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Rahul's Basics > DPD Deck - RESP > Flashcards

DPD Deck - RESP Flashcards

1
Q

What are 3 important questions to ask in a respiratory history?

A

Ask about cough, sputum, and hemoptysis

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2
Q

What are 4 signs that may lead you to think a patient has a PE?

A

Sudden onset SOB
Signs of DVT
History of DVT/PE
Patient has been immobile, has had surgery or malignancy

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3
Q

What causes SOB within seconds

A

PE
Pneumothorax
A foreign body

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4
Q

What causes SOB within minutes-hours?

A 
Chest infection (pus)
Airway inflammation/obstruction 
Acute heart failure (fluid accumulates)
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5
Q

What causes SOB within days-weeks?

A 
Chest infection, airway inflammation/obstruction, heart failure that is CHRONIC or NON-RESOLVING
Interstitial lung disease
Malignancy
Large pleural effusion
Neuromuscular
Anemia/thyrotoxicosis
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6
Q

What are the 2 types of pneumothoraces?

A

Primary and Secondary

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7
Q

What is the management plan for a patient with a PRIMARY PNEUMOTHORAX

A

Step 1: Supplemental oxygen
Step 2: Determine if it is <2 or >2 cm
IF <2 cm: DISCHARGE patient and repeat CXR

IF >2 cm or SOB: Perform aspiration, if that fails insert a chest drain
Give analgesia - regular

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8
Q

What is the management plan for a patient with a SECONDARY PNEUMOTHORAX

A

Step 1: Supplemental oxygen
Step 2: Determine if its <2 or > 2 cm
IF <2 cm: Aspiration

IF >2 cm: Insert chest drain
Give analgesia - regular

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9
Q

How do you determine whether an ECG has a normal axis?

A

Look at leads 1 and 2

If one of them is overall more negative then it is NOT a normal axis

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10
Q

How do you determine if an ECG has right or left axis deviation?

A 
Ensure there is abnormal axis deviation from leads 1 &amp;2
Look at aVL
Is there positive deflection: 
YES - there is left axis deviation 
NO - there is right axis deviation
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11
Q

What is the sign on an ECG for right bundle branch block?

A

MaRRoW

That is: an M on V1’s QRS and a W on V6

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12
Q

What is the sign on an ECG for left bundle branch block?

A

WiLLiaM

ie: there is a W in V1 and a M in V6

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13
Q

What is the management of a patient with PE?

A

Step 1: Is this patient haemodynamically unstable?
Step 2: YES - Begin thrombolysis
NO - Start patient on Low molecular weight heparin
Step 3: Perform a CT angiogram
Step 4: Once diagnosis is confirmed - start the patient on warfarin

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14
Q

What does a FEV1/FVC ratio of >70% indicate?

A

RESTRICTIVE lung disease

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15
Q

What does a FEV1/FVC ratio of <70% indicate?

A

OBSTRUCTIVE lung disease

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16
Q

DDx of progressive SOB, dry cough, clubbing, FEV/FVC ratio >70%?

A 
Idiopathic fibrosing alveolitis
Connective tissue disease
Rheumatoid arthritis
Drugs
Asbestosis (ship builder's disease)
17
Q

When presenting an X-RAY how do you start?

A

This is a PA/AP CXR of
“Patient’s name and DOB”
“Taken on (date)”
“At (time)”

Comment on the quality of the film:
Rotation
Inspiration
Penetration

18
Q

How do you determine whether an x-ray is rotated?

A

Look at the spine on the x-ray, are the spinous processes equidistant to each clavicle

19
Q

How do you determine the penetration of the x-ray?

A

If the x-ray is ‘too white’ then it is underpenetrated

20
Q

What are the different opacities on a CXR and what do they indicate?

A
  1. Interstitial/alveolar shadowing (fluffy white): pus from pneumonia, fluid from heart failure or blood from a pulmpnary haemorrhage
  2. Reticulo-nodular shadowing: pulmonary fibrosis
  3. Homogenous (white) shadowing: Pleural effusion
  4. Masses/cavitations
21
Q

How can you differentiate between a pleural effusion and collapsed lung?

A

A pleural effusion will PUSH the trachea away from the pathology. The collapsed lung will PULL the trachea towards the pathology

22
Q

What is a globular heart a sign of?

A

Fluid around the pericardium, i.e PERICARDIAL EFFUSION

23
Q

Name 3 causes of bilateral hilar lymphadenopathy

A

Infection - TB
Inflammation - Sarcoidosis
Maligancy - Lymphoma

24
Q

What should you look for in a CXR other than opacities?

A

Pneumothorax
Pleural thickening
Costophrenic angles - are they sharp?
The diaphragm
The heart (should be less than 50% of the chest)
The mediastinum - check for lymphadenopathy

25
Q

What do hyperinflated lungs and a flattened diaphragm indicate?

A

COPD

26
Q

What are the respiratory causes of clubbing?

A 
Pulmonary fibrosis
Suppurative lung disease - abscess, empyema, cystic fibrosis, bronchiectasis
Bronchial carcinoma
Mesothelioma
TB

Rahul's Basics (11 decks)

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