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Core conditions Respiratory Flashcards

1
Q

Generic treatment for Staph. Aureas infections?

A

Flucloxicillin

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2
Q

Generic treatment for Strep infections?

A

Penicillin

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3
Q

List the common presentations of Respiratory conditions.

A 
Cough
Sputum  - clear, yellow, green
Haemoptysis
Wheeze/Stridor
Chest pain - pleuritic
SOB
Cyanosis
Weight loss
Clubbing
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4
Q

Name the common Respiratory condtions.

A 
Asthma
COPD
PE
Pneumothorax
Pleural effusion
Bronchial carcinoma
Lobar pneumonia
Pulmonary fibrosis
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5
Q

What is the most common Occupational disease?

A

Asthma

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6
Q

Asthma = ?

A

Chronic inflammation of the small airways

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7
Q

Risk factors of asthma?

A

FH/PMH (atopic triad)
Parental smoking
Low birth weight
Premature birth

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8
Q

A ten year old boy comes into the GP and has asthma, he presents as having…

A 
Cough   (esp noctural)
\+/- sputum
SOB (exertion)
Wheeze
Chest tightness
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9
Q

You go on to examine the boy for signs of asthma. What would you look out for?

A

Use of accessory muscles

Auscultation - wheeze

Peak flow - low

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10
Q

Diffrentials of asthma in children?

A

Viral-induced wheeze
CF
Tumour

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11
Q

The diffrentials of asthma differ in adults. What are they?

A 
COPD
Bronchiectasis
Inhaled foreign body
PE
Pneumothorax
Lung Cancer
Sarcoidosis
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12
Q

The boy in the GP goes to see the HCA for spirometry. What results would you expect to see with asthma?
What would you see in a CXR?

A

FEV/FEV1 < 0.7 (reversible with Salbutamol)

CXR - hyper-inflated lungs

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13
Q

State the treatment for asthma.

How would you explain it to the patient?

A

SABA e.g. Salbutamol (blue inhaler, reliever)

/LABA - Sameterol, Foromterol

Corticosteroid e.g. Beclametasone, Predisolone (Brown inhaler - preventer)

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14
Q

You advise the asthma patient to avoid their triggers. What could they be?

A

House-duse mite
Exercise
Cold
Air-bourne irritants

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15
Q

Name possible complications of asthma in children/adults.

A

Acute exacerbations
Delayed growth/puberty
Cor pulmonale
Impaired QoL

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16
Q

The patient asks what the side effects of Salbutamol are. What would you say?

A

Tremor
Palpitations
Decrease [K+]

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17
Q

COPD is irreversible and progressive. What 2 conditions make up COPD?

A

Chronitic bronchitis

Emphysema

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18
Q

Who tends to get COPD?

A

Smokers
Coal miners (occupational)
> 35yrs

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19
Q

The presentation of COPD is similar to asthma. What additional presentation may they have in COPD?

A

Cough, sputum, wheeze, SOB

COR PULMONALE

20
Q

What signs would you see in a patient that would suggest COPD?

A 
SOB - use of accessory muscles
Cyanosis
Pursed lips
Peak flow - low
Auscultation - wheeze

Pulmonary oedema, raised JVP - Cor pulmonale

21
Q

Investigations for COPD are the same as asthma i.e Spirometry, CXR. What would find in COPD?

A

FEV/FEV1 < 0.7 (irreversible after Salbutamol)

CXR: Hyper-inflated chest

22
Q

What are the diffrentials of COPD?

think of persistent cough

A 
Asthma
Bronchiectasis
Lung Cancer
Interstitial Lung D
TB
Anaemia
23
Q

State treatments used in COPD.

A 
SABA
LABA
SAMA
LAMA
Corticosteroid
02
24
Q

The complications of COPD are numerous. State some of them.

A 
Acute exacerbations
Recurrent infections
2" polycythaemia 
Cor pumonale
Lung Cancer
Disbaility
Depression
25
PE = clot in pulmonary venous system from leg veins causing obstruction and therefore reduced gas exchnage and reduced cardiac ouput. T/F?
F Clot in pulmonary ARTERIAL system
26
Name the risk factors of PE.
``` Previous PE DVT/Previous DVT Immobolisation - surgery, leg fracture Pregnancy Cancer obesity ```
27
You walk into an elderly ward and are told by the nurse that one of the patients is having a PE. What symptoms would you expect the patient to have?
Sudden SOB Pleuritic chest pain Haemoptysis Syncope/Dizzy
28
What signs are common in PE?
``` Tachypnoea > 25 bpm Tachycardia > 100bpm Hypotension Fever/Cough Cyanosis Raised JVP Pleural rub Syncope ```
29
The diffrentals of PE are numerous and cover acute conditions in which systems?
RESPIRATORY - ARDS, pneumothorax CV - Acute coronoary syndromes, Angina, Cardiogenic shock, Aortic stenosis, Core pulmonale, Cardiomypoathy, AF NEUROLOGICAL - syncope PSYCHOLOGICAL - Anxiety
30
You suspect the patient on the ward has a PE. What investigations would you do?
``` CT pulmonary angiography D-Dimer (low specificity) ABG ECG FBC, U&Es, Clotting ``` (Two level PE Well's score)
31
Treatment for PE has a pathway. Describe the pathway for a small PE.
02 --> Morphine --> LMW Heparin (Tinziparin) --> Warfarin (If systolic BP > 90mmHg)
32
What is the treatment pathway for a massive PE?
02 --> Morphine --> Thrombolysis (Alteplase)/ Surgery --> If systolic BP < 90mmHG, colloid fluids --> if BP still low, Noradrenaline
33
What is the condition where the lung collapses due to air collection in the pleural cavity?
PNEUMOTHORAX
34
Tension pneumothorax is an emergency. T/F?
T
35
How many types of pneumothorax are there? What are they?
2 types: 1" pneumothorax = spontaneous 2" pneumothorax = ass with underlying Lung D/ Conn Tissue D
36
Which type of pneumothorax typically occurs in young thin males/ in trauma/iatrogenic/rupture of sub-pleural bulla?
1" pneumothorax
37
2" pneumothorax can occur with underlying lung D e.g. asthma, COPD, pneumonia, lung abscess, cancer etc..and what other underlying conditions?
Conn Tissue Disorders: - Marfan's - Enlos-Danlos
38
State the 5 risk factors for pneumothorax.
``` Tall Smoking Lung D Conn Tissue Disorder Sub-pleural bulla ```
39
What symptoms would a patient complain of in pneumothorax?
ASYMPTOMATIC Sudden SOB +./- pleuritic chest pain Deterioration of Lung D
40
Symptoms of pneumothorax are similar to PE minus haemoptysis. What signs would you see that would rule out PE?
Reduced expansion Hyper-resonant - percussion Reduced breath sounds - auscultation Tachycardia
41
A pneumothorax presents similar to a PE. What are the other diffrentials?
Same diffrentials as PE | acute
42
How would you treat pneumothorax?
Chest drain Aspiration 02, 100%
43
What is the main complication of pneumothorax?
RECURRENCE
44
What is the term given for fluid in pleural cavity from transudates or exudates?
Pleural effusion
45
Pleural effusions can be ASYMPTOMATIC. If they are not, what symptoms could a patient complain of?
SOB | Pleuritic chest pain

Year 3 (2 decks)

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