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Miscellaneous Flashcards

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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?

Study These Flashcards
A

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

25
What is the dosage of IV chlorphenamine in anaphylaxis?
Adults: 10mg 6-12 years: 5mg 6months-6years: 2.5mg <6months: 250micrograms/kg
26
What is the dosage of IV hydrocortisone in anaphylaxis?
Adults: 200mg 6-12 years: 100mg 6months-6years: 50mg <6months: 25mg
27
How long should patients with anaphylaxis be monitored post-treatment?
At least 6 hours due to risk of biphasic reaction
28
When should mast cell tryptase be taken for anaphylaxis?
Immediately after treatment commenced, 1-2 hours post-reaction and 24 hours post-reaction
29
With what should you discharge patients after anaphylaxis?
5 days oral steroids | Prescription for an epipen
30
What does a RAST look for?
Specific IgE antibodies
31
What is the most common cause of transudative pleural effusion?
Heart failure
32
What is Meig's syndrome?
Benign ovarian fibroma with ascites and pleural effusion
33
What is the most common cause of exudative pleural effusion?
Pneumonia
34
What is Dressler's syndrome?
Injury to the pericardium or heart causes fever, pleuritic pain, pericarditis and/or pericardial effusion
35
What is yellow nail syndrome?
Primary lymphoedema associated with yellow nails and exudative pleural effusion
36
Rheumatoid arthritis and SLE cause what type of pleural effusion?
Exudate
37
Pancreatitis causes what type of pleural effusion?
Exudate
38
Hypothyroidism causes what type of pleural effusion?
Transudate
39
A pulmonary embolism causes what type of pleural effusion?
Exudate
40
What appearance on ultrasound would suggest an exudative pleural effusion?
Pleural fluid septations
41
What protein level characterises a definitive exudative pleural effusion?
>35g/l
42
What protein level characterises a definitive transudative pleural effusion?
<25g/l
43
When is Light's criteria used to determine if a pleural effusion is a transudate or an exudate?
Protein content of 25-35g/l
44
What are Light's criteria?
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
Give 4 conditions that are associated with a pleural effusion giving low glucose, raised LDH, and pH<7.2
Malignancy SLE Rheumatoid arthritis Tuberculosis
46
Give 4 conditions that are associated with a pleural effusion with a raised amylase
Pancreatitis Oesopheal perforaton Carcinoma Bacterial pneumonia
47
Give 4 conditions that are associated with bloody pleural effusion
Mesothelioma Pulmonary embolism Tuberculosis Trauma
48
Which disease is suggested by the finding of giant cells in a pleural effusion?
Rheumatoid arthritis
49
What is the risk of draining a pleural effusion too quickly?
Re-expansion pulmonary oedema
50
Give 3 management options for recurrent pleural effusions
Recurrent aspiration Talc pleurodesis Indwelling pleural catheter
51
What are the indication for referral of a pregnant woman to stop smoking services?
Woman smokes or stopped within the last 2 weeks | >7ppm carbon monoxide
52
What is the mechanism of action of varenicline?
Nicotinic receptor partial agonist
53
When should a patient start varenicline?
1-2 weeks before target stop date
54
What is the recommended course of treatment for varenicline?
12 weeks
55
Give 5 side effects of varenicline
``` Nausea Headache Insomnia Abnormal dreams Possible increased suicide risk ```
56
Give 2 contraindications of varenicline
Pregnancy | Breastfeeding
57
What is the mechanism of action of buproprion?
NA and dopamine reuptake inhibitor and nicotinic receptor antagonist
58
When should a patient start buproprion?
1-2 weeks before target stop date
59
Give 3 absolute contraindications for buproprion
Epilepsy Pregnancy Breastfeeding

Respiratory (6 decks)

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