GeriQBank · Topic
COPD, asthma, interstitial lung disease, sleep-disordered breathing.
Set twice
GOLD Criteria for Assessment of COPD and Treatment Options 15 marks High-Yield Points The GOLD Initiative and Diagnosis GOLD = Global Initiative for Chronic Obstructive Lung Disease, established 1997, first strategy report 2001, revised…
SLEEP APNOEA / POLYSOMNOGRAPHY — 15 MARKS DEFINITIONS Sleep apnoea–hypopnoea syndrome (SAHS) — repetitive episodes of complete or partial upper-airway obstruction during sleep producing intermittent hypoxaemia, hypercapnia, sympathetic…
Set once
Source note: Bronchogenic carcinoma is not covered adequately as a standalone topic in the uploaded textbook — Pathy's refers to lung cancer chiefly in the context of paraneoplastic syndromes, therapy-related myelodysplasia and…
Burden and normal ageing changes. More than half of people over 65 report a sleep-related problem. Normal ageing produces a shorter, more superficial and more fragmented total sleep time, with increased sleep latency, reduced slow-wave…
Definition. REM sleep behaviour disorder (RBD) is a parasomnia characterised by the apparent acting out of dreams, caused by loss of the normal muscle atonia of REM sleep. Normal REM sleep has both tonic phenomena (muscle atonia) and…
Chronic Obstructive Pulmonary Disease — Risk Factors, Pathology, Clinical Features, Differentiation from Bronchial Asthma, Management and Complications 15 marks High-Yield Points Definition and Epidemiology Definition: COPD is airflow…
Community-Acquired Pneumonia in the Elderly — Etiology, Clinical Features and Management 15 marks High-Yield Points Definition and Epidemiology Definition: acute infection of the lung parenchyma acquired outside hospital, with new…
Causes, Diagnosis and Management of Pulmonary Embolism 15 marks High-Yield Points Definition and Epidemiology Definition: obstruction of the pulmonary arterial tree, usually by thrombus embolised from the deep veins of the leg or…
Interstitial Lung Disease 7 marks Pathy's does not carry a dedicated ILD chapter; ILD appears within the COPD differential diagnosis (Table 42.3), the muscle disorders chapter (anti-synthetase syndrome and dermatomyositis-associated…
Respiratory Failure — Types, Causes and Management 15 marks Pathy's addresses respiratory failure within the chapters on ageing of the respiratory system, COPD and pneumonia rather than as a stand-alone chapter; the answer below builds…
Long-Term Oxygen Therapy 7 marks High-Yield Points Definition and purpose: LTOT is the provision of supplemental oxygen at home for at least 15 hours per day to patients with chronic severe resting hypoxaemia. Its aim is to prolong…
Metered Dose Inhalers 7 marks High-Yield Points Definition and principle: a pressurised metered dose inhaler (pMDI) is a hand-held device that delivers a fixed, reproducible dose of drug suspended or dissolved in a hydrofluoroalkane…
Extrapulmonary Tuberculosis 15 marks Pathy's covers tuberculosis in the elderly within the chapter on the epidemiology of respiratory infections rather than as a dedicated extrapulmonary chapter; that material is combined below with the…
COPD is characterised by airflow obstruction that is not fully reversible, shows little variability over time, is usually progressive, and reflects small-airway disease and emphysema. Diagnosis requires a post-bronchodilator FEV /FVC <…
Oxygen is a drug: it must be prescribed with a target saturation range, a device and a flow rate, and signed for on the drug chart like any other medicine. The therapeutic target is a saturation range, not a flow rate. In COPD with an…
Definition: permanent enlargement of the airspaces beyond the terminal bronchioles, with destruction of their walls and without obvious fibrosis. It affects mainly the alveoli, and the small airways indirectly. Cause: cigarette smoke…
No university frequency data yet
management Definition. Community-acquired pneumonia (CAP) is an acute infection of the lung parenchyma acquired outside hospital, or within 48 hours of admission, characterised by new symptoms and signs of lower respiratory tract…
Burden. Pneumonia is a major cause of hospitalisation and death in old age — about two out of three pneumonia admissions are patients over 70. It is often the terminal event in frailty and dementia ("the old man's friend"), and carries…
Definition and types. Hospital-acquired (nosocomial) pneumonia is pneumonia developing 48 hours or more after hospital admission and not incubating at the time of admission. Ventilator-associated pneumonia (VAP) arises more than 48…
Recognise the diagnosis in the first line: this is severe community-acquired pneumonia with sepsis and septic shock. Marks are earned for immediate resuscitation running in parallel with investigation, not sequentially. Immediate…
Confirm the diagnosis and assess. COPD requires post-bronchodilator spirometry showing a persistent airflow limitation. In older adults use the lower limit of normal rather than the fixed FEV /FVC < 0.70 ratio, 1 because ageing alone…
Diagnosis and the geriatric difficulty. Asthma is chronic airway inflammation with bronchial hyper-responsiveness and variable airflow obstruction, causing episodic wheeze, cough, chest tightness and dyspnoea, which is fully or partly…
Definition and why the name is a misnomer. "Senile emphysema" (better called the ageing or senile lung) is the physiological enlargement of alveolar ducts and alveoli that occurs with normal ageing. Crucially, it occurs WITHOUT…
Why it matters. Inhaled therapy is first-line in COPD and asthma, but the drug only reaches the airway if the technique is correct. Using inhaler devices is a demanding task for older patients because it needs coordination and…
Source note: Diffuse parenchymal lung disease is not covered adequately as a standalone topic in the uploaded textbook — Pathy's refers to it mainly in the context of ageing lung changes, drug-related pneumonitis and the differential…
Definition and normal physiology. Pleural effusion is abnormal accumulation of fluid in the pleural space. Normally only 10–20 mL of fluid is present, produced by the parietal pleural capillaries and absorbed by parietal pleural…
Definition and classification. Respiratory failure is failure of the lungs to maintain adequate gas exchange, defined on arterial blood gas as PaO < 60 mmHg (8 kPa) breathing room air, with or without PaCO > 50 mmHg (6.7 2 2 kPa). Type…
Definition and diagnosis. By the Berlin definition, ARDS requires all four of: onset within one week of a known insult; bilateral opacities on chest imaging not fully explained by effusion, collapse or nodules; respiratory failure not…
Definition and principle of LTOT. Long-term oxygen therapy is supplemental oxygen given for at least 15 hours per day, which was shown in the NOTT and MRC trials to improve survival in severe COPD with persistent hypoxaemia. Along with…
Definition and risk factors. Pulmonary embolism (PE) is obstruction of the pulmonary arterial tree, usually by thrombus embolising from a deep vein of the leg or pelvis. Risk factors follow Virchow's triad: immobility, hospitalisation,…
Definition. Chronic thromboembolic pulmonary disease (CTEPD) is the persistence of organised, fibrotic thromboembolic material obstructing the pulmonary arteries with mismatched perfusion defects, persisting after at least 3 months of…
with cough Definition and first principle. A solitary pulmonary nodule (SPN) is a single, rounded opacity up to 3 cm in diameter, completely surrounded by aerated lung, with no associated atelectasis, hilar enlargement or pleural…
prognosis Definition and epidemiology. Obstructive sleep apnoea (OSA) is the most frequent respiratory sleep disorder and involves repeated episodes of complete (apnoea) or partial (hypopnoea) upper airway obstruction during sleep. It…