Resp Flashcards
What some complications of lung ca?
What are some causes of lung fibrosis?
Simple ix for fibrosis?
More complex ix for fibrosis?
Difference between coarse and fine crackles?
Coarse = Bubble popping sound - changes with cough (deeper) - found in bronchiectasis, wet cough and may have sputum bottle next to bed
Fine = Velcro pulled apart sound (higher) - found in fibrosis, dry cough
What is bronchiectasis?
Chronic dilated airways secondary to prolonged inflammation which become filled with mucus
What is Kartageners Syndrome?
This is a congenital cause of bronchiectasis + situs invertus
What are some causes of bronchiectasis?
Differential for Bronchiectasis?
Could also be fibrosis - however this would present with a dry cough and fine end-inspiratory crackles
What are the causes of clubbing - resp, cardio and abdo?
Ix of Bronchiectasis?
Bedside:
- Basic obs
- Sputum MCS - screen for infection and colonisation eg H influenza and P aeruginosa
Bloods:
- FBC and CRP - evidence of infection
- ABC - resp failure
Imaging:
- CXR - tramlines and ring shadows
- CT thorax - signet ring sign
Special tests:
- Spirometry - obstructive pattern
- Screen for underlying condition eg RF, immunoglobulins and sweat test for CF
Describe the obstructive and restrictive spirometry findings?
What does this show?
Signet ring sign as seen in bronchiectasis -> several dialted bronchioles present through lungs
Mx of Bronchiectasis?
Differentials for COPD?
Ix for COPD?
Bedside:
- Basic obs
- Sputum MCS - screen for infection and colonisation eg H influenza and S pneumonia
- ECG - signs of RHF (RBBB and RAD)
Bloods:
- FBC and CRP - evidence of infection
- ABC - type 2 resp failure
- a-1 antitrypsin (protease inhibitor without these protease breaks down the lung tissue)
Imaging:
- CXR - looking for hyperexpansion and signs of infection
- Echo could be needed to check for signs of HF
Special tests:
- Spirometry for obstructive pattern
What are the indications of LTOT?
Pulmonary HTN + pO2 <8
pO2 <7.3
Cyanosis, Raised JVP and SpO2 <92% means you should assess the pt for need of LTOT
Mx of COPD?
Mx of COPD?
What techniques were used in the past for TB treatment and what was the rationale behind them?
It was believed that lower PaO2 levels would inhibit TB proliferation
Therefore, techniques used to induce apical collapse were used
a. Apical lobectomy
b. Thoracoplasty (= rib removal to collapse lung)
c. Phrenic nerve crush (= hemi-diaphragm paralysis)
d. Plombage (= insertion of polystyrene balls into thoracic cavity)
How can TB be classified?
● Drug-resistant TB
- Resistant to one of the anti-TB therapies
● Multi-drug resistant TB
- Resistant to atleast R&I
● Extremely drug resistant TB
- Resistant to R&I & fluoroquinolone + atleast 1 other agent
Ix for pleural effusion
