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3B + Finals > Resp > Flashcards

Resp Flashcards

1
Q

Patient presents with epistaxis, rhinorrhoea. Resent blood tests show decline in renal function

1) Diagnosis
2) Other associated symptoms
3) ANCA status
4) Management .

A

1) GPA/Wegeners granulosis
2) Epitaxis, cough, haemoptysis, renal involvement = fatigue. Nerve and skin involvement
3) ANCE +
4) cyclophosphamide +/- rituximab

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2
Q

CXR/CT presentation of sarcoidosis

A

Hilar lymphadenopathy 50% of cases

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3
Q

Other presentations of sarcoidosis

A 
fatigue 
weight loss
cough
chest pain 
fever
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4
Q

skin presentation of sarcoidosis

A

erythema nodosum

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5
Q

Patient presents with cough, low grade fever and chest pain, myalgia and fatigue

1) Most common CXR finding.
2) Diagnosis
3) skin finding
4) Associated eye condition

A

1) hilar lymphadenopathy
2) Sarcoidosis
3) erythema nodosum
4) Ant uveitis. Conjunctivitis

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6
Q

mx of sarcoidosis

A

6 months should resolve (WAW)

If not –> 30mg pred 6 weeks, then 15mg alt daily for 6 weeks

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7
Q

ANCA type in GPA

A

cANCA

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8
Q

pANCA is found in what granulomatous lung disease

A

Chur-Strauss

Eosinophilic, causes rhinitis and asthma

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9
Q

2 common causes of acute bronchitis

A

S. Pneumoniae

H influenzae

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10
Q

3 parts to COPD pathophysiology

A

Increased mucus cells and mucus production
Interstitial damage and reduced elasticity
squamous cell metaplasia
neutrophil infiltration
increased air space, more dead space

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11
Q

type 1 resP failure

A

Low Oxygen, normal CO2

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12
Q

type 2 resp failure

A

low oxygen, low co2

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13
Q

Cause of cor pulmonate

A 
COPD
Increased pulmonary pressure
R sided heart strain 
R sided HF
Peripheral oedema
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14
Q

Signs of cor pulmonale

A

Pulmonary hypertension and RV hypertrophy
Sternal heave
Loud second heart sound

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15
Q

First line management of COPD

A

SABA - salbutamol
or
SAMA - ipratropium

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16
Q

second line management of copd

A

combination of the above

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17
Q

third line x of copd

A

LABA - salmeterol

LAMA - tiotropium, umeclidinium

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18
Q

Add on treatments in copd

A

theophylline
prednisolone in exacerbations only
abx prophylaxis (macrocodes commonly used)

19
Q

Investigations for asthma

A

PEFR - diurnal variation

Spirometry - 15% improvement on bronchodilator

20
Q

first 3 steps of mx of asthma

A

1) SABA as and when
2) SABA + low dose ICS (beclo, budesonide). Can add LTRA (especially in children)
3) Add on LABA - salmeterol

21
Q

steps 4-6 of asthma mx

A

4) High dose ICS + LABA + LTRA or theophylline
5) Regular oral corticosteroids
6) Hospital admission

22
Q

Criteria for moderate asthma exacerbation

A

PEFR 50-70% predicted. Able to speak normally

23
Q

Criteria for acute-severe asthma attack

A

30-50% predicted PEFR
RR>25 HR>110 O2 reaching 92%
Unable to talk in full sentences

24
Q

Life threatening asthma attack criteria

A

<33% predicted PEFR
<92% O2
Altered consciousness
low BP

25
Q

Management of Asthma exacerbation

A 
O  -  Oxygen 24% Venturi mask, 6l/min
S - Salbutamol neb 2.5-5mg (10/h)
H - hydrocortisone 100mg IV
I - Ipratropium bromide 
T - theophylline 1g 
M - Magnesium 2g over 20min
E - escalate
26
Q

Indications for intubation in asthma attack

A

pH < 7.25

27
Q

Non specific symptoms of pneumonia in elderly

A

Recurrent falls

Confusion

28
Q

Causes of CAP

A

S. Pneumoniea

H Influenzea

29
Q

causes of hap

A

S Aureus
Pseudonoms
Klebsiella

30
Q

Causes of pneumonia in people with decreased immunity

A

PCP
pneumocystis Jirovecii
Candida
Aspergileosis

31
Q

Management of Mild cap

A

Amoxicillin 500mg TDS 5 days

Doxycycline 200mg then 100mg for 5 days OD

32
Q

Management of moderate CAP

A

Amox + clarithromycin 500mg BD 5 days

33
Q

Management of severe pneumonia or atypical cause

A

Co-amoxclav 1.2g TDS + clarithromycin BD 500mg both IV

34
Q

DD of pneumonia

A

PE
Atelecactisis
Acute respiratory failure

35
Q

Complications of pneumonia

A 
Pleural effusions (exudative) 
Empyma 
Lung abscess 
ARDS
AF in elderly
36
Q

Signs of lung abscess

A 
swinging fever (on background of improving pneumonia) 
foul smelling sputum
37
Q

stain used to test for tb

A

Ziehl-neelson stain

38
Q

2 tests for TB immunity/prev infection

A

Mantoux test

Interferon gamma test (if mantoux is positive but no active tb)

39
Q

Management of TB

A

Rifampicin 2 months then 4 months
Isoniazid 2 months then 4 months
Pyrazinamide 2 months
Ethambutol 2 months

40
Q

Side effects of ethambutol

A

Optic neuritis
colour blindness
decreased visual acuity

41
Q

side effects of isoniazid

A

peripheral neuropathy by inhibiting B6 formation

42
Q

Side effects Pyrazinamide

A

Hepatotoxic

Lower dose if eGFR low

43
Q

side effects of rifampicin

A

Orange jizz

3B + Finals (15 decks)

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