Chronic Phase 1 Flashcards
Topics
Cardio
Resp
Rheumatology
Chronic gynaecology
Breast triple assessment
- Clinical Examination: Includes inspection and palpation of both breasts and the axilla.
- Imaging: Mammography and ultrasound are the mainstays for initial assessment. MRI may be considered for further evaluation.
- Biopsy: Core needle biopsy (preferably under ultrasound or mammographic guidance) is essential for histological diagnosis.
Asthma
Acute exacerbation: Administer oxygen, inhaled bronchodilators (e.g., salbutamol), corticosteroids (oral or IV), and consider magnesium sulfate in severe cases.
Long-term: Inhaled corticosteroids, long-acting beta agonists, leukotriene receptor antagonists, and monitoring with peak flow meters.
COPD
Acute exacerbation: Oxygen therapy (target SpO2 88-92%), nebulized bronchodilators (salbutamol and ipratropium), systemic corticosteroids (prednisolone), and antibiotics if indicated.
Long-term: Smoking cessation, inhaled bronchodilators, corticosteroids, pulmonary rehabilitation, and vaccinations (influenza, pneumococcal).
Bronchiectasis
Acute exacerbation: Antibiotics, airway clearance techniques, and bronchodilators.
Long-term: Physiotherapy, prophylactic antibiotics, and management of underlying conditions.
ILD
Acute exacerbation: Oxygen therapy, corticosteroids, and treating underlying cause.
Long-term: Antifibrotic agents (e.g., pirfenidone, nintedanib), pulmonary rehabilitation, and oxygen therapy.
Cystic fibrosis
Acute exacerbation: Antibiotics (oral, IV, or nebulized), chest physiotherapy, and nutritional support.
Long-term: Enzyme replacement, high-calorie diet, regular physiotherapy, and prophylactic antibiotics.
Pulmonary hypertension
Acute management: Oxygen therapy, diuretics, and vasodilators (e.g., sildenafil).
Long-term: Disease-specific treatments (endothelin receptor antagonists, phosphodiesterase inhibitors, prostacyclins), anticoagulation, and diuretics.
Chronic HF
Acute exacerbation: Diuretics (e.g., furosemide), oxygen, nitrates (if indicated), and consider inotropes.
Long-term: ACE inhibitors/ARBs, beta-blockers, aldosterone antagonists, lifestyle modification, and monitoring with echocardiography.
Ischaemic heart disease
Acute exacerbation (unstable angina/MI): MONA (Morphine, Oxygen, Nitrates, Aspirin), antiplatelets (clopidogrel), beta-blockers, and consider revascularization (PCI/CABG).
Long-term: Antiplatelets, statins, beta-blockers, ACE inhibitors, lifestyle changes.
AF
Acute management: Rate control (beta-blockers, calcium channel blockers), rhythm control (amiodarone, cardioversion), anticoagulation (warfarin, NOACs).
Long-term: Anticoagulation, rate/rhythm control, and regular monitoring.
Hypertension
Acute severe hypertension: IV antihypertensives (e.g., labetalol, nitroprusside).
Long-term: Lifestyle changes, antihypertensives (ACE inhibitors, ARBs, calcium channel blockers, diuretics).
Valvular heart disease
Acute exacerbation: Symptom management (diuretics for heart failure), treatment of arrhythmias.
Long-term: Regular monitoring, valve repair/replacement if indicated.
Rheumatoid arthritis
Acute flare: NSAIDs, corticosteroids (oral or intra-articular), DMARDs (methotrexate, sulfasalazine).
Long-term: DMARDs, biologics (TNF inhibitors), regular monitoring, physiotherapy
Osteoarthritis
Acute exacerbation: NSAIDs, corticosteroid injections, pain management.
Long-term: Lifestyle modifications, physiotherapy, analgesics, joint replacement surgery if severe.