Dz-es of resp tract

Question 1

what specific features are you looking for in resp tract dz

Answer 1

symmetry
d/c
crusting
nares
patent air flow
submand LN
dental ex, palate ex, and sinus percussion (frontal)

Question 2

what does a serosanguinous/mucopurulent d/c suggest

Answer 2

chronic

Question 3

what are the commonly indicated investigative techniques

Answer 3

haem and biochem
serology
virus isolation
xray 
rhinoscopy & retrograde version (look behind SP)
nasal flush and swab +- bsy
FNA of submand LN

Question 4

what 2 agents cause fungal rhinitis

Answer 4

aspergillus

cryptococcus

Question 5

what does aspergillus do

Answer 5

destroys turbinates
ulcerates nares
muco-sanguinous d/c
begins in the cd1/3

Question 6

how do you tx aspergillus inf

Answer 6

clotramazole.. or itraconazole

frontal sinus flushes + drainage

Question 7

what are the 2 causes that nasal neoplasia does

Answer 7

destructive
obstructive
– usually malignant, but slow to metastasise

Question 8

what are the signs and tx of non-infectious inflm rhinitis

Answer 8

bilat muco-p d/c

allergen prev, abx, mucolytics and steroids

Question 9

how do you tx a nasal foriegn body

Answer 9

flush

rhinotomy

Question 10

what is the most common direction to access the thorax

Answer 10

intercostal thoracostomy - but only gets to 1 side

Question 11

what are the clinical signs of BOAS

Answer 11

stridor
stertor (snorting)
heat/exercise intol

Question 12

what happens in 1ry and 2ry BOAS

Answer 12

1ry - XS SP; Stenotic nares; tracheal/laryngeal hypoplasia (pugs=XSnasal turbinates)
2ry - eversion larryngeal saccules, tonsil enlargement, lryngeal or tracheal collapse

Question 13

what is the emergency management for acte BOAS issues

Answer 13

O2
sedation
dark quiet room
csteroids
anaesthesia + intubate

Question 14

when is laryngeal collaspe worse

Answer 14

inspiration

Question 15

what causes laryngeal paralyisis

Answer 15

neuropathy of L recurrent laryngeal, X

atophy/damage of the cricoarytenoid dorsalis

Question 16

how do you tx laryngeal paralysis

Answer 16

parlaysis - light plane of GA and test laryngeal reflex
xry - confirm no blockage (always include chest)
tie back

Question 17

how do you tx laryngeal collapse

Answer 17

aim = make as much room as pos
tie back
Sp resection
sacculectomy
tonsilectomy
tracheostomy

Question 18

what are the ddx of tracheal collapse and how do you tx

Answer 18

LRT dz
Cardiac dz
tx = stent (extra or intralumenal)

Question 19

what sections of the tracheal can collapse - and how can you access it

Answer 19

cervical - V-M incision by separating the sternohyoideus m

thoracic - RHS intra-costal thoracotomy bw 3rd/4th ribs