Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Respiratory > Conditions > Flashcards

Conditions Flashcards

1
Q

Asthma

A

= recurrent episodes of dyspnoea, cough and wheeze caused by reversible airway obstruction
Clinical: tachypnoea, audible wheeze, hyperinflated chest, diminished air entry
Ix: PEF, spirometry (normal bloods)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Signs of Severe Asthma Attack

A

Unable to complete sentances, RR > 25/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Managment of Chronic Asthma

A
  1. SABA
  2. SABA and ICS
  3. SABA and ICS and LABA
  4. If LABA ineffective swap for leukotriene receptor/oral theophylline: if LABA helping, increase dose
  5. Oral Prednisalone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Management of Acute Asthma Attack

A 
Oxygen (100% non-rebreather mask)
Nebulised Salbutamol
IV Hydrocortisone OR PO Prednisalone
Ipratropium Bromide
Theophylline
Mag Sulphate (anaesthetist)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

COPD

A

= combined effect of chronic bronchitis and emphysema > characterised by airway obstruction with little or no reversibility
Clinical: chronic dyspnoea, sputum production, wheeze
Ix: pulmonary function tests, show obstructive pattern
Complications: acute exacerbations, infection, respiratory failure, pneumothorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Management of Chronic COPD

A
  1. SAMA
  2. LAMA
  3. LAMA and ICS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Management of Acute COPD

A
  1. 2-28% oxygen
  2. High dose salbutamol and ipratropium (nebulized)
  3. Oral Prednisalone
  4. Amoxicillin
  5. Doxapram
    May need intubation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Pathology of Bronchiectasis

A

= chronic infection of the bronchi and bronchioles which leads to localised reversible dilation of the bronchial tree
- The dilated, inflammed bronchi are easily collapsible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Bronchiectasis

A

Agents: H. influenzae, Strep. pneumoniae, Staph. aureus
Causes: CF, measles, pertussis, bronchiolitis, pneumonia, TB, bronchial obstruction
Clinical: persistent cough, purulent sputum, wheeze, crackles, haemoptysis
Ix: sputum culture, CXR, high resolution CT, spirometry (obstructive pattern)
Management: postural drainage, antibiotics
- Bronchodilators may be useful in COPD and asthma patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Cystic Fibrosis

A

= autosomal recessive condition: mutations in the CFTR gene on chromosome
Clinical: failure to thrive
Resp (cough, wheeze, recurrent infections, bronchiectasis, haemoptysis, pneumothorax)
GI (pancreatic insufficiency, gallstones, cirrhosis)
Ix: genetic testing
Managment: regular physiotherapy, prophylactic antibiotics, enzyme replacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Pulmonary Embolism

A

= usually as a result of venous thrombus, clots break off and pass through the veins, R side of heart and into pulmonary circulation
Rarer causes: air, fat or amniotic fluid embolism
RF: recent surgery, thrombophilia, fracture, malignancy, previous PE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Clinical Signs and Ix of PE

A

Clinical: acute breathlessness, pleuritic chest pain, haemoptysis, cyanosis, tachypnoea, pleural rub, hypotension
- Features depend on size/vessel blocked
Ix: Bloods, D-Dimer, ABG, V/Q scan, CT pulmonary angiogram?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Management of PE

A 
Hypoxic = give oxygen
Pain = morphine (may need anti-emetic)
Critical - immediate thrombolysis (tPa)
Not Critical - heparin
- LMW heparin 
- Unfractioned heparin
Low Systolic = rapid colloid infusion, dobutamine, (if not given) thrombolysis
Good Systolic = start warfarin regimen, confirm diagnosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Type I Respiratory Failure

A

Hypoxia with a normal PaCO2 - usually the result of a V/Q mismatch
Causes: pneumonia, PE, asthma, emphysema
Clinical: dyspnoea, restlessness, confusion, central cyanosis
Ix: Bloods, ABG, CXR, blood cultures
Managment: treat underlying cause, high flow oxygen - may need assisted ventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Type II Respiratory Failure

