03/03 Flashcards
What are features of life threatening asthma?
PEF <33% of predicted Sats <92% Normal pCO2 Silent chest/ cyanosis/poor resp effort Bradycardia or hypotension Exhaustion, confusion or coma
When should LTOT be offered to patients with COPD?
PaO2 <7.3kPa after 2 ABG
OR
PaO2 7.3-8 kPa plus one of the following
- secondary polycythaemia
- peripheral oedema
- pulmonary hypertension
Cannot be offered to patients who refuse to stop smoking despite support and programmes being offered
What are features of pulmonary fibrosis?
Exertional dyspnoea
Clubbing
Dry cough
Bi-basal fine end inspiratory crepitations
How can thoracic kyphosis impact on lung function?
It is a restrictive chest wall disease- meaning the lungs cannot expand as well as they would like to
- causes an increase in FEV1:FVC
- a normal or decreased TLCO
- an increased transfer coefficient
- massively reduced FVC
- reduced FEV1
What are causes of increase TLCO?
Asthma Pulmonary haemorrhage e.g. Wegeners Left to right cardiac shunts Polycythaemia Exercise
What are causes of decreased TLCO?
Pulmonary fibrosis Pneumonia PE Emphysema Pulmonary oedema Anaemia Poor CO
What testing is needed in adults with suspected asthma?
Spirometry with bronchodilator reversibility
FeNo testing
What is the mode of action of varencline?
Partial nicotine receptor agonist
Most common SE- nausea
What is the mode of action of bupropion?
A norepinephrine and dopamine reuptake inhibitor, and nicotinic antagonist
Small risk of seizures
Contraindicated in epilepsy, pregnancy and breast feeding
What scale is used to determine likelihood of obstructive sleep apnoea?
Epworth scale
What vasculitis can cause nasal polyps?
Churg Strauss syndrome
What criteria needs to be met in order for a diagnosis of asthma to be made?
Exhaled FeNo testing of >40
Post bronchodilator improvement
-Total long volume >200ml
-FEV1 >12%
PEF variability of 20%
FEV1:FVC <0.7
What are causes of ARDs?
Infection Acute pancreatitis Smoke inhalation Trauma Massive blood transfusion
What are features of ARDs?
Dyspnoea
Raised resp rate
Bilateral lung crackles
Low sats
