Pulmonary Flashcards
Describe the next investigation when managing a child with prolonged cough over 2 weeks and fever, according to the content.
Serology for pertussis.
What is the best initial investigation for bronchial asthma according to the content?
Spirometry before and after SABA (with FEV1 increase of at least 15%).
What is the most important parameter to assess in spirometry for a patient with bronchial asthma according to the content?
FEV-1.
What is the most important parameter to assess in spirometry for a patient with chronic obstructive pulmonary disease (COPD) according to the content?
FVC.
Management of acute attack???
Pt with low O2 saturation next step…….
1st step………
Best way to give puffs to the kids……
If no response…….
Management of acute attack???
Pt with low O2 saturation next step…….give O2
1st step………inhaled salbutamol…..up to 12 puffs
Best way to give puffs to the kids……spacer
If no response…….oral cortisone
How should an acute asthma attack be managed according to the content?
Start with inhaled salbutamol (up to 12 puffs), then consider oral cortisone if no response.
What is the most common side effect of inhaled cortisone according to the content?
Oropharyngeal candidiasis.
Describe the most serious sign in status asthmaticus according to the content.
Silent chest.
What is the first step if a patient with asthma presents with cyanosis according to the content?
Intubation.
How should puffs be administered to children with asthma according to the content?
Using a spacer.
What is the first-line treatment for long-term management of asthma according to the content?
SABA (Short-acting beta agonist).
Long term management:
First line…………
If still symptomatic…….
If still symptomatic………..
Long term management:
First line………….SABA
If still symptomatic…….inhaled cortisone
If still symptomatic………..LABA
What is the best way to prevent asthma exacerbations according to the content?
Avoiding dust and smoking.
What drug is commonly used for prevention of asthma by inhalation according to the content?
Fluticasone.
What is the recommended management for asthma triggered by exercise according to the content?
Using salbutamol before exercising.
How should critical cases be assessed according to the content? asthma
Look for confusion, drowsiness, and agitation as very important signs.
Pt returned from long flight develops acute chest pain& dyspnea. Exam shows clear lung… Dx:
pulmonary embolism (PE)
Describe the best investigation for diagnosing pulmonary embolism (PE) according to the content.
CTPA (CT pulmonary angiography).
Best inv of PE/ Inv of choice of PE…………………………..
Inv of choice in pregnant, pt with ESRD or allergy…
Best inv of PE/ Inv of choice of PE………………………….. CTPA
Inv of choice in pregnant, pt with ESRD or allergy… V/Q scan
What is the treatment of choice for PE according to the content?
LMWH (Low molecular weight heparin) followed by warfarin.
These patients, and those presenting with massive PE, may require pulmonary angiography (still regarded as the gold standard test). Treatment is anticoagulation, typically with low molecular weight heparin followed by 6 months of warfarin. Thrombolytic therapy is reserved for the acute massive presentation.
What is the duration of warfarin use in PE treatment according to the content?
3-6 months with a target INR of 2-3.
What is the next step for a patient with contraindications to anticoagulation and recurrent PE despite anticoagulant therapy according to the content?
IVC filter placement.
Describe the diagnosis of a patient presenting with cough and dyspnea, dullness to percussion, and increased tactile vocal fremitus according to the content.
Pt with cough and dyspnea. Exam shows dullness to percussion& ++ TVF… Dx: pneumonia.
Pneumonia.
Pt with cough and dyspnea. CXR shows pneumonic patch…
Dx: pneumonia