A

Hypoxia with hypercapnia, caused by alveolar hyperventilation
Causes: COPD, asthma, pneumonia, reduced respiratory drive
Clincal: dyspnoea, confusion, headache, tachycardia, coma
Ix: Bloods, ABG, CXR, blood cultures
Management: treat underlying cause, give oxygen with care (e.g. COPD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Acute Respiratory Distress Syndrome

A

= lung damage and release of inflammatory mediators causes increased capillary permeability and pulmonary oedema - often accompanied by multi-organ failure
Cause:
Pulmonary (pneumonia, inhalation, injury, aspiration)
Other (shock, sepsis, haemorrhage, ALF, trauma, eclampsia)
Clinical: cyanosis, tachypnoea, tachycardia, bilateral fine crackles
Ix: Bloods (inc FBC and amylase), cultures, ABG, CXR
Management: ICU, supportive therapy ( treat underlying cause)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Management of ARDS

A

Early: continuous positive pressure ventilator with 40-60% oxygen > most need mechanical ventilation
- Diuretics (-VE fluid balance)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Indication for Ventilation

A

PaO2 < 8.3 kPa AND/OR PaCO2 > 6kpa

This is DESPITE 60% oxygen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Sarcoidosis

A

= multisystem granulomatous disease - it is a Type IV hypersensitivity reaction which causes pulmonary fibrosis
- Involves lymph nodes, joints, liver, skin
Clinical: asymptomatic
ACUTE - erythema nodosum which resolves itself
Pulmonary - bilateral hilar lympahdenopathy, infiltrates, dry cough, dyspnoea, chest pain
Ix: CXR, spirometry (restrictive)
Can have raised calcium and LFTs
Management: bed rest, NSAIDs - use of corticosteroids in interstitial lung disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Interstitial Lung Disease

A

= collective term for conditions which affect the lung interstitium/parachyma in a diffuse manner
- Characterised by chronic inflammation, progressive fibrosis
Clinical: SOB on exertion, non-productive paroxysmal cough, abnormal breath sounds, abnormal CXR, high resolution CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Classification of ILD

A
  1. Those with known cause
  2. Those with associated systemic disorders
  3. Idiopathic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Extrinsic Allergic Alveolitis or Hypersensitivity Pneumonitis

A

= type III hypersensitivity reaction to inhalation of allergens
ACUTE - alveoli are infiltrated with acute inflammatory cells
CHRONIC - granulomas form > obliterative bronchiolitis
Clinical: cough, breathlessness, fever, crackles, wheeze
- Chronically may have weight loss, increasing dyspnoea
Ix: CXR (upper zone mottling/consolidation), bloods, restrictive changes
- Chronically would show honeycomb lung
Management: removal of antigen, oxygen > oral prednisalone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Causes of EAA/HP

A

Bird-Fanciers Lung
Pigeon-Fanciers Lung
Farmer’s/Mushroom Worker’s Lung
Malt/Sugar Worker’s Lung

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Idiopathic Pulmonary Fibrosis

A

= a type of idiopathic interstitial pneumonia: it is an inflammatory cell infiltrate and pulmonary fibrosis disorder
Clinical: dry cough, exertional dyspnoea, malaise, weight loss, arthralgia, cyanosis, finger clubbing
Ix: Bloods (ABG), CXR (LOWER zone shadows of honeycomb lung) CT scan, restrictive pattern, lung biopsy
Management: mostly supportive, oxygen, opiates, palliative care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Coal Workers Pneumoconiosis

A

= inhalation of coal dust particles which are ingested by macrophages
- The death of the macrophages causes fibrosis
CXR: may show round opacities, UPPER zones
Usually asymptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Silicosis

A

= inhalation of silica particles which are very fibrogenic
Clincal: shows progressive dyspnoea, increased incidence of TB
CXR: miliary or nodular pattern in UPPER zones
- Spirometry shows restrictive defects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Asbestosis

