Resp Flashcards
More common type of lung cancer
- Non small cell lung cancer = 80%
- SCLC = 20%
types of non small cell lung cancer
- adenocarcinoma
- squamous cell carcinoma
- large cell carcinoma
S+S lung cacner
- Cough
- Haemoptysis
- SOB
- Weight loss
- Supraclavicular LN
Extrapulmonary manifestations
- Recurrent laryngeal nerve palsy = hoarse voice
- Phrenic nerve palsy = SOB
- SVC obstruction = face swell, distended neck and upper chest veins = pembertons sign
- Horners = ptosis, anhidrosis, miosis, pancoast
Paraneoplastic syndromes
- SIADH = SCLC
- Cushings = SCLC
- Hypercalcaemia = squamous cell
- Lambert eaton = SCLC = antibodies against SCLC cells and calcium channels
guidelines for lung cancer 2ww
> 40 with
- clubbing
- lymphadenopathy
- recurrent chest infections
- thrombocytosis (increased plt)
- chest signs
CXR for patients over 40 who have
- 2+ unexplained sx in pt who never smoked
- 1+ unexplained sx in pt that have ever smoked or had asbestos
UE - cough, sob, chest pain, fatigue, weight loss
CXR in lung cancer
- hilar enlargement
- peripheral opacity (visible lesion)
- pleural effusion (unilateral)
- collapse
lung ca ix
- CXR
- Staging CT (contrast)
- PET CT (for mets)
- Bronchoscopy with endobrachial USS
- histology = bronchoscopy
1st line tx NSCLC
surgery
- radiotherapy can also be curative
Tx SCLC
- chemo and radio
CURB65
- Confusion
- urea >7
- RR >30
- BP <90 s or <60 d
- > 65
Atypical pneumonia treatment
- Macrolides (clarithromycin)
- fluoroquinolones (levofloxacin)
- tetracyclines (doxy)
Legionella S+S
- can cause SIADH = hyponatraemia
- urine antigen test to screen
Mycoplasma pneumoniae
- rash = erythema multiforme
- target lesions
- neuro sx in young
PCP
- Fungal pneumonia
- Immunocompromised patients = steroids
- Dry cough, SOB, night sweats
- Prophylactic co-trimoxazole
Spirometry results for obstructive disease
- FEV1 <70%
- Obstruction is slowing air passage out the lungs
Sprirometry results for restrictive
- FEV1 and FVC are equally reduced
- FEV1:FVC ratio >70%
Asthma exam finding
- Polyphonic expiratory wheeze
drugs that can worsen asthma
- BB
- NSAIDs
Asthma Ix
- Spirometry
- Reversibility testing >12% increase on testing
- FeNO >40
- Peak flow variabulity >20%
Asthma Mx
1 = SABA
2 = Inhaled corticosteroid (beclametasone)
3 = Leukotrine receptor antagonist
4 = LABA (salmeterol)
5 = MART regime
6 = increase ICS dose
ABG in acute asthma
- initially = respiratory alkalosis as a raised RR caused drop in CO2
- Normal PCo2 or low O2 = SCARY = getting tired
moderate exacerbation features asthma
- peak flow 50-75%