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Resp Qu review > 05/01 > Flashcards

05/01 Flashcards

1
Q

What smoking cessation therapy is first choice in pregnancy?

A

Nicotine replacement therapy

Others are contraindicated

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2
Q

What options are there for smoking cessation therapy?

A

NRT, Bupropion and Varenicline

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3
Q

What are the side effects of NRT?

A

Headache, flu like illness, N&V

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4
Q

How long should a course of varenicline go on for?

A

Began 1wk before target stop date and continued for 12wks as long as patient is not smoking

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5
Q

What are the side effects of varenicline?

A 
Headache
Insomnia 
Nausea
Abnormal dreams
Thought to increase risk of suicide in depressed patients so caution
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6
Q

What are side effects of bupropion?

A

Seizures- contraindicated in epilepsy

Should be started 1-2wks before target stop date

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7
Q

What antibiotic is used as prophylaxis for infections in patients with COPD?

A

Azithromycin

Only done if patient has recurrent exacerbations, do not smoke, are good with medications and have relevant vaccinations

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8
Q

What is transfer factor?

A

The rate in which a gas is transported from the alveoli into the blood

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9
Q

What causes an increase in transfer factor?

A 
Asthma
Male
Exercise
Left to right cardiac shunts
Polycythaemia
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10
Q

What causes a decrease in transfer factor?

A

Pulmonary fibrosis
PE
Pulmonary oedema
Pneumonia

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11
Q

What is the optimal way to administer a dose from a pressurised meter dose inhaler?

A

Shake inhaler
Breathe out gentley
Place inhaler in mouth and breathe in deeply and slowly as you press the button
Hold breath for 10 seconds

Wait 30 seconds before repeating dose

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12
Q

If a patient with COPD has pneumonia, what additional medication should be given?

A

Prednisolone- even if no sign of COPD exacerbation

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13
Q

How is COPD staged?

A

Based on FEV1:FVC and FEV1 predicted

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14
Q

What is stage 1 (mild) COPD?

A

FEV1: FVC <0.7

FEV1 >80%

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15
Q

What is stage 2 (moderate) COPD?

A

FEV1:FVC <0.7

FVEV1 50-79%

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16
Q

What is stage 3 (severe) COPD?

A

FEV1:FVC <0.7

FEV1 30-49%

17
Q

What is stage 4 (very severe) COPD?

A

FEV1:FVC <0.7

FVC <30%

18
Q

How should asthma treatment be stepped down?

A

Work backwards down the asthma treatment pathway

Aim for a reduction in dose by 25-50% (depending on what you are reducing)

19
Q

What is sarcoidosis?

A

Multisystem disorder of unknown cause

Non caseating granulomas (areas of inflammation)

20
Q

What are symptoms of sarcoidosis?

A 
Hypercalcaemia
Parotid swelling
Facial palsy 
Erythema nodosum
Eye problems
Swinging fever
Persistent cough
Hilar lymphadenopathy
21
Q

What are the causes of a white out on CXR?

A 
Pleural Effusion
Consolidation
Collapse
Specific lesions e.g. tumour
Pneumonectomy
22
Q

What causes tracheal deviation towards white out on CXR?

A

Pneumonectomy
Lung collapse
Pulmonary hypoplasia

23
Q

What causes tracheal deviation away from whiteout on CXR?

A

Pleural Effusion
Diaphragmatic hernia
Thoracic mass

24
Q

What is raised in sarcoidosis?

A

Serum ACE is raised in 60% of patients

25
Q

What are the symptoms if idiopathic pulmonary fibrosis?

A 
Exertional Dyspnoea
Dry Cough
Weight Loss
Clubbing
More common in men
Peak age 50-70
26
Q

When should a chest drain be inserted in a pneumothorax?

A

Primary
- >2cm

Secondary

  • > 50yo and >2cm
  • 1-2cm then attempt aspiration
  • <1cm admit and observe
  • all pts should be admitted for 24 hrs
27
Q

How do panic attacks present on ABG?

A 
Hyperventilation
Resp alkalosis (low CO2)
Normal oxygen as no impairment of gas exchange
28
Q

What is the most common cause of infective exacerbations of COPD?

A

H.influenzae

Treat with amoxicillin

29
Q

How is occupational asthma diagnosed?

A

Serial peak flow readings both inside and outside of work

Then referred to resp medicine where they can have IgE testing

30
Q

What spirometry picture does pulmonary fibrosis give?

A

FEV1:FVC >0.7
FVC reduced
Transfer capacity reduced
Is a restrictive picture

31
Q

How can exudative pleural effusion be diagnosed?

A

Protein level >30g/L

Or Lights Criteria (at least one should be met)

  • pleural fluid protein divided by serum protein >0.5
  • pleural fluid LDH divided by serum LDH >0.6
  • Pleural fluid LDH more than 2 times upper normal limit of serum
32
Q

What are exudative causes of pleural effusion?

A

Lung Cancer
Pneumonia
RA
TB

33
Q

What are transudative causes of pleural effusion?

A

Congestive cardiac failure
Hypoalbuminaemia e.g. Nephrotic Syndrome
Meig Syndrome
Hypothyroidism

Resp Qu review (6 decks)

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