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Respiratory > Miscellaneous > Flashcards

Miscellaneous Flashcards

1
Q

What is the gold standard investigation for obstructive sleep apnoea?

A

Polysomnography

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2
Q

Give 3 lifestyle measures that may be beneficial in obstructive sleep apnoea

A

Weight loss
Avoidance of tobacco
Avoidance of alcohol

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3
Q

What is the first line management (apart from lifestyle) for moderate-to-severe obstructive sleep apnoea?

A

CPAP via nasal mask set to 5-20cmH2O

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4
Q

What is central sleep apnoea?

A

Patients stop breathing for 10-30s in cycles due to instability of chemoreceptors that monitor CO2

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5
Q

Give 4 causes of central sleep apnoea

A

Drugs such as opioids
High altitude
CPAP
Arnold-Chiari malformations

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6
Q

What is the management of central sleep apnoea?

A

Treat cause

CPAP

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7
Q

What is the management of post-operative atelectasis?

A

Chest physiotherapy

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8
Q

What causes post-operative atelectasis?

A

Blockage of airways by bronchial secretions, leading to collapse of basal alveoli

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9
Q

What is the most common symptom of carbon monoxide poisoning?

A

Headache

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10
Q

What is the management for carbon monoxide poisoning?

A

100% oxygen via non-rebreathe mask for at least 6 hours until symptoms resolve

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11
Q

What are 4 indications for considering hyperbaric oxygen in carbon monoxide poisoning?

A

COHb>25%
Pregnancy
Loss of consciousness
Neurological signs

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12
Q

What is the pathophysiology of acute respiratory distress syndrome?

A

Damage to alveolar-capillary interface causes increased capillary permeability and fluid accumulation in alveoli

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13
Q

Give 2 investigations for acute respiratory distress syndrome

A

CXR

Pulmonary artery catheter to measure pulmonary capillary wedge pressure

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14
Q

What are the diagnostic criteria for acute respiratory distress syndrome?

A

Acute onset
Bilateral pulmonary infiltrates on CXR
Pulmonary capillary wedge pressure <19mmHg
Refractory hypoxia

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15
Q

What is used to treat pulmonary hypertension in acute respiratory distress syndrome?

A

Nitric oxide

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16
Q

What is the definition of type 1 respiratory failure?

A

PaO2<8kPa

PaCO2<6kPa

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17
Q

What is the definition of type 2 respiratory failure?

A

PaO2<8kPa

PaCO2>6kPa

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18
Q

What is the most common food allergen which cause anaphylaxis?

A

Nuts

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19
Q

Give 4 classes of drugs commonly associated with anaphylaxis

A

NSAIDs
Penicillins
Anaesthetic agents
Cephalosporins

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20
Q

What is the leading cause of drug-induced angioedema?

A

ACE inhibitors

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21
Q

What genetic deficiency causes angioedema?

A

C1 esterase inhibitor deficiency

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22
Q

What is the dose of IM adrenaline given for anaphylaxis?

A

Adults: 0.5mg (0.5ml 1:1000)
6-12years: 0.3mg
<6 years: 0.15mg

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23
Q

How often should you repeat IM adrenaline in anaphylaxis if required?

A

Every 5 minutes

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24
Q

How much IV fluid should be given in anaphylaxis?

A

500-1000ml bolus for adults or 20ml/kg for children

25
Q

What is the dosage of IV chlorphenamine in anaphylaxis?

A

Adults: 10mg
6-12 years: 5mg
6months-6years: 2.5mg
<6months: 250micrograms/kg

26
Q

What is the dosage of IV hydrocortisone in anaphylaxis?

A

Adults: 200mg
6-12 years: 100mg
6months-6years: 50mg
<6months: 25mg

27
Q

How long should patients with anaphylaxis be monitored post-treatment?

A

At least 6 hours due to risk of biphasic reaction

28
Q

When should mast cell tryptase be taken for anaphylaxis?

A

Immediately after treatment commenced, 1-2 hours post-reaction and 24 hours post-reaction

29
Q

With what should you discharge patients after anaphylaxis?

A

5 days oral steroids

Prescription for an epipen

30
Q

What does a RAST look for?

A

Specific IgE antibodies

31
Q

What is the most common cause of transudative pleural effusion?

A

Heart failure

32
Q

What is Meig’s syndrome?

A

Benign ovarian fibroma with ascites and pleural effusion

33
Q

What is the most common cause of exudative pleural effusion?

A

Pneumonia

34
Q

What is Dressler’s syndrome?

A

Injury to the pericardium or heart causes fever, pleuritic pain, pericarditis and/or pericardial effusion

35
Q

What is yellow nail syndrome?

A

Primary lymphoedema associated with yellow nails and exudative pleural effusion

36
Q

Rheumatoid arthritis and SLE cause what type of pleural effusion?

A

Exudate

37
Q

Pancreatitis causes what type of pleural effusion?

A

Exudate

38
Q

Hypothyroidism causes what type of pleural effusion?

A

Transudate

39
Q

A pulmonary embolism causes what type of pleural effusion?

A

Exudate

40
Q

What appearance on ultrasound would suggest an exudative pleural effusion?

A

Pleural fluid septations

41
Q

What protein level characterises a definitive exudative pleural effusion?

A

> 35g/l

42
Q

What protein level characterises a definitive transudative pleural effusion?

A

<25g/l

43
Q

When is Light’s criteria used to determine if a pleural effusion is a transudate or an exudate?

A

Protein content of 25-35g/l

44
Q

What are Light’s criteria?

A

Exudate if 1+ of these criteria are met:
Pleural fluid protein > 0.5 serum protein
Pleural fluid LDH >0.6 serum LDH
Pleural fluid LDH >2/3 serum upper limit of LDH

45
Q

Give 4 conditions that are associated with a pleural effusion giving low glucose, raised LDH, and pH<7.2

A

Malignancy
SLE
Rheumatoid arthritis
Tuberculosis

46
Q

Give 4 conditions that are associated with a pleural effusion with a raised amylase

A

Pancreatitis
Oesopheal perforaton
Carcinoma
Bacterial pneumonia

47
Q

Give 4 conditions that are associated with bloody pleural effusion

A

Mesothelioma
Pulmonary embolism
Tuberculosis
Trauma

48
Q

Which disease is suggested by the finding of giant cells in a pleural effusion?

A

Rheumatoid arthritis

49
Q

What is the risk of draining a pleural effusion too quickly?

A

Re-expansion pulmonary oedema

50
Q

Give 3 management options for recurrent pleural effusions

A

Recurrent aspiration
Talc pleurodesis
Indwelling pleural catheter

51
Q

What are the indication for referral of a pregnant woman to stop smoking services?

A

Woman smokes or stopped within the last 2 weeks

>7ppm carbon monoxide

52
Q

What is the mechanism of action of varenicline?

A

Nicotinic receptor partial agonist

53
Q

When should a patient start varenicline?

A

1-2 weeks before target stop date

54
Q

What is the recommended course of treatment for varenicline?

A

12 weeks

55
Q

Give 5 side effects of varenicline

A 
Nausea
Headache
Insomnia
Abnormal dreams
Possible increased suicide risk
56
Q

Give 2 contraindications of varenicline

A

Pregnancy

Breastfeeding

57
Q

What is the mechanism of action of buproprion?

A

NA and dopamine reuptake inhibitor and nicotinic receptor antagonist

58
Q

When should a patient start buproprion?

A

1-2 weeks before target stop date

59
Q

Give 3 absolute contraindications for buproprion

A

Epilepsy
Pregnancy
Breastfeeding

Respiratory (6 decks)

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