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Finals RP > Resp > Flashcards

Resp Flashcards

1
Q

What is Obstructive and Restrictive lung disease?

A

Obstructive, FEV1 / FVC is <0.7

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2
Q

What is a good measure of disease progress in Obstructive and Restrictive lung diseases?

A

Obstructive: FEV1/FVC
Restrictive: TLC

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3
Q

What physiological changes occur in Asthma?

A

Mast cell degradation and histamine release

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4
Q

What is Samter syndrome?

A

Aspirin intolerance, nasal polyps and asthma

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5
Q

What are the investigations for Asthma in an <17 y old?

A

Spirometry and Bronchodilator reversal test –> If negative, add FeNO test

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6
Q

What are the investigations for Asthma in an >=17 year old?

A

Spirometry, BDR test and FeNO

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7
Q

What counts as “positive” Asthma result in <17 y old?

A

Bronchodilator shows >12% improvement

FeNO shows >35 ppb

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8
Q

What counts as “positive” Asthma result in >=17 y old?

A

Bronchodilator shows >12% + 200ml improvement

FeNO shows >40 ppb

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9
Q

Main indicators for it being Asthma?

How do they effect investigations?

A 
Family/ patient history of atopy 
Diurnal variability
Wheeze observed by HCP 
Symptoms of Asthma
No other possible diagnoses

If ALL present = high risk –> trial treatment
If some present = mod risk –> Spiro + BDR test
If none, low risk –> Ix for other diagnoses first

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10
Q

Management ladder for Asthma?

A

SABA - such as salbutamol
then add ICS 400mcg - such as beclametasone
then add LABA - such as salmetrol or formetrol

If some response to LABA, but still not perfect control, continue LABA and increase ICS dose to 800mcg

Then increase ICS to 1000mcg
Consider steroid tablet on top

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11
Q

What are some features of Moderate and Severe asthma?

A

Moderate asthma: Severe asthma:
PEFR 50 -75% PEFR 33 - 50%
Normal speech No sentences
RR <25 RR >25
HR <110 HR >110

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12
Q

What are some features of Life-threatening Asthma?

A

PEFR <33%
Bradycardia, Hypotension, Arrythmia
Confusion, Exhaustion, Coma
Silent chest, bad resp effort, cyanosis

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13
Q

What is the most common organism causing infective exarcebation of COPD?

A

H. influenzae

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14
Q

What two conditions within COPD, and what are their main physiological features?

A

Emphysema - alveolar destruction

Chronic Bronchitis - goblet cell hyperplasia + mucus

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15
Q

What is a cause of lower lobe emphysema in young non-smoking patients?

A

Alpha 1 anti-trypsin deficiency

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16
Q

What is the role of Alpha 1 anti-trypsin?

A

Stops the breakdown of elastin by neutrophil elastase

17
Q

Investigations for COPD?

A

Spirometry, CXR, sputum culture

FBC, bmi

18
Q

What would CXR of COPD show?

A

Hyperinflation
Flattened diaphragm
Hyperlucent lung fields

19
Q

Management of COPD?

A

Stop smoking! - can help them stop smoking with Varicyline or Buproprion

20
Q

What are the contra-indications for Varicycline and Buproprion?

A

Varicycline - MH issues

Buproprion - epilepsy

Finals RP (11 decks)

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