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Second Year Medicine 1 > Common Cardio and Resp diseases > Flashcards

Common Cardio and Resp diseases Flashcards

1
Q

Asthma aetiology

A

Atopy - familial, IgE.

Airway hyper responsiveness and intermittent airway obstruction.

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2
Q

Signs of Asthma

A 
Tachypnoea
Audible wheeze 
Hyper inflated chest
Hyper resonant percussion. 
Decreased air entry - widespread polyphonic wheeze.
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3
Q

Symptoms of Asthma

A

Intermittent dyspnoea
Wheeze
Cough (nocturnal)
Sputum production

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4
Q

Investigations for Asthma

A 
Peak Expiratory Flow on walk before and after dilators
Spirometry
Exercise tolerance test
FBC 
Skin prick for allergen
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5
Q

Treatment for Asthma

A
  1. Inhaled short acting B2 agonist
  2. Add standard dose of inhaled corticosteroid
  3. Add Long acting beta agonist.
  4. Consider trials of increasing corticosteroid.
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6
Q

What is COPD?

A

Chronic Obstructive Pulmonary Disease - Bronchitis, Emphysema,.

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7
Q

Causes of COPD

A

Smoking
Air pollution
Occupational exposure

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8
Q

Signs of COPD

A 
Use of accessory muscles on expiration 
Decreased chest expansion 
Coarse crackles 
Hyper - resonance 
Clubbing
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9
Q

Symptoms of COPD

A

Morning cough - then constant.
Productive sputum
SOB
Wheeze

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10
Q

Investigations for COPD

A 
FBC
Spirometry 
Chest X-ray 
ECG (cor pulmonale)
Arterial Blood Gas
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11
Q

Treatment for COPD

A 
Smoking cessation 
Pulmonary rehabilitation 
1. Short-acting beta agonist. 
Systemic corticosteroid 
2. Inhaled corticosteroid 
3. Long acting beta agonist or Long acting muscarinic antagonist.
Oxygen (long term)
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12
Q

Lung cancer aetiology

A 
Smoking 
Asbestos 
Environmental 
Occupation 
Air pollution
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13
Q

What are the different types of lung cancer?

A

Squamous cell carcinoma (40%)
Adenocarcinoma (41%)
Small cell carcinoma (15%)
Large cell carcinoma (4%)

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14
Q

Signs of Lung cancer

A 
Chest signs 
Finger clubbing
Lymphadenopathy 
Horner's syndrome 
Hepatomegaly
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15
Q

Symptoms of lung cancer

A 
Cough 
Haemoptysis
Dyspnoea 
Chest pain 
Recurrent pneumonia 
Unexplained weight loss.
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16
Q

Investigations for lung cancer

A 
Chest x-ray 
FBC
LFT 
Spirometry 
CT thorax and abdomen
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17
Q

Treatment for Lung cancer

A

Surgery (lobectomy)
Radiotherapy
Chemotherapy
Immunotherapy

T (tumour) N (nodes) M (metastases) staging used for severity.

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18
Q

Tuberculosis aetiology

A

Mycobacteria species, mainly:
mycobacterium tuberculosis and mycobacterium bovis.
HIV

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19
Q

TB signs

A

Lung consolidation
Bronchial breath sounds
Crackles on auscultation

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20
Q

TB symptoms

A 
Presence of risk factors
Cough
weight loss
Fever
Night sweats
Fatigue and malaise
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21
Q

TB investigations

A 
3 sputum specimens on successive days (smear, culture and PCR)
Chest X-ray 
CT thorax
Bronchoscopy 
Biopsy
22
Q

TB treatment

A 
Rifampicin 
Isoniazid
Ethambutol
Pyrazinamide
All for 2 months

Then for 4 months
Rifampicin
Isoniazid

23
Q

Side effects of TB drugs

A

Rifampin - Orange urine, tears, inactivation of oral contraceptive.

Isoniazid - Hepatitis and peripheral neuropathy

Ethambutol - Optical neuropathy

Pyrazinamide - Gout

24
Q

Stable angina aetiology and risk factors

A

Atherosclerosis
Thrombosis / Blood clot
Risk factors: Obese, history of heart disease, high cholesterol, hypertension,d diabetes.

