and weakness
   • Oedema
   • Sepsis

Read And Learn More: General Medicine Question and Answers

Question 3. Aspiration pneumonia

Answer:

Aspiration pneumonia

• It is a consolidation of the lung in which there is the continued destruction of parenchyma by the inflammatory cells leading to the formation of microabscesses

Clinical Features:

• High intermittent fever
• Cough
• Dyspnoea
• Tachycardia
• Restlessness
• Perspiration
• Weight loss
• Digital clubbing

Question 4. Two causes of dull notes on percussion of the chest

Answer:

Causes of dull note on percussion of the chest

• Thickened pleura
• Pleural effusion
• Presence of solid growth

Question 5. Chronic obstructive lung disease

Answer:

Chronic obstructive lung disease

• Chronic obstructive pulmonary disease is characterized by irreversible obstruction to the airflow throughout the lungs

Clinical Features:

• Age- common above 40 years of age
• Cough with small amounts of mucoid sputum
• Presence of pitting edema
• Types- pink puffers and blue bloaters

Investigations:

• Chest radiograph B Blood test
• Measurement of lung volumes
• Exercise test

Management:

• Smoking cessation
• Bronchodilators
• Corticosteroids
• Pulmonary rehabilitation
• Oxygen therapy

Question 6. Drug resistance in tuberculosis

Answer:

• Drug resistance in tuberculosis develops due to

1. 1. Slow division of mycobacterium
   2. Inadequate regimen
   3. Incomplete duration or dosage
   4. Presence of spontaneous point mutation
   5. The ability of mycobacterium to remain as persisted for years
   6. Intracellular location of bacilli
   7. Poor patient compliance
   8. Presence of caseous material

Question 7. Complication of chronic bronchitis

Answer:

Complication of chronic bronchitis

• Type 1 and 2 respiratory failure
• Pulmonary arterial hypertension and corpulmonale
• Secondary infection
• Secondary polycythemia

Question 8. Hoarseness of voice

Answer:

Hoarseness of voice

Abnormal changes in the voice are called hoarseness

Causes

• Acute laryngitis
• Voice misuse
• Benign vocal cord lesions
• Gastroesophageal reflux disease
• Laryngopharyngeal reflux disease
• Smoking
• Neurological diseases
• Thyroid problems
• Allergies
• Trauma to the voice box
• Laryngeal cancer

Question 9. Tracheal foreign body

Answer:

Tracheal foreign body

1. It is common in children
2. Common sites involved are
   • Larynx
   • Trachea
   • Bronchus
3. Symptoms depend upon the site where the foreign body is settled
4. Symptoms occur are:

Investigations:

• Anteroposterior and lateral radiograph
• Biplane fluoroscopy
• Chest auscultations

Question 10. DOTS on tuberculosis

Answer:

DOTS on tuberculosis

• DOTS is Directly Observed Treatment Short course
• It was recommended by WHO in 1995
• It is found to be effective
• It involves providing the most effective medicine and confirming that it is taken
• Anti-tubercular drugs during the intensive phase are administered under the direct supervision of peripheral health staff or through voluntary workers
• It ensures a high cure rate through its following components
  • Appropriate medical treatment
  • Supervision and motivation by health and non-health workers
  • Monitoring of disease status by health services

Category:

• According to DOTS, patients are grouped into two categories

1. Category-1- New patients
   • New sputum smear positive
   • New sputum smear-negative
   • New extrapulmonary
   • New others
2. Category 2- previously treated patients
   • Smear positive relapse
   • Smear positive failure
   • Smear positive treatment after default

Question 11. CT scan

Answer:

Uses:

• Evaluation of hilar and paratracheal lymph nodes
• Differentiate localized collection of fluid from a tumor
• Determine the position and size of pulmonary nodule
• Assess the spread of lung cancer
• Differentiate vascular mediastinal lesions
• Used to mark the site for pleural aspiration

Question 12. Causes of hemoptysis

Answer:

Causes of hemoptysis

1. Inflammatory lung disease
   • Bronchitis
   • Tuberculosis
   • Pneumonia
   • Lung abscess
   • Bronchiectasis
2. Neoplasms of lung
   • Bronchial adenoma
   • Bronchial carcinoma
3. Cardiovascular
   • Mitral stenosis
   • Left ventricular failure
   • Deep vein thrombosis
4. Miscellaneous
   • Pulmonary vasculitis
   • Anticoagulant therapy
   • Trauma to the lungs

Question 13. Paroxysmal nocturnal dyspnoea

Answer:

