CCC - Respiratory Flashcards
If breathlessness has sudden onset what are DDx?
- pneumothorax
- PE
- FB
If breathlessness has a mins/hr onset what are DDx?
- airways (inflammation/obstruction)
- chest infection (pus)
- acute heart failure (fluid)
If breathlessness has a days/weeks onset what are DDx?
- above (chronic/non-resolving)
- ILD
- Malignancy/large pleural effusion
- neuromuscular
- anaemia/thyrotoxicosis
What is the management of a pneumothroax primary <2cm?
discharge repeat CXR
What is the management of a pneumothroax primary >2cm/SOB?
aspiration, if unsuccessful chest drain - analgesia (regular)
What is the management of a pneumothorax secondary <2cm?
aspiration
What is the management of a pneumothorax secondary >2cm?
chest drain
How do you know if primary or secondary?
- primary: healthy
- secondary: predisposing e.g. COPD
How do you know the distance of the pneumothroax?
edge of heart and chest wal
Why might you have recurrent SOB after 2 hrs of chest drain?
rexpansion pulmonary oedema
What is a quick way to determine the axis?
- Lead I and II: overall negative?
- Yes: axis deviation - Look at avL: overall positive?
- Yes: left axis deviation
- No: right axis deviation
What is the inital treatment in PE?
- LMWH
2. Thrombolysis: if haemodynamic compromise (hypotensive systolic <90 unstable)
Why do you not give warfarin as inital PE management?
have a paradoxically pro-thrombotic effect initally
How can you see pulmonary oedema on chest x ray?
fluffy shadowing
How can you see a PE on x ray?
- Area of hypovoelamia (PE)
- Western Mark sign
- Focus of olgemia
- Rarely shown as PE usually normal X ray