Lecture 16 Flashcards

(53 cards)

1
Q

What are the 3 kinds of lower respiratory tract infection?

A

May be viral, bacterial, or fungal

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2
Q

What are the symptoms of a LRTI?

A

Cough, shortness of breath, fever, generalized malaise, chest pain

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3
Q

How are LRTI diagnosed?

A

Auscultation of the lungs, x-ray, CRP blood test, microbiological tests, PCR

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4
Q

What is bronchitis caused by?

A

Inflammation of the lining of bronchial tubes

Viral (90%) or bacterial

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5
Q

What are the symptoms of bronchitis?

A

Nasal congestion or runny nose, sore throat, mild cough

Increased coughing >10 days, fatigue, fever, shortness of breath, tightness/pain in the chest

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6
Q

What does the physical examination for bronchitis consist of?

A

Physical examination:

Auscultation (rhonchi, wheezing)
Slight fever or may be afebrile

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7
Q

What is the treatment of bronchitis?

A

Suspension of training
Adequate hydration
Cough suppressant
Asthma inhalers
If other symptoms still present: NSAIDs, nasal decongestants

Usually resolves without antivirals/antibiotics

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8
Q

What happens if a bronchitis persists for longer than 3 weeks?

A

Alternative diagnosis should be considered (ex: asthma, pertussis)

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9
Q

What is the bronchitis RTS protocol?

A

Acute typically lasts 3-10 days (dry cough may last for several weeks)

Once symptoms resolve, it is usually safe to return to low levels of activity

Getting back to regular training levels may take a few weeks

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10
Q

What are the symptoms of pertussis?

A

Highly contagious, characterized by severe spasmodic coughing episodes

Bacterial infection

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11
Q

What is the treatment of pertussis?

A

Antibiotics and supportive care

What doesnt work: cough mixtures suppressants

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12
Q

What is the prevention for pertussis?

A

Pertussis vaccine is included in routine immunization in Canada

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13
Q

What are the 4 pertussis complications?

A

Pneumonia, apnea, rib fractures, seizures

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14
Q

What is the course of pertussis?

A

Incubation: 5-10 days
Stage 1: 1-2 weeks
Stage 2: 1-10 weeks
Stage 3: 2-3 weeks

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15
Q

What is pneumonia?

A

Infection that inflames the air sacs in lungs

Can be bacterial, viral, or fungal

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16
Q

What are the symptoms of pneumonia?

A

Persistent cough
Fever, chills, night sweats
Shortness of breath, chest pain, cyanosis
Headache, muscle ache
Fatigue
Confusion

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17
Q

What are the complications of pneumonia?

A

Myocarditis, pericarditis, meningitis, sepsis

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18
Q

What is the diagnosis and treatment for pneumonia?

A

Physical exam, x-ray, lab tests

Antibiotics/antivirals/antifungals

Pain management, cough suppressant, asthma inhaler, oxygen therapy

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19
Q

What is the RTS protocol for LRTI?

A

Lack of reliable studies to accurately guide RTS

Infections: neck check

Clearance form a physician

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20
Q

What causes a pneumothorax?

A

Spontaneous
Trauma
Damage from underlying disease

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21
Q

What are the symptoms of penumothorax?

A

Sudden chest pain and shortness of breath

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22
Q

What is the diagnosis and treatment for pneumothroax?

A

Physical exam, chest x-ray, CT scan

Small (less than 15%): conservative treatment with weekly x-rays

Large (>15% of lung space):
chest tube in the lung for re-expansion (for several days)

23
Q

What is an important rule for treating a pneumothroax?

A

No strenuous training until properly treated and resolved

Repeat x-ray and physical exam

RTS is different for everyone

24
Q

What are the signs and symptoms of asthma?

