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Year 3 Common cases investigation and management only > RESP > Flashcards

RESP Flashcards

1
Q

Ix of pneumonia

A 
a-e assessment 
obs 
sputum MCS
urinary antigens
FBC- WCC
U&E
CRP
ESR
LFTS
ABG 
BLOOD culture 
image- CXR
pleural fluid MCS
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2
Q

ix for mycoplasma pneumonia

A

PCR

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3
Q

legionella ix?

A

urinary antigens

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4
Q

blood film ix for pneumonia ?

A

blood film - cold agglutyins

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5
Q

crub65 score of 3?

A

icu admission

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6
Q

curb65 score of 2

A

admit to hospital

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7
Q

pneumonia Mx

A

amoxicillin
clarithromycin - atypical cover
doxycycyline - if allergic to penicillin

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8
Q

if curb65 3

mx?

A

IV co amoxiclav

clarithromycin

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9
Q

pneumonia and pregnant
CAP
mx?

A

erythromycin

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10
Q

HAP- staph aureus confirmed

A

flucloxacillin

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11
Q

PCP confirmed pneumonia mx?

A

co-trimoxazole

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12
Q

anerobes from gut flora pneumonia

A

amoxicillin and metronidazole

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13
Q

1st line HAP

mx?

A

co amoxiclav

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14
Q

MRSA pneumonia mx?

A

IV vancomycin

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15
Q

pseudomonas mx?

A

iv tazocin and gent

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16
Q

bronchiectasis IX

A 
sputum MCS- haemophilus
\FBC
ue
crp
LFTs
ABG
culture 
xray 
HRCT
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17
Q

What is gold standard Ix for bronchiectasis

A

High resolution

CT

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18
Q

xray finding of bronchiectasis

A

tram tracking

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19
Q

bronchiectasis HRCT

A

signet ring sign

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20
Q

bronchiectasis Mx

gold standard conservative

A

airway clearance - chest physio

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21
Q

bronchiectasis vaccines?

A

one of pneumococcal seasonal influenza

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22
Q

bronchiectasis oral abx for pseudomonas exarcebation

A

ciprofloxacin

23
Q

Tb bedside investigation

A

sputum MCS x3 early morning
acid fast bacilli stain - zieiel neelson -
takes 6-8 weeks to culture

24
Q

TB imaging

A

CXR- bilateral bi hilar lympahdenopthy

caseating granulomas on lymph node biopsy

25
Q

non caseating granuloma on CXR

A

sarcoidosis

crohns

26
Q

latent tb test?

A

mantoux / tuberculin skin

interferon gamma relase assay

if + > cxr

27
Q

lung cancer Ix

A 
sputum cytology
fbc
ca2
alp - bone mets
lfts - liver mets

cxr
ct chest abdo pelvis
pet

28
Q

cavitaing lesion on CXR?

malignancy cause

A

SqCC

29
Q

secondary lung cancer on CXR?

A

canon ball mets

30
Q

SIADH ix results?

A

hyponatraemia - euvolemic from SCLC

urine osmolality high

31
Q

mesothelioma

ausculatation?

A

malignant neoplasm of mesothelial cells - asbestos

pleural friction rub

32
Q

xray mesothelioma

A

pleural thickening
plaques
pleural effusion

33
Q

gold standard for asthma investigation?

A

spirometry

FENO >40

34
Q

peak flow is useful investigation for what?

A

asthma

35
Q

ECG sign of PE

A

tachycardia
RBBB
s1q3t3

36
Q

cxr on PE

A

westermark sign

37
Q

gold standard for PE

and pregnant?

A

CTPA

V/Q perfusion screen

38
Q

Mx of a PE

A

respiratory support
thrombolysis anticoagulate

DOAC 3/6 months

39
Q

haemodynamically unstable PE

A

thrombolysis - alteplase, rtPA

thrombectomy

40
Q

primary pneumothorax sob and 0.8cm in size?

A

needle aspirate and give oxygen admit

41
Q

no sob

Pneumothorax 3cm in size

A

needle aspirate and admit

42
Q

1cm pneumothorax no sob

A

discharge

OPD review

43
Q

tension pneumothorax

mx

A

large bore cannula - 2nd ICS MCL

orange or grey cannula

44
Q

ARDS mx?

A 
ICU referral 
ventilator support 12-24 hours 
trial aprv >6
dueresis if volume overload
drainage of effusion

proning

45
Q

gold standard for pulmonary htn?

A

Right heart catheterisation

46
Q

pulmonary fibrosis Ix gold standard?

A

HRCT

spirometry

47
Q

cystic fibrosis Mx

when pancreatic insufficency has occured

A

creon

48
Q

mesothelioma management

A

Extrapleural pneumonectomy / Pleurectomy

Cisplatin / Pemetrexed

49
Q

acute management of asthma

A
  1. Oxygen – target 94-98%
  2. Salbutamol (SABA) Nebulised
  3. Ipratropium Bromide
  4. Hydrocortisone IV / Oral Prednisolone
  5. Magnesium Sulfate IV
  6. Aminophylline / IV Salbutamol (SABA)
50
Q

when can you be discharged from an acute asthma attack in hospital stay?

A

Can discharge if:

a. Stable on discharge meds for 12-24hrs
b. Inhaler technique checked and documented
c. PEF >75% of best/predicted

51
Q

is bronchiectasis an obsturctive or restrictiive picture

A

obstructive

52
Q

mx of bronchiectasis

A

carbocysteine
nebulsied isotonic/ hypertonic saline
azithromycin >3 exarcebations

53
Q

Antifibrotic agents:

when indicated

A

pirfenidone or nintedanib – indicated if

FVC is 50% - 80%

Year 3 Common cases investigation and management only (8 decks)

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