Resp Flashcards
What are the signs of pulmonary oedema?
A-E
alveolar oedema (bat wings)
Kelley B lines
Cardiomegaly
Diversion of blood to upper lobes (where the vessels in the upper zone are larger than in lower zone)
pleural Effusions
How to assess adequacy of a plain CXR?
RIPE
Rotation
Inspiration
Projection (AP or PA)
Exposure
OR
PRIM
Projection
Rotation
Inspiration
Markings
Assessment of a chest x ray
Airway
Breathing (lungs and pleura)
Cardiac (size and borders)
Diaphragm (incl. costophrenic angles)
Everything else (mediastinal contours, bones, soft tissues, tubes, valves, pacemakers and review areas)
CXR findgins of pectus excavatum
7-shaped ribs
missing right heart border
heart displaced to the left
What ix should patients with unexplained persistent cough have?
CXR
What can increase the reliability of the sweat test?
giving fludrocortisone before
Summarise the BTS asthma management ladder
- Inhaled SABA
- add ICS
- Add LABA
- consider increasing ICS dose and adding 4th drug (LTRA, SR theophylline, b2 agonist tablet)
- oral steroids and refer to specialist care
examination findings in PE
sinus tachycardia
tachypnoea
hypoxaemia
loud s2
elevated JVP
calf swelling/tenderness
haemoptysis
3 commonest causes of persistent cough with normal CXR
asthma (50%)
sinusitis with postnasal drip (25%)
GORD (20%)
Causes of hypoxaemia (PaO2 <8)
- hypoventilation
- V/Q mismatch (shunting vs deadspace)
- Diffusion impairment
- high altitude
genetic RF for PE
protein C & S deficiency
Factor V leiden
FH
Management of haemodinamically unstable with PE
LMWH
thrombolysis
thromectomyn
IV fluids
warfarin
NOAC
medication for thrombolysis
alteplase
Causes of pulmonary HTN
group 1: PAH (idiopathic, hereditary, drug/toxin, CTD)
group 2: PH secondary to LHF (raised capillary wedge pressure)
group 3: PH secondary to underlying lung disease and hypoxia
group 4: chronic thromboembolic pulmonary HTN
group 5: secondary to conditions with multifactorial mechanisms causing PH
(you don’t come across group 5 that much)
sx of pulmonary HTN
breathlessness on exertion
Lower leg swelling