GP - Resp Flashcards
What is the management for asthma in children?
- SABA
- SABA + low-dose ICS
- SABA + low-dose ICS + LTRA
- SABA + low-dose ICS + LABA
- SABA + low-dose ICS MART
- SABA + moderate-dose ICS MART or separate LTRA
- Increase ICS dose + refer
What is the management for asthma in children <5 years?
- SABA
- SABA + 8-week trial of moderate-dose ICS
- SABA + low-dose ICS + LTRA
- Refer
What is the management for asthma in adults?
- SABA
- SABA + low-dose ICS
- SABA + low-dose ICS + LTRA
- SABA + low-dose ICS + LABA
- SABA +/- LTRA + low-dose ICS MART
- SABA +/- + moderate-dose ICS MART
- Increase ICS dose and refer
What are features of moderate acute asthma?
- PEFR 50-75%
- Speech normal
- RR <25/min
- Pulse <110bpm
What are features of severe acute asthma?
- PEFR 33-50%
- Can’t complete sentences
- RR >25/min
- Pulse >110bpm
What are features of life-threatening acute asthma?
- PEFR <33%
- O2 sats <92%
- Silent chest/cyanosis/feeble respiratory effort
- Bradycardia/dysrhythmia/hypotension
- Exhaustion/confusion/coma
What is the management for acute asthma?
O SHIT ME (different order)
- Oxygen
- Nebulised salbutamol
- Nebulised ipratropium bromide
- Hydrocortisone IV or oral prednisolone
- IV Magnesium sulphate
- Theophylline/aminophylline
- IV salbutamol
- Escalate
Give an example of each type of asthma medication
- SABA = salbutamol
- ICS = budesonide/beclomethasone
- LTRA = montelukast
- LABA = formoterol
What are the investigations for COPD?
- Spirometry = FEV1/FVC <70%
- Chest x-ray = hyperinflation/bullae/flat hemidiaphragm
- FBC (exclude secondary polycythaemia)
- BMI
When do you give each type of oxygen therapy?
Type 1 respiratory failure (normal CO2) = CPAP
Type 2 respiratory failure (high CO2) = BiPAP
What findings are seen on CXR in a PE?
- Fleischner sign (dilated central pulmonary vessels)
- Westermark sign (collapse of vasculate distal to PE)
- Hampton’s hump (wedge-shaped infarct)
What findings are seen on ECG in a PE?
- Sinus tachycardia
- ST depression
How are management options in COPD decided?
Whether or not there are features of steroid responsiveness:
- Asthmatic features
- Atopic illness
- Variation in FEV1
What is the management for COPD in steroid responsive patients?
- SABA or SAMA
- SABA + LABA + ICS
- SABA + LABA + ICS + LAMA
What is the management for COPD in non steroid responsive patients?
- SABA or SAMA
- SABA + LABA + LAMA
What will an x-ray show in transient tachypnoea of the newborn?
Fluid in the horisontal fissure
What will an x-ray show in COPD?
- Chest hyperinflation
- Bullae
- Flat hemidiaphragm
What will an x-ray show in croup?
Posterior anterior view = subglottic narrowing (steeple sign)
What will an x-ray show in acute epiglottitis?
Lateral view = swelling of epiglottis (thumb sign)
What will a high resolution CT show in interstitial lung disease?
Ground glass appearance
What are the causes of typical community-acquired pneumonia?
- Strep. pneumoniae
- Haemophilus influenzae
- Staph aureus
What are the causes of atypical community-acquired pneumonia?
- Mycoplasma pneumoniae
- Coxiella burnetii
What are the causes of bacterial hospital-acquired pneumonia?
- Klebsiella
- E. coli
- Pseudomonas
What is the management for pneumonia?
- Abx
- Oxygen
- IV fluids
- Analgesia/antipyretics
- Pneumococcal vaccine