... Flashcards
What test can be done ona suspected case of lung cancer?
FBC + Clotting Screen Serum Calcium Bone Profile LFT + RFT CXR Biopsy Bronchoscopy + bronchoalveolar lavage Aspirate any pleural effusion PET Scan + Bone Scan
How does Lung Cancer present?
Dyspnoea Chest Pain Chronic cough +/- Haemoptysis Recurrent Chest Infections Weight Loss Wheezing - Dysphagia - Bone Pain - Shoulder Pain - Horners Syndrome - Swollen neck/face - Hoarseness
What are the most common causative organisms in pneumonia>
Strep Pneumoniae Mycoplasma Pneumoniae Haemophilus Influenzae Viral Pseudomonas Aeruginosa Staph Aureus Legionella
Explain the Curb 65 Score for severity and treatemnt of Pneumonia?
C - Confusion U - Urea>7mmol/L R - Resp. rate > 30/m B - BP <60 or 90 65 - >65yrs
o = community treated 1-2 = Hospital Treated 3-5 = ITU
o-1 = Clarithromycin (macrolide) or Amoxicillin (B-lactam) or Doxycyclin 2 = Clarithromycin and Amoxicillin (or Levofloxacin - Fluroquinolone) 3-5 = Clarithromycin & Co-Amoxiclav (Or Levofloxacin)
Add Vancomycin for MRSA
Add Flucloxacillin for Staph
Can also add rifampicin in severe cases
What are the complications of Pneumonia?
Lung abscess
Pleural Effusion
Empyema
Bronchiectasis
What tests are done on suspected pneumoina?
FBC - CRP - ABG - U&E - LFT CXR Bronchoscopy + Bronchoalveolar Lavage Sputum & Blood Cultures Urinary Legionella Throat Swab for atypical Pathogens
What none antibiotic treatments are there for pneumonia?
Analgesia Anti-pyretics Fluids (IV if necessary) O2 - CPAP - Intubate CCS~ help with inflammation
What are the common organisms behind a lung abscess?
Pseudomonas Aeruginosa Or Staph Aureus
What treatments are there for lung abscess?
Postural Drainage
Percutaneous Drainage
Long course of antibiotics
Surgical Excision
How do we test for a mesothelioma and how does it present?
Dyspnoea - Chest Wall Pain - Pleural effusions/pneumothorax - Haemoptysis - Weight loss - Fatigue - Fever - Night Sweats - Clubbing - Cough
CXR - Diffuse or localised pleural thickening (unilateral)
Biopsy
Aspirate Effusion
What could make sinusitis chronic and what would we do?
Nasal Polyps - Immunocompromised - Allergy - Asthma - Smoking
CT/MRI/XR - Nasal Endoscopy
Amoxicillin - Nasal Irrigation - Surgical Intervention
How do we treat Otitis Media and what are the common organisms?
Analgesia and ~antibiotics
Haemophilus Influenzae or Strep Pneumoniae
What causes Croup vs epiglottitis?
Croup: Parainfluenza Virus Type 1
Epiglottitis: Haemophilus Influenzae B
Compare Croup and Epiglottitis presentation?
Croup:
Hoarse - Barking Cough - Dyspnoea worse at night - Stridor - Look relatively well - Slow onset
Epiglottitis:
Little Cough - Drools - Dyspnoea better when leaning forward - Stridor - Dysphagia - Look very Sick - Rapid onset
How do we treat croup vs epiglottis?
Croup; Oral CCS (Add O2 an Adrenaline if dyspnoea severe)
Epiglottitis: Secure Airway with O2 and intubation Throat Swab for culture and viral smears Blood culture for bacteraemia FBC - Raised WCC ANTIBIOTICS