A

= inhalation of asbestos fibres (blue most fibrogenic)
Clinical: progressive dyspnoea, clubbing, fine crackles
- Can cause pleural plaques, bronchial adenocarcinoma, mesothelioma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Caplan’s Syndrome

A

Association between rheumatoid arthritis, pneumoconiosis and pulmonary rheumatoid nodules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Pulmonary Oedema

A

= collection of watery fluid in the lungs making it difficult to breath
Causes: heart failure, high altitude exposure, ARDS, kidney failure, lung damage
Clinical: coughing up blood (pink frothy sputum), PND, shortness of breath
Ix: CXR, echocardiogram, ECG
Managment: treatment of underlying causes, oxygen, loop diuretics, nitrates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Pleural Effusion

A

= fluid in the pleural space which can be transudate or exudate
Clinical: usually asymptomatic/dyspnoea, pleuritic chest pain, stony dull to percuss, diminished breath sounds, bronchial breathing (if lung compressed)
Ix:
CXR - small effusions blunt angle
Diagnostic aspiration - draw off 10-30ml pleural fluid
Pleural biopsy, ultrasound
Management: treat underlying cause, drainage or pleurodesis (if mesothelioma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Blood in pleural space

A

Haemothorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Pus in pleural space

A

Empyema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Both blood and air in pleural space

A

Haemopneumothorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Transudate

A 
<30g/l
Increased venous pressure 
e.g. cardiac failure, constrictive pericarditis, fluid overload
OR
Hypoproteinaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Exudate

A

> 30g/l

Increased leakiness of pleural capillaries secondary to infection, inflammation or malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Foul smelling pleural effusion

A

Anaerobic Empyema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Food particles in pleural effusion

A

Oesophageal Rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Straw coloured pleural effusion

A

Cardiac Failure

Hypoalbuminaemia

39
Q

Influenza

A

Influenza A = Pandemics
Flu-like illness = parainfluenza viruses
Clinical: fever (high, abrupt onset), malaise, headache, cough
Ix: PCR, antibody detection, culture
Treatment: self-limiting + paracetamol, antivirals can be used in serious cases e.g. oseltamivir
Prevention: killed vaccine (HC workers, complex patients)

40
Q

Bronchiolitis

A 
= bronchi inflammation and occlusion
Causes: RSV, metapneumovirus
Clinical: 1st/2nd year of life, fever, corzya, cough, wheeze
Ix: PCR on throat or nasal swabs
Treatment: supportive treatment
41
Q

Pertussis

A

= acute tracheobronchitis
Clinical: cold-like symptoms, paroxysmal cough, vomiting is common
Ix: serologoy of nasal swabs
Management: Erithromycin

42
Q

Lung Abscess

A

= cavitating area of localised supportive infection withing the lung
Causes: inadequately treated pneumonia, aspiration, obstruction, infection, septic emboli
Clinical: swinging fever, cough, foul smelling sputum, pleuritic chest pain, weight loss, malaise
Ix: Bloods, CRP, cultures
CXR - walled off cavity

43
Q

Tuberculosis

A

= infectious disease of the respiratory tract > macrophages from a caseating granuloma: usually in the lungs
Clinical: GRADUAL > cough, sputum, weight loss, malaise, night sweats, haemoptysis, breathlessness
Ix: ZN stain, INF-gamma test, bronchosopy
CXR - caseous necrosis, fibrosis, calcification in UPPER lobes

44
Q

Management of Pulmonary TB

A

2 Months = rifampicin, isoniazid, ethambutol, pyrazinamide

4 months = rifampicin, isoniazid

45
Q

Pneumonia

A

= acute respiratory tract illness associated with fever, chest signs and abnormal x-ray
Clinical: fever, rigors, malaise, anorexia, dyspnoea, cough, sputum, pleuritic pain, haemoptysis
Ix: identify pathogen and assess severity, assess oxygenation, CXR

