Core Clinical Problems (Respiratory) Flashcards
Give 2 acute and 2 chronic causes of wet cough.
Acute: LRTI, pneumonia. Chronic: chronic bronchitis, bronchiectasis.
What 2 things should you ask for about sputum?
Volume, colour.
What does the SPUR acronym stand for (used to see if sputum cultures would be useful or not)?
Severe, persistent, unresponsive to treatment, recurrent.
When would a cancer cause a cough?
When it is big or close to the carina.
What are the 2nd look areas of CXRs when looking for cancers?
Apices, retrocardiac and retrophrenic.
What are the differential diagnoses of a dry cough?
Serious pathology, drug reaction, reflux, perennial rhinitis, asthma (cough variant).
How long does a cough have to be present for before it is unlikely to resolve?
A year.
What is the primary care management of chronic cough?
Smoking cessation, stop ACEI, lansoprazole 30mg BD and ranitidine 300mg nocte and gaviscon advance nocte (also maybe domperidone), Qvar 100 2p BD, nasal steroid BD.
What is the problem with 3rd line cough treatment?
They have bad side effects.
What is Ondine’s curse?
When you stop breathing when you go to sleep.
What are the likely causes for breathlessness if it is instant, acute, subacute and chronic?
Instant - pneumothorax, PE. Acute - asthma, pneumonia, acute MI, cardiac tamponade. Subacute - PE, pulmonary vasculitis, SVCO. Chronic - COPD, ILD, pulmonary hypertension, anaemia.
How can a physio help someone with dysfunctional breathing?
Breathing retraining.
What are the big 4 causes of haemoptysis?
Lung cancer, bronchiectasis, PE, TB.
What is embolisation of an artery?
When you put beads in a hole in the artery through a catheter put into the groin.
Give some rare examples of haemoptysis.
AVMS (hereditary haemorrhagic telangectasia), trauma, idiopathic pulmonary haemosiderosis, Wegener’s ganulomatosis, Goodpasture’s syndrome.