Paroxysmal nocturnal dyspnoea

• Dyspnoea is abnormal and uncomfortable breathing which makes the patient aware of it
• Dyspnoea that occurs at night and awakens the patient is called paroxysmal nocturnal dyspnoea
• It indicates left heart failure
• It gets precipitated by recumbent posture at night

Question 14. Bronchiectasis- three complications

Answer:

Bronchiectasis- three complications

• Recurrent pneumonia
• Corpulmonale
• Secondary amyloidosis
• Bacteraemia and septicemia
• Meningitis or brain abscess
• Massive hemoptysis

Question 15. Respiratory failure

Answer:

Respiratory failure

• Failure of the respiratory system to maintain normal partial pressure of oxygen and carbon dioxide in the blood is called respiratory failure

Types:

• Depending on the arterial blood gas analysis, it is classified into the following types

1. Type 1 respiratory failure- hypoxemia
   • Acute
     • There is an acute alteration in blood gas concentration with hypoxemia and normal or hypocapnia
   • Chronic
     • There is a chronic alteration in blood gases due to the slow diffusion of carbon dioxide
2. Type 2- respiratory failure- Hypercapnia
   • Acute- low PaO₂ and pH but high PaO₂
   • There is hypercapnia and acute respiratory acidosis
   • Chronic- low PaO₂ high PaCO₂ but low or normal pH

Question 16. Pleural effusion
(or)
Pulmonary effusion

Answer:

Pulmonary effusion

• The collection of fluid in the pleural cavity irrespective of the nature of the fluid is called pleural effusion

Causes:

• Congestive cardiac failure
• Tuberculosis
• Nephrotic syndrome
• Pulmonary infarction
• Lymphomas
• Rheumatoid arthritis
• Cirrhosis of liver
• Pancreatitis

Clinical Features:

• Fever
• Pleuritic pain
• Pyrexia
• Dyspnoea
• Treatment:
• Aspiration of pleural effusion
• Removal of the etiological agent

Question 17. Pulmonary embolism

Answer:

Causes:

• Thrombotic
• Deep vein thrombosis
• Congestive heart failure
• Right-sided endocarditis
• Atrial fibrillation
• Nonthrombotic
• Fat embolism
• Amniotic fluid embolism
• Tumor embolism
• Parasitic embolism
• Air embolism

Clinical Features:

• Acute dyspnoea
• Tachypnoea
• Tachycardia
• Haemoptysis
• Chest pain
• Pleuritic pain
• Wheezing
• Weakness, fatigue
• Syncope
• Hepatomegaly

Question 18. Anti-tubercular drugs

Answer:

Anti-tubercular drugs

• According to the clinical utility, the anti-tubercular drugs are divided into

1. First line drugs
   • They have high antitubercular efficacy
   • Have low toxicity
   • They are:
     • Isoniazid (H)
     • Rifampicin (R)
     • Pyrazinamide (Z)
     • Ethambutol (E)
     • Streptomycin (S)
2. Second line drugs
   • They have low antitubercular efficacy
   • Have high toxicity
   • They are:
     • Thiacetone (Tzn)
     • Para-aminosalicylic acid (PAS)
     • Ethionamide (Etm)
     • Kanamycin (Kmc)
     • Amikacin (Am)
3. Newer drugs are
   • Ciprofloxacin
   • Ofloxacin
   • Clarithromycin
   • Azithromycin

Question 19. Indications of oxygen therapy

Answer:

Indications of oxygen therapy

• Type 1 respiratory failure
• Type 2 respiratory failure
• Shock
• Asphyxia
• Acute myocardial infarction
• Cardiac tamponade
• Acute severe asthma
• Acute pulmonary edema
• Tension pneumothorax
• Carbon monoxide poisoning

Question 20. Lung cancer- three extra pulmonary manifestations

Answer:

Lung cancer- three extra pulmonary manifestations

• Dyspnoea
• Haemoptysis
• Chronic coughing
• Wheezing
• Chest pain
• Cachexia
• Dysphonia
• Dysphagia

VIVA VOCE

1. A decreased expiratory flow rate is the hallmark of obstructive lung disease
2. Klibessela pneumonia is characterized by red current jelly sputum
3. Legionella pneumonia is frequently associated with diarrhea
4. Pneumonia alba is due to Treponema palladium
5. Bronchopneumonia in measles is due to immunosuppression
6. Plasma cell pneumonia is caused by pneuma- cystitis carnie
7. Nosocomial pneumonia is hospital-induced pneumonia
8. Koch’s phenomenon is seen in tuberculosis
9. Most common cause of hemoptysis is bronchitis
10. Pigeon chest is seen in severe asthma
11. Barrel shaped chest is seen in COPD