46
Q

Causes of CAP

A

Strep pneumoniae
H. influenzae
Mycoplasma pneumoniae

47
Q

Causes of HAP

A

Gram negative enterobacteria

Staph aureus

48
Q

Causes of pneumonia in the immunocompromised patient

A 
Strep pneumoniae
H. influenzae
Staph aureus
Gram -VE bacilli
Pneumocystis
49
Q

Management of CURB CAP 0-2

A

Amoxicillin (Doxycycline if penicillin allergic)

50
Q

Management of CURB CAP 3-5

A

Co-amoxiclav (Levofloxacin if allergic)

Doxycycline

51
Q

Managment of ICU/HDU pneumonia

A

Co-amoxiclav (Levofloxacin if allergic)

Clarithromycin

52
Q

Management of Acute Exacerbation of COPD

A
  1. Amoxicillin

2. Doxycycline

53
Q

Chlamydia psittaci

A
  • From birds (parrots)

CXR: patchy consolidation

54
Q

Management of Chlamydia psittaci pneumonia

A

Doxycycline
OR
Clarithromycin

55
Q

Chalmydia pneumoniae

A
  • Illness of two phases (phrayngitis > pneumonia)
56
Q

Management of Chalmydia pneumoniae

A

Doxycycline
OR
Clarithromycin

57
Q

Legionella pneumonia

A
  • Water tanks/air conditioning units
  • Flu-like, dry cough
    CXR: bi-basal consolidation
58
Q

Management of Legionella pneumonia

A

Clarithromycin/erythromycin
OR
Levofloxacin

59
Q

Staphylococcal Pneumonia (staph aureus)

A
  • May be a complication of influenza
  • Young, elderly, IV drug users
    CXR: bilateral cavitating pneumonia
60
Q

Management of Staphylococcal Pneumonia

A

Flucloxacillin
- May add in rifampacin
MRSA - Vancomycin

61
Q

Klebsiella Pneumonia

A

Rare - usually elderly, diabetics, alcoholics

CXR: cavitating in UPPER lobe

62
Q

Management of Klebsiella Pneumonia

A

Cefotaxime

63
Q

Mycoplasma pneumoniae

A

Epidemics every 4 years
- Dry cough
Complications: erythema multiforme, G-B and S-J syndrome
CXR: patchy shadowing of one lower lobe

64
Q

Management of Mycoplasma pneumoniae

A

Clarithromycin/Doxycycline

65
Q

PCP

A
  • In the immunosuppressed e.g. HIV
    Clinical: dry cough, exertional dyspnoea, fever, bilateral crepitations
    CXR: interstitial shadowing - some cavitation
66
Q

Management of PCP

A

Co-trimoxazole

67
Q

Obstructive Sleep Apnoea Syndrome

A

= intermittent closure/collapse of the pharyngeal airway which causes episodes during sleep
Clinical: Typical = obese middle aged man, presents because of snoring or day time somolence
Poor sleep quality, morning headache
RF: enlarged tonsils, adenoids, obesity, hypothyroidism, COPD, drugs
Ix: pulse oximetry, sleep study
Management: weight reduction, avoidance of tobacco/alcohol, nasal mask

68
Q

Aspergillus Affects the Lung…

A
  1. Asthma
  2. Allergic Bronchopulmonary Aspergillosis
  3. Aspergilloma
  4. Invasive Aspergillosis
69
Q

Asthma

A

Type I Hypersensitivity reaction

70
Q

Allergic Bronchopulmonary Aspergillosis

A

= type I and III hypersensitivity reactions
bronchoconstriction > continued inflammation = bronchiectasis
Clinical: wheeze, cough, sputum, dyspnoea
Ix: CXR, aspergillus in sputum, eosinophilia and raised IgE

71
Q

Mycetoma (aspergilloma)

A

= fungus ball with a pre-existing cavity, usually asymptomatic
Clinical: cough, lethargy, haemoptysis, weight loss
Ix: CXR - apacity within a cavity
Managment: Surgical excision of solitary lesions

