07/01 Flashcards
What are the indications for steroid treatment in sarcoidosis?
Parenchymal lung disease
Uveitis
Hypercalcaemia
Neurological or cardiac involvement
What is the treatment for an acute exacerbation of COPD?
Amoxicillin or Clarithromycin or Doxycycline
What is the most common cause of bacterial exacerbation of bronchiectasis?
H. influenzae
Other causes include pseudomonas aeruginosa, Klebsiella and step pneumoniae
What is the management of a primary pneumothorax with no symptoms and <2cm in size?
Discharge and review
Aspiration should only be attempted if pneumothorax is >2cm or patient is symptomatic
What clinical sign can help differentiate between a simple and tension pneumothorax?
Patient will be hypotensive
What is the management of an acute asthma attack?
1) admit
2) oxygen if hypoxic
3) SABA either via inhaler or nebuliser- repeat as often as needed
4) commence PO prednisolone and continue for 5 days
6) Ipratropium bromide if do not respond to SABA or in severe cases via nebuliser
7) IV magnesium sulphate
8) IV aminophylline following consultation from senior staff
9) Consider ITU admission
What are features of Klebsiella pneumonia?
More common in alcoholics and diabetics
Red-currant jelly sputum
Often affects upper lobes
What are clinical features of ARDs?
Acute dyspnoea and hypoxia hours/days post even
Multi organ failure
Rising ventilatory pressures
What are causes of ARDs?
Sepsis Direct lung injury Trauma Acute pancreatitis Long bone fractures or multiple fractures Head injury
What are causes of acute mediastinal widening?
Vascular problems e.g. thoracic aortic aneurysm Lymphoma Retrosternal goitre Teratoma Tumours of the thymus
How can you differentiate between a right lower and middle lobe pneumonia?
Lower lobe would obscure the hemidiaphragm whereas the middle would not
When diagnosing alpha -1 antitrypsin deficiency what is an important counselling point?
It can be detected pre natally
When should non invasive ventilation be considered in patients with COPD?
Acute exacerbation with resp acidosis PaCO2 >6kPA and pH between 7.26 and 7.35 persists despite maximal treatment
