Brainscape's Knowledge GenomeTM

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


See full index

Junior Medicine > Cough > Flashcards

Cough Flashcards

1
Q

How does a lung abscess present

A

Subacute productive cough
Foul smelling sputum
Night sweats

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

Commonest cause of stridor in children

A

Laryngomalacia

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

What is taken everyday for the treatment of asthma regardless of whether the patient has symptoms

A

Inhaled corticosteroids eg beclometasone dipropionate

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

Features of moderate asthma

A

PEFR 50-75% of best or predicted
Speech normal
RR <25 / min
Pulse <110 bpm

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

Features of severe asthma

A

PEFR 33-50% of best or predicted
Can’t complete sentences
RR >25/min
Pulse >110

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

Features of life threatening asthma

A

PEFR <33% of best or predicted
O2 sats <92%
Silent chest, cyanosis or feeble respiratory effort
Bradycardia, dysrhythmia or hypotension
Exhaustion, confusion or coma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

List conditions that lead to respiratory acidosis

A

Life threatening asthma (decompensated)
COPD
Opiate overdose
Benzodiazepines overdose
Neuromuscular disease
Obesity hypoventilation syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

List some conditions that cause respiratory alkalosis

A

Pulmonary embolism
Anxiety leading to hyperventilation
CNS disorders eg stroke, subarachnoid haemorrhage, encephalitis
Altitude
Pregnancy
Salicylate poisoning

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

Define asthma

A

Chronic inflammatory disorder of the airways secondary to T1 hypersensitivity
Symptoms are variable and recurring and manifest as reversible bronchospasm

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

CF of asthma

A

Wheezing
SOB
Worse during night or on exercise
Peak flow worse in morning
Chest tightness

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

Common asthma precipitants

A

Environmental allergens
Viral infections
Cold air
Emotion
Drugs: NSAID, B blockers
Atmospheric pollutants
Occupational pollutants

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

Features that suggest asthma diagnosis

A

Recurrent episodes
Variable symptoms
PH/FH of atopy
Recorded observation of wheeze
Variable PEF or FEV1
Absence of symptoms of an alternative diagnosis

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

2 phases of acute asthma

A

Early phase: bronchospasm due to spasmogen production - SM contraction narrows airway

Late phase due to chemotaxins attracting eosinophils and mononuclear cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Features of acute severe asthma

A

RR>25
HR >110
PEF 33-50% of best
Can’t complete sentences in 1 breath

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

Features of life threatening acute asthma

A

PEF <33% of best
SpO2 <92%
Silent chest, cyanosis, or feeble resp effort
Bradycardia, hypotension or dysarhythmia
Exhaustion or confusion

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

Blood gas features that indicate a life threatening asthma attack

A

Normal PaCO2: should normally be low due to hyperventilation - raised = near fatal

Severe hypoxia

Acidosis

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

Management of acute severe asthma

A

Oxygen 15L/min by non rebreather
Salbutamol 5mg via oxygen derived nebuliser
Ipratropium bromide 0.5mg
Oral prednisolone or IV hydrocortisone
CXR required if suspecting pneumothorax

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

Management of acute life threatening asthma

A

Discuss with ICU team
Add IV magnesium sulphate
Give nebulised salbutamol
IV aminophylline

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

Management of chronic asthma

A
  1. SABA prn (less than 3x per week)
  2. Low dose ICS for all with confirmed asthma
  3. LABA eg salmeterol
    If no response from LABA stop it and increase dose of ICS
    If not enough continue LABA and increase ICS
  4. Add leukotriene receptor antagonist if further needed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

MOA of B agonists

A

Relax bronchial SM leading to bronchodilation

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

What causes side effects of B agonists

A

Action on other B adrenoceptors eg B1 in heart leads to tachycardia
B2 in skeletal muscle leads to tremor and cramps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How long do SABAs work for as oppose to LABAs

A

SABA - 4-6hrs
LABA - >12hrs

23
Q

MOA of ICS

A

Reduce exacerbations due to anti inflammatory side effects

24
Q

Side effects of ICS

A

Oral candidiasis
Pneumonia

25
Q

MOA of LTRA

A

Block the effects of leukotrienes in the airways benefitting the actions of the ICS

26
Q

Side effects of LTRA

A

Thirst
GI disturbance
Churg strauss syndrome

27
Q

MOA of theophylline / aminophylline

A

Relax SM so dilate airways but also reduce exacerbations

28
Q

Side effects of theophylline / aminophylline

A

Dose related
In high dose can get headache, insomnia, nausea, tachycardia and arrhythmias

29
Q

Pathophysiology of COPD

A

Progressive airflow limitation that is not fully reversible associated with abnormal inflammatory response of the lungs to nitrous oxide particles or gases