A

Wheezing (expiratory)
Cough, wheeze, chest tightness with exercise

Characterized by inflammation, increase mucus production and airway narrowing

25
How is asthma diagnosed?
Medical history Physical exam Allergy tests Pulmonary function tests
26
What are the 4 steps of a pulmonary function test?
1. Spirometry 2. Diffusing capacity 3. Bronchodilator reversibility 4. Exercise testing
27
What are the 4 types of asthma treatment?
Inhaled corticosteroids Leukotriene modifiers (oral) Long-acting beta agonists (inhaled) Combination inhalers
28
What are used for rapid relief of an asthma attack?
Short-acting beta agonists (inhaled) Ipratropium (atrovent) Oral and intravenous corticosteroids
29
What is exercise induced asthma?
Patients who have underlying asthma, and exercise is a trigger that exacerbates their asthma
30
What is exercise induced bronchospasm?
Patients who do not have a history of asthma and who have bronchospasms associated with exercise
31
What is the prevalence of EIA and EIB?
Seen in 90% of asthmatics Seen in up to 50% of athletes in cold outdoor sports
32
What is the EIB Treatment?
Short-acting beta agonists (first choice) Long-acting beta agonists (effectively used to treat EIB) Warming and humidifying of the air- masks may help Avoiding exposure to cold and pollutants
33
What is a warm up for asthmatics?
About 1-3 hours before the event: High-intensity interval training: 3-4 x 20-30 seconds sprints Steadily increasing 5-30 min sport specific activity In addition, a bronchodilator medication: 15-60 minutes before the competition
34
What is exercise-induced laryngeal obstruction?
Larynx partially closes during intense exercise, making it hard to breathe in
35
What are the symptoms and signs of EILo during high-intensity exercise?
Shortness of breath Throat tightness Noisy breathing Chest or throat discomfort Symptoms usually start during exercise and resolve within minutes after stopping
36
What is the diagnosis for EILO?
Continuous laryngoscopy during exercise
37
What is the treatment for EILO?
Physiotherapy (breathing technique training) Speech therapy Relaxation training
38
What are the 3 ranges of EILO?
1. Supraglottic: upper structures may collapse inward when breathing in *most common type 2. Glottic (level of vocal cords): vocal cords close abnormally during inspiration *also known as vocal cord dysfunction 3. Subglottic (area below vocal cords): Rarely involved in EILO
39
What is the PR interval?
Time from P wave to beginning of QRS complex Normal: 0.12-0.20 seconds
40
What is the QT interval?
Time from beginning of QRS complex to end of T wave Normal: 0.36-0.44 seconds
41
What are the ranges of tachy and bradycardia?
Tachy: >100 Bpm Brady: <60 Bpm (commonly seen in athletes)
42
What are heart rate changes seen with age?
2 year old: 80-130 bpm Adult: 60-100 bpm
43
What is premature atrial contraction?
Early beat, p wave changes, QRS complex usually normal Palpitations Causes: stress, caffeine, alcohol, fatigue, underlying heart conditions Diagnosis: EKG Treatment: Lifestyle modifications, medications if frequent and symptomatic
44
How are athlete's hearts different?
Volume and pressure loads in the LV increase: increased muscle mass, wall thickness, and chamber size *maximal stroke volume and cardiac output increase Bradycardia, extra heart sounds, EKG abnormalities, enlarged heart *No treatment necessary*
45
What are 6 characteristics of sudden cardiac death in sport?
Commonly death is the first indication of a problem Male to female 2:1 High school age and little older 0.75 in 100 000 athletes per year Most often caused by underlying heart condition Athletes <35 years- genetic and acquired cardiovascular abnormalities commonly responsible Athletes 35 and older: most events due to coronary artery disease
46
What are causes of SCD?
Hypertrophic cardiomyopathy Commotio cordis Myocarditis
47
What is hypertrophic cardiomyopathy?
Genetic condition LV hypertrophy which can lead to ventricular tachycardia/fibrillation and SCD Prevalence: 1 in 200 Competitive athletes dying suddenly are usually within 13-30 yrs of age and have LV wall thickening HCM is inherited, can't be prevented
48
What is the treatment for hypertrophic cardiomyopathy?
Beta blockers Blood thinners Surgery Implantable cardioverter-defibrillator (ICD)
49
What is commotio cordis?
Blunt chest trauma over heart (sternum) leads to sudden cardiac arrest *Hit in the chest just before T wave Chest protectors may reduce risk
50
What is myocarditis?
Inflammation of heart muscle Caused by viral infection (65%) or other cause
51
What are the symptoms, diagnosis and treatment of myocarditis?
Chest pain, fatigue, shortness of breath Can affect heart's electrical system, reducing heart's ability to pump and causing arrhythmias EKG, echo, blood tests, cardiac MRI, biobsy Prolonged period of rest (6 months) Medication for arrhythmias RTS: different for everyone
52
What is marfan syndrom?
Genetic disorder that affects connective tissues Tall, flexible, high pressure in eyes, cystic changes in the lungs, abnormal heart sounds Prevalence: 1:5000 in general population
53
What issues does Marfan syndrome cause in sport participation?
Increased risk for cardiac problems Increased risk for pulmonary conditions Low intensity, non-contact sports are generally safe Competitive sports may be allowed if they don't have severe risks and under regular cardiology follow-up