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Respiratory > Clinical > Flashcards

Clinical Flashcards

1
Q

Upper respiratory tract infections

A

Common cold
Pharyngitis
Sinusitis
Epiglottitis

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2
Q

Lower respiratory tract infections

A 
Acute bronchitis
Acute exacerbation of chronic bronchitis/ COPD
Pneumonia
Influenza
Fungal infection
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3
Q

Coryza

A

Acute viral infection of the nasal passages
Often accompanied by sore throat
Sometimes mild fever
Spread by droplets and fomites

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4
Q

Viruses causing coryza

A

Adenovirus
Rhinovirus
Respiratory syncytial virus

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5
Q

Acute sinusitis

A 
Preceded by common cold
Frontal headache, 
Retro-orbital pain, 
Maxillary sinus pain, 
Tooth ache, 
Discharge
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6
Q

Diphteria

A

Bacterial infection
Produces toxin
Life threatening

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7
Q

Acute bronchitis

A 
Productive cough
Fever – minority of cases
Normal chest examination
Normal chest X-ray
May have a transient wheeze
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8
Q

Rhinovirus incubation time

A

1-5 days

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9
Q

Group A streptococci incubation time

A

1-5 days

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10
Q

Influenza and para influenza virus incubation time

A

1-4 days

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11
Q

RSV virus incubation time

A

7 days

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12
Q

Pertussis incubation time

A

7-21 days

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13
Q

Diphtheria incubation time

A

1-10 days

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14
Q

Epstein-Barr Virus incubation time

A

4-6 weeks

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15
Q

Pneumonia

A

Signs and symptoms of a lower respiratory tract infection, with a new infiltrate on a CXR

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16
Q

CURB 65 Severity Score

A 
C new onset of Confusion
U Urea >7
R Respiratory rate >30/min
B Blood pressure Systolic <90,Diastolic <61
65 Aged 65 or older

Score 1 point for each above
Only applies to community acquired pneumonia

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17
Q

Other severity markers for pneumonia

A

Temperature <35 or >40
Cyanosis PaO2 <8kPa
WBC <4 or>30
Multi-lobar involvement

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18
Q

Complications of pneumonia

A

Respiratory failure
Pleural effusion
Empyema
Death

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19
Q

Cases of pneumonia (4)

A

Community acquired
Hospital acquired
Aspiration pneumonia
Legionella

20
Q

Aetiology of classical flu

A

Influenza A virus

Influenza B virus

21
Q

Aetiology of flu-like illnesses

A

Parainfluenza viruses

many others

22
Q

Aetiology of Haemophilus influenzae

A

Bacterium

23
Q

‘Flu complications

A 
Primary influenzal pneumonia
Secondary bacterial pneumonia
Bronchitis
Otitis media
Pregnancy complications
24
Q

Causes of community acquired pneumonia (other than flu)

A

Microbiological causes:
Mycoplasma pneumoniae
Coxiella burnetii
Chlamydia

25
Q

What are most cases of bronchiolitis caused by?

A

Respiratory syncytial virus

26
Q

Empyema

A

Pus in the pleural space

27
Q

Signs of complicated effusion

A 
\+ve gram stain
pH <7.2
low glucose
septations
loculations
28
Q

Stridor

A

Inspiratory wheeze due to large airway obstruction

29
Q

Possible causes of stridor in the supraglottis/larynx

A

Laryngomalacia
Supraglottic mass
Glottic lesion
Vocal cord paralysis

30
Q

Main causes of stridor in children

A

Infection
Foreign Body
Anaphylaxis/ Angioneurotic oedema
Other (eg burns)

31
Q

Main causes of stridor in adults

A 
Neoplasms
Anaphylaxis 
Goitre
Trauma (burns, strangulation, irritant gases)
Bilateral vocal cord palsy
Cricoarytenoid arthritis 
Tracheopathia
32
Q

Infections causing stridor in children

A 
Epiglottitis
Croup/ Pseudomembranous croup
Retropharyngeal abscess
Diphtheria
Infectious mononucleosis
33
Q

Tracheomalacia

A

Inflammatory condition which causes destruction of cartilage

34
Q

Investigation in stridor

A 
Laryngoscopy (beware in acute epiglottitis)
Bronchoscopy
Flow volume loop
Chest X ray
Other imaging
35
Q

Treatment of laryngeal obstruction

A

Treat underlying cause eg foreign body removal,
Mask bag ventilation with high flow O2
Cricothyroidotomy
Tracheostomy

36
Q

Treatment of malignant airway obstruction

A

Tumour removal (laser; photodynamic therapy; cryotherapy; diathermy; surgical resection)
Tumour compression
Radiotherapy
Chemotherapy

37
Q

Acute anaphylaxis

A 
Type 1 Hypersensitivity (IE)
Flushing, pruritus, urticaria
Angioneurotic oedema
Abdominal pain, vomiting
Hypotension
Stridor, wheeze and respiratory failure
38
Q

Treatment of anaphylaxis

A 
IM Adrenaline
IV antihistamine
IV corticosteroid
High flow O2
Nebulised bronchodilators
Endotracheal intubation
39
Q

Snoring

A

Relaxation of pharyngeal dilator muscles during sleep
Upper airway narrowing
Turbulent airflow
Vibration of soft palate and tongue base

40
Q

Obstructive sleep apnoea

A

Intermittent upper airway collapse in sleep
Hypoxia
Sleep fragmentation

41
Q

Risk factors for sleep apnoea

A 
Enlarged tonsils
Obesity
Retrognathia
Acromegaly
Oropharyngeal deformity
Neurological
Drugs/alcohol
Post-operative period
42
Q

Clinical presentation of sleep apnoea

A

Excessive daytime sleepiness
Personality change
Cognitive / functional impairment
Major impact on daytime function

43
Q

Consequences of sleep apnoea

A 
Hypertension
Activated sympathetic system
Raised CRP
Impaired endothelial function
Impaired glucose tolerance
Increased CDV risk
44
Q

Diagnosis of sleep apnoea

A 
Snoring &amp; EDS (raised Epworth score)
Overnight sleep study
		- oximetry
		- domicillary recording 
		- full polysomnography
45
Q

Treatment for obstructive sleep apnoea

A

Remove underlying cause
Continuous Positive Airway Pressure (CPAP)
Mandibular Advancement Device
Surgery

Respiratory (19 decks)

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