Conditions Flashcards
which goes to the chest Preceded by common cold Clinical features Productive cough Fever – minority of cases Normal chest examination Normal chest X-ray May have a transient wheeze
Acute bronchitis
Chicken pox pneumonia in which group of people?
Adult smokers!
These patients can die from this type of pneumonia
Complications of mycoplasma pneumoniae are common, list some of these?
haemolytic anaemia, erythema multiformes, hepatitis, meningoencephalitis
Complications of influenza?
Difference between primary and secondary pneumonia?
Death 0.37% Primary viral pneumonia Dry cough, bloody sputum and respiratory failure within 24 hours of onset of initial fever Secondary bacterial pneumonia A new fever on day 7 Myositis (Skeletal and cardiac) Encephalitis Depression
Who do you give pneumococcal and influenza vaccines to?
Influenza and pneumococcal vaccines Over 65 Chronic chest or cardiac disease Diabetes Immunocompromised e.g. splenectomy Influenza vaccine Health care workers
Hospital acquired
Need extended gram negative cover
Aspiration pneumonia
Need anaerobic cover
Gram negative: gentamicin
Anaerobic: metronidazole
CURB65
C New onset of confusion U Urea >7 R Respiratory rate >30/min B Blood pressure Systolic < 35 or > 40 Cyanosis PaO2 < 8 kPa WBC < 4 or > 30 Multi-lobar involvement
Acute exacerbation of chronic bronchitis management?
Management in primary care Antibiotic. e.g. doxycycline or amoxicillin Bronchodilator inhalers Short course of steroids in some cases Refer to hospital if Evidence of respiratory failure Not coping at home
Management in hospital – same as before AND
Measure arterial blood gases
CXR to look for other diseases
Give oxygen if has respiratory failure
Sarcoidosis hypersensitivity?
Type 4
Calcium levels in sarcoidosis?
Hypercalcemia
Skin condition associated with sarcoidosis?
Erythema nodosum
Activity level marker in sarcoidosis?
ACE
you also have raised calcium and raised inflammatory markers
Treatment for Sarcoidosis
Treatment
Acute: self-limiting condition - usually no treatment
Steroids if vital organ affected (eg impaired lung function, heart, eyes, brain, kidneys)
Chronic: oral steroids usually needed
Immunosuppression (eg azathioprine, methotrexate)
monitor chest X-ray and pulmonary function for several years
often relapses
Extrinsic allergic alveolitis hypersensitivity?
Type III
Gold, bleomycin and sulfasalazine could cause which ILD?
EAA
EAA presentation
Cough, breathlessness, fever, myalgia
Signs of EAA?
Crackles
clubbing is unusual!
Pulmonary fibrosis in EAA?
Upper zones
FEV1 & FVC and TLCO in EAA?
low FEV1 & FVC, high or normal ratio, low gas transfer - TLCO
Drugs which could cause idiopathic pulmonary fibrosis?
Amiodarone, methotrexate
Progressive breathlessness (over several years) Dry cough
Idiopathic pulmonary fibrosis
Clubbing in idiopathic pulmonary fibrosis?
Yes
clubbing, bilateral fine inspiratory crackles
Idiopathic pulmonary fibrosis
Fibrotic change worse where in idiopathic pulmonary fibrosis?
At the lung bases
Caplan’s syndrome?
Rheumatoid arthritis and pneumoconiosis
Silicosis on x-ray?
Egg shell calcification of hilar nodes
Presentation of malignant mesothelioma?
Pleural effusion and chest pain
Acute asbestos pleuritis presentation?
Fever, pain, bloody pleural effusion