Airflow limitation is due to decreased outflow pressure + increased airway resistance

30
Q

What is emphysema

A

Dilation of any part of the respiratory acinus with destructive changes in alveolar walls

Absence of scarring

31
Q

What is chronic bronchitis

A

Daily cough with sputum for at least 3mo per year for 2yrs

Abnormal amounts of mucus causes plugging of the airway lumen

Hypersecretion is due to hypertrophy and hyperplasia of bronchial mucus secreting glands

32
Q

What is bronchiolitis

A

Cigarette smokers also develop inflammation of the airways <2mm in diameter eg the bronchioles with macrophage and lymphoid cell infiltration

33
Q

COPD risk factors

A

Cigarette smoke exposure
Occupational exposure to dusts
A1-antitrypsin deficiency
Recurrent childhood chest infections
Low socioeconomic status
Asthma

34
Q

How does cigarette exposure predispose COPD

A

Stimulates neutrophils to produce elastase - this can inactivate a-1-antitrypsin and directly cause mucus gland hypertrophy

35
Q

CF of COPD

A

Productive morning cough
Increased amount of LRTIs
Slowly progressive dyspnoea and wheezing
Resp failure
Chronic right heart failure occurs late

36
Q

Signs of COPD

A

Mild disease:
- widespread wheeze

Severe disease:
- tachypnoea, hypoxia
- hyperinflation
-poor chest expansion
- hyperresonant throughout chest
- decreased breath sounds

37
Q

Complications of COPD

A

Acute exacerbations (infective or non)
Secondary polycythaemia
Cor pulmonale
Pneumothorax
Lung carcinoma

38
Q

Investigations for suspected COPD

A
  • post bronchodilator spirometry : FEV1/FVC ratio less than 70%
  • CXR - hyperinflation, bullae, flat hemidiaphragm
    FBC
    BMI
39
Q

How to calculate the severity of COPD

A

Use FEV1

> 80% of predicted = mild
50-79% of predicted = moderate
30-49% of predicted - severe
<30% = very severe

40
Q

Medical management of long term COPD

A

SABA or SAMA

If no features of asthma or steroid responsiveness: LABA +LAMA
Add ICS if still symptomatic or ongoing exacerbations

If features of asthma / steroid responsiveness: add LABA +ICS + LAMA (exacerbations)

41
Q

When is pulmonary rehabilitation considered

A

If a person is functionally disabled by COPD

Increases exercise capacity, decreases breathlessness and improves QOL

3 sessions per week for 6 weeks: physical, educational and behavioural

42
Q

When to consider long term oxygen therapy for patients with COPD

A

Assess for LTOT if patients have SpO2 <92% on air, FEV1 <30% of predicted, cyanosis, secondary polycythaemia or cor pulmonale

Assess while at their best

Must not be smokers

Increases survival if used for >15hr / day

43
Q

Management of pneumothorax

A

If <2cm and no SOB - consider discharge
If not aspiration attempted
If >2cm or SOB or patient is >50 - chest drain

44
Q

Indications for placing a chest tube in pleural infection

A
  • patients with frankly purulent or turbid / cloudy pleural fluid on sampling
  • presence of organisms identified by gram stain and / or culture from a non purulent pleural fluid sample
  • pleural fluid <7.2 pH
45
Q

Management of acute bronchitis

A

Analgesia
Fluid intake
Doxycycline (not in children or pregnant women)
Amoxicillin

46
Q

Investigation of choice for idiopathic pulmonary fibrosis

A

CT scan

47
Q

When is BIPAP used vs CPAP

A

BIPAP is used in acute T2 respiratory failure and COPD

CPAP in T1 respiratory failure and pulmonary oedema

48
Q

How to recognise lung collapse on X-ray

A

Trachea is pulled towards the opacity

49
Q

What type of lung cancer presents with central weight gain, thinner and fragile skin

A

Small cell lung cancer as it secretes ACTH and can cause Cushing’s syndrome

50
Q

What paraneoplastic syndrome is associated with squamous cell lung cancer

A

PTH related protein secretion

51
Q

Management of a secondary pneumothorax <1cm

A

Admit and give oxygen for 24 hours and review

52
Q

X ray findings in heart failure (ABCDE)

A

Alveolar oedema (bat’s wings)
Kelley B lines (interstitial oedema)
Cardio eagle
Dilated upper lobe vessels
Effusion (pleural)

53
Q

What does normal PaCO2 on ABG in asthma attack indicate

A

Exhaustion
Suggests it is a life threatening attack

54
Q

Panic attack results on ABG

A

Hyperventilation which causes respiratory alkalosis (high pH, low CO2)
PO2 will be normal as no issues with gas exchange
No metabolic compensation as attack resolves rapidly

Junior Medicine (6 decks)

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