72
Q

Invasive aspergillosis

A

RF: immunocompromised, broad spectrum antibiotic therapy
Ix: sputum culture, biopsy
CXR - consolidation, abscess
Treatment: voriconazole

73
Q

Cor pulmonale

A

= right heart failure as a result of pulmonary hypertension
Cause: pulmonary hypertension, lung disease
Clinical: dyspnoea, fatigue, syncope, cyanosis, tachycardia, raised JVP, pansystolic murmur (tricuspid regurgitation), hepatomegaly
Ix: FBC, ABG (hypoxia with/without hypercapnia)
CXR - enlarged right side, prominent pulmonary arteries
ECG - right axis deviation and hypertrophy

74
Q

Primary Pulmonary Hypertension

A

Disease of the arteries within the lung themselves

75
Q

Management of Cor Pulmonale

A

ACUTE - oxygen, monitor the ABG and gradually increase

Cardiac Failure treated using loop diuretics and U&E monitored

76
Q

Pneumothorax

A

= can be primary or secondary (e.g. COPD)
Causes: spontaneous, asthma, COPD, TB, pneumonia, connective tissue disorders
Clinical: asymptomatic, sudden onset of dyspnoea, pleuritic chest pain, rapid deterioration
= reduced exaspansion, hyper resonance, diminished breath sounds
Ix: CXR - reduced lung markings

77
Q

Tension Pneumothorax

A
  • Similar signs, trachea may be deviated away from affected side - MEDICAL EMERGENCY
    Treatment: high flow oxygen and needle flow compression: 2nd intercostal space in mid clavicular line and chest drain
78
Q

Non-small cell cancer

A

Large Cell
Adenocarcinoma
Squamous Cell Carcinoma (SCC)

79
Q

Large Cell

A

Poorly differentiated

Metastasises early

80
Q

Adenocarcinoma

A
  • Usually peripheral
    Origin: mucus secreting glandular cells
    Most common type in non-smokers
81
Q

Squamous Cell

A

Occurs centrally, often obstructing lesions of the bronchus

Origin: epithelial cells

82
Q

Associations with squamous cell

A

Parathyroid hormone related protein (results in hypercalcaemia)
Finger clubbing

83
Q

Small Cell Carcinoma

A

Central and metastasises early

Origin: neuroendocrine cells

84
Q

Associations with small cell carcinoma

A

Polypeptide hormones;
ACH
ACTH

85
Q

Bronchial Carcinoma

A
  • Can be divided into small cell and non-small cell
    RF: Cigarette smoking (asbestos)
    Clinical: cough, haemoptysis, dyspnoea, unexplained weight loss, chest pain, lethargy, anorexia, clubbing, pleural effusion
    Ix: FBC, CXR, CT scan, bronchoscopy and biopsy
86
Q

Management (NON-SMALL CELL)

A

Excision if possible, curative radiotherapy

87
Q

Management (SMALL CELL)

A

Usually disseminated, can respond to chemotherapy (usually a palliative option)

88
Q

Complications of Bronchial Carcinoma

A

Recurrent laryngeal nerve palsy
Dysphagia (compression)
Metastatic complications

89
Q

Pancoast Tumour

A

Apex of the lung, invades the brachial plexus > SVC obstruction

90
Q

Mesothelioma

A

= tumour of the mesothelial cells which usually occurs in the pleura
- Very strong association with previous asbestos exposure
Clinical: chest pain, dyspnoea, weight loss, finger clubbing, recurrent pleural effusions
Ix: CXR, CT scan, histology of pleural fluid
Managment: chemotherapy can improve survival

91
Q

Pseudomonas

A
  • In those with bronchiectasis and CF

- Usually hospital acquired

92
Q

Management of Pseudomonas Pneumonia

A

Ciprofloxacin

Gentamicin

93
Q

Classic PE presentation

A

Swollen ankle/leg
One sided chest pain
Chest pain worse on inspiration

Respiratory (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions