lung ting Flashcards
what is interstitial lung disease?
conditions that affect lung parenchyma & fibrosis with replacement of normal elastic tissue with stiff scar tissue
causes of drug induced pulmonary fibrosis?
- Amiodarone
- Methotrexate
- Sulfasalazine
- Cyclophosphamide
- cytotoxic agents (Bleomycin & Busulphan)
lung damage and release of inflammatory mediators causing increased capillary permeability & non cardiogenic pulmonary oedema
Acute respiratory distress syndrome
4 diagnostic criteria for ARDS?
1) Acute onset
2) CXR shows bilateral infiltrates
3) PCWP < 19 mmHg/lack of CCF
4) Refractory hypoxaemia
pulmonary fibrosis spirometry?
restrictive picture
outline the acute & chronic phase of extrinsic allergic alveolitis
acute = infiltration of alveoli with acute inflammatory cells
chronic = granuloma formation
specific occupations with allergens causing extrinsic allergic alveolitis
Mushrooms workers lung (reaction to specific mushroom antigens)
Malt workers lung (mould on barley)
Bird fanciers lung (reaction to bird droppings)
Farmers lung (mouldy spores in hay)
sleep apnoea severity scale?
Epworth sleepiness scale
what happens in obstructive sleep apnoea
collapse of pharyngeal airway causing apnoeic episodes during sleep lasting a few minutes
symptoms patients with obstructive sleep apnoea may present with
- morning headache
- daytime sleepiness
- feel unrefreshed from sleep
- partner reports loud snoring
- reduced sats during night
investigations for sleep apnoea
- ENT referral
- Pulse oximetry
- sleep studies
- video recording
- Polysomnography
management of sleep apnoea
- weight reduction
- reduce tobacco & alcohol
- CPAP via nasal mask
- surgery e.g. UPPP
prophylaxis for PE (2)
low weight molecular heparin (enoxaparin)
&
Compression stockings (work by increasing blood flow out of capillaries to prevent pooling of blood in deep veins)
wells score: high & low - what is investigation of choice
likely: CTPA & CXR
unlikely: D-dimer
supportive management of PE
- analgesia
- admission
- oxygen
- monitoring
2 causes of trachea deviation towards a white out
- pneumonectomy
- complete lung collapse
3 causes of tachea deviation away from a white out
- massive pleural effusion
- diaphragmatic hernia
- large thoracic mass
deviation of trachea in a tension pneumothorax
trachea deviates away from affected side
difference between primary and secondary pneumothorax?
primary occur spontaneously in a previously non pathological lung - typically a tall thin young male
secondary - occur in previously diseases lung e.g. COPD/asthma
management of
- primary pneumothorax
- < 2 cm
- not SoB
- consider discharge
- follow up in 2-4 weeks
management of
- primary pneumothorax
- < 2 cm
- SoB
Fine needle aspiration
if aspiration fails then insert a chest drain
location of Percutaneous needle aspiration for pneumothorax
2nd ICS, mid clavicular line
management of primary pneumothorax if > 2 cm
Percutaneous needle aspiration
location of chest drain insertion?
5th intercostal space, mid axillary line in safe triangle bordered by lateral edge of pec major
