Misc Flashcards
Xray signs for pulmonary oedema?
bilateral perihilar alveolar shadowing
upper lobe diversion
bilateral patchy batswing shadowing
fluid in the horizontal fissure
difference between lobar and bronchopneumonia on CXR?
lobar - clearly defined
bronchopneumonia - multi-lobular
most common cause of lobar pneumonia?
Strep pneumoniae
know at least 3:
-
-
what organism is signified by rusty sputum?
Streptococcus pneum
what organism is common for pneumonia after influenza?
Staphyloccocus
what organism is common for pneumonia in alcoholics/elderly? often red-current jelly sputum
klebsiella
what organism is common for pneumonia in COPD/bronchiectasis?
Haemophilus
name 3 respiratory causes of clubbing?
Bronchiectasis
Lung cancer
Cystic fibrosis
Lung abscess
CT findingds of bronchiectasis?
dialted bronchi - signet ring sing
how do we ivx bronchiectasis?
sputum mcs
Imaging; cxr, High res CT
Pulmonary function tests; FEV1
Tests for Specific causes: CFTR, a1-at, chloride sweat test
how do we mx bronchiectasis?
Acute exacerbation:
- PO abx Amox (or IV if severe) - or alternatives if allergic
Chronic mx:
- Diet & Lifestyle advice
- Chest physiotherapy
- Inhaled bronchodilator
- Mucolytic agent: n-acetlycysteine
how do we decide to do ctpa or ddimer for PE?
WELLS >4:
- ctpa
WELLS<4:
Ddimer, anticoagulate
NEW guideline for PE mx?
HAEMODYNAMICALLY STABLE
Treat with DOAC - rivaroxaban
Special groups:
low or v high weight, renal failure cancer:
- lmwh or UFH
Pregnant women: LMWH
HAEMODYNAMICALLY UNSTABLE:
1ST- unfractionated heparin
2nd - alteplase IV
stony dull percussion, reduced breath sounds and vocal remitus is indicative of?
pleural effusion
difference between exudate and transudate in pleural effusions?
exudate
so must have Higher protein and Higher LDH in
pleural fluid compared to serum
causes of exudate and transudate?
Transudate:
- caused by systemic factors (trans for travelling far)
- Congestive cardiac failure, PE
- Cirrhosis, Nephrotic syndrome, low albumin
Exudate:
- Local factors
- Pneumonia, cancer, TB, PE, Autoimmune
how do we mx pleural effusions?
Treatment is based on the nature of the effusion and underlying condition.
Congestive heart failure:
- Diuretics
- Therapeutic thoracocentesis + O2 (if symptomatic)
Cancer:
1. Therapeutic thoracocentesis + O2
or pleural catheter drainage
Infective:
1. Antibiotics + Thoracocentesis
Mx of suspected Pulmonary embolism?
- Offer apixaban or rivaroxaban first line,
and if these are not suitable;
- low molecular weight heparin (LMWH) for at least 5 days followed by dabigatran or edoxaban,
2b. or LMWH concurrently with a vitamin K antagonists for at least 5 days.
how does cartageners syndrome present?
Bronchiectasis
Infertility
Sinusitis
Dextrocardia
aka primary ciliary dyskinesia
