resp Flashcards
most common pneumonia in alcoholics?
klebsiella pneumoniae
previous influenza predisposes you to which organism of pneumonia?
staph aureus
CAP causative organisms:
- Streptococcus pneumoniae (accounts for around 80% of cases)
- Haemophilus influenzae
- Staphylococcus aureus: commonly after influenza infection
- atypical pneumonias (e.g. Due to Mycoplasma pneumoniae)
- viruses
COPD management
COPD mgt if asthma features:
- SABA/ SAMA
- add ICS +LABA
- PRN SABA
+ regular LABA+ LAMA+ ICS
COPD MGT if no asthmatic features
- SABA/ SAMA
- PRN SABA
regular LABA+ LAMA - regular LABA + LAMA +ICS
silicosis features on CXR
- upper zone fibrosis
- “egg shell calcification” of hilar lymph nodes
occupations at risk of silicosis (4)
mining
slate workers
foundries (metal casting/ moulding)
potteries
sarcoidosis skin signs (3)
painful shin rash (pretibial nodules)
erythema nodosum
lupus pernio
sarcoidosis eye sx:
uveitis
sarcoidosis electrolyte derangement:
hypercalcaemia
macrophages inside the granulomas cause an increased conversion of vitamin D to its active form (1,25-dihydroxycholecalciferol)
sarcoidosis presentation
i. acute (4)
erythema nodosum
bilateral hilar lymphadenopathy
swinging fever
polyarthralgia
sarcoidosis presentation
ii. insidious (4)
dyspnoea
non-productive cough
malaise
weight loss
obstructive lung disease spirometry findings:
FEV1 - reduced
FVC - reduced or normal
FEV1/ FVC - reduced
obstructive lung diseases (5)
asthma
COPD
bronchiectasis
bronchiolitis obliterans
alpha-1 antitripsin deficiency (emphysema)
restrictive lung disease spirometry findings:
FEV1 - reduced
FVC - significantly reduced
FEV1/FVC - normal/ increased
restrictive lung diseases (7)
Pulmonary fibrosis
Asbestosis
Sarcoidosis
Acute respiratory distress syndrome
Infant respiratory distress syndrome
Kyphoscoliosis e.g. ankylosing spondylitis
Neuromuscular disorders
Severe obesity
features of klebsiella pneumonia (3)
- hx aspiration
- “red currant jelly” sputum
- often affects upper lobes
which patient groups are at higher risk of klebsiella pneumonia (2)
diabetics
alcoholics
antibiotic of choice for prevention of IECOPD
azithromycin
CURB 65
Confusion
Urea >7
RR >30
BP <90/60
age >65
bupropion
i. what is it used for?
ii. which patient group should it be avoided in?
i. smoking cessation
ii. epileptics (reduced seizure threshold
CXR findings in heart failure:
A alveolar oedema
B Kerley B lines
C cardiomegaly
D dilated prominent upper lobe vessels
E pleural effusions
asthma mgt in adults
- SABA
- SABA + ICS
- SABA + ICS + LTRA
- SABA + ICS + LABA (+/- LTRA
SABA examples
salbutamol
terbutaline
albuterol
lavabuterol
ICS examples
budesonide
beclometasone
fluticasone
LTRA example
montelukast
LABA examples
formoterol
mometasone
salmeterol
LAMA examples
Incruse (umeclidinium)
Seebri (glycopyrrolate)
Spiriva (tiotropium)
Tudorza (aclidinium)
SAMA examples
ipratropium
causes of upper lobe fibrosis
CHARTS
Coal miners’ pneumocionosis
Histocytosis
Ankylosing spondylitis
Radiation
TB
Sarcoid/ silicosis
causes of lower zone fibrosis (2)
asbestos
idiopathic