25
Q

Signs of stable angina

A

Xanthalasma and corneal arcus.
Hypertension
Tremor
Tachycardia

26
Q

Symptoms of stable angina

A 
Central chest tightness - often radiation to neck and arms. 
Aggravated by exertion and stress.
Dyspnoea 
Dizziness 
Fatigue 
Sweating 
Palpitations
Claudication
27
Q

Investigations for stable angina

A

Exercise tolerance test
Stress ECHO
Exercise with ECG
Exercise stress test

28
Q

Treatment for stable angina

A

Relief by stopping activity/ stress.
Sublingual nitrate spray (GNT spray)
Smoking cessation
Treat risk factors - Hypertension, obesity etc

29
Q

Hypertension aetiology

A 
Polygenic 
Age 
Genetics and Fam history.
Environment 
Weight 
Alcohol 
Race - black more at risk.
30
Q

Signs of Hypertension

A

Retinopathy

BP over or equal to 140/90

31
Q

Symptoms of Hypertension

A

Usually not any
Chest pain
SOB

32
Q

Investigations for hypertension

A

BP home monitoring to confirm diagnosis.
ECG
Echocardiogram
Urine analysis

33
Q

Treatment for Hypertension

A

Step 1: CCB if over 55 and black. If CCB not suitable then thiazide type diuretic.

Ace inhibitor if <55yrs,
NOT WOMEN OF CHILD BEARING AGE OR BLACK ETHNICITY.

Step 2:
Thiazide-type diuretic added to CCB or Ace inhibitor.

Step 3:
Add ACE inhibitor, CCB and diuretic together.

Step 4:
Resistant hypertension:
low dose spironolactone or higher dose diuretic if K over 4.5mmol/l.

34
Q

What are the stages of hypertension?

A

Stage 1: Clinic BP 140/90 or higher.
Stage 2: Clinic BP 160/100mmHg or higher.
Severe: Systolic 180 or higher. Diastolic 110mmHg or higher

35
Q

Deep Vein Thrombosis aetiology

A 
Many factors:
Surgery
Lower limb problems 
Reduced mobility 
Previous proven venous thromboemboli
36
Q

DVT signs

A

Can be clinically silent.
Unilateral pitting oedema.
Unilateral limb swelling.

37
Q

DVT symptoms

A 
Warmth 
Erythema (redness)
Prominent collateral veins
Persisting discomfort 
Calf tenderness 
Pigmentation 
Ulceration (severe)
38
Q

DVT investigations

A

Clinical assessment
Pre-test probability score (well’s score)
Blood test ( D dimer has high sensitivity for VTE)
Compression Ultrasound

39
Q

DVT treatment

A 
Unfractionated heparin 
Low molecular weight heparin 
Warfarin
Direct oral anticoagulants 
Thrombylisis (massive DVT)
40
Q

NSTEMI / STEMI aetiology

A

Thrombosis
Atherosclerosis
Risk Factors:
Age, gender, family history, smoking, diabetes.

41
Q
  1. NSTEMI what is it?

2. STEMI what is it?

A
  1. Partial occlusion of coronary artery.

2. Complete obstruction of the coronary artery.

42
Q

Signs of 1. NSTEMI 2. STEMI 3. BOTH

A
  1. Common ST-segment depression and T wave inversion. ELEVATED troponin.
  2. ST segment elevation in ECG.
  3. Distress, anxiety, 4th heart sound, pallor, pan systolic murmur, low grade fever.
43
Q

Symptoms of NSTEMI and STEMI

A 
Extreme fatigue 
Dyspnoea 
Dizziness
Angina
Oedema 
Abdominal swelling 
Profuse sweating
44
Q

NSTEMI and STEMI Investigations

A 
ECG
Cardiac biomarkers (troponin) 
ECHO 
Elevated serum levels 
FBC
CT angiogram
45
Q

Treatment for NSTEMI

A 
MONAC:
Morphine 
Oxygen 
Nitro-glycerine
Aspirin 
Clopidiogrel 
ABAS:
Aceinhib
Beta blockers 
Aspirin 
Statins
46
Q

Treatment for STEMI

A

Primary coronary artery bypass or thrombolysis. Angiography.

MONAC:
Morphine
Oxygen 
Nitro-glycerine 
Aspirin 
Clopidogrel

MORE SEVERE

47
Q

Pneumonia aetiology

A

Strep pneumonia +ve
Staph aureus +ve
E.coli -ve

48
Q

Pneumonia signs

A 
Pyrexia 
Tachnopnoea
Central cyanosis 
Dullness on percussion of affected lobes.
Brachial breathing 
Increase vocal resonance
49
Q

Pneumonia symptoms

A 
Malaise 
Myalgia
Fever
Chest pain (pleuritic)
Cough 
Rusty sputum 
SOB
50
Q

Pneumonia investigations

A 
CRP and FBC
Chest X-ray 
Blood cultures 
Throat swab
HIV test
51
Q

Treatment for pneumonia

A

CURB65 (confusion, blood, Urea > 7, RR >30, diastolic BP<60 age > 65.

  1. Amoxycillin, or clarithromycin
  2. BOTH
  3. Then add amoxiclav

Oxygen, IV fluids, intubation.

Second Year Medicine 1 (27 decks)

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