Resp Flashcards
salmeterol is
LABA
ipratropium is a
SAMA
3 types of non small cell lung cancers
adenocarcinoma
squamous cell carcinoma
large cell carcinoma
latent period in mesothelioma
45 years
lung cancer extrapulmonary manifestations
recurrent laryngeal nerve palsy
phrenic nerve palsy
superior vena cava obstruction
horners syndrome
SIADH
cushings syndrome
hypercalcaemia
lambert eaton myasthenic syndrome
sign for superior vena cava obstruction and how it is done
pembertons sign
raising hands over your head causes facial congestion and cyanosis
what tumor causes horners syndrome and what does it press on
pancoast tumor pressing on the sympathetic ganglion
lambert eaton myasthenic syndrome pathophysiology
antibodies against small cell lung cancer cells cause sx of:
proximal muscle weakness
diplopia
ptosis
slurred speech
dysphagia
autonomic dysfunction
non small cell lung cancer mx
surgery if isolated to one area
radiotherapy
chemotherapy
small cell lung cancer mx
chemotherapy and radiotherapy
what type of surgery is done for lung cancer
thoracotomy
VATs- keyhole
what does a thoracotomy scar suggest
lobectomy
pnuemonoectomy
what is a pneumonectomy
removal of an entire lung
HAP is classified as how many hrs post admission
48
what bacteria is aspiration pneumonia associated with
anaerobic bacteria
urea in CURB65
above 7
resp rate in CURB65
30 bpm or above
BP in CURB65
less than 90 systolic
60 or lower diastolic
age in CURB65
65 or older
CURB65 scores and mx
0-1= treat at home
2 or above= consider hospital admission
3 or above= consider intensive care
what abx are used in atypical pneumonia
macrolides
fluoroquinolones
tetracyclines
atypical pneumonia does not respond to
amoxicillin
coxiella burnetti/ q fever pneumonia is associated with
farmers
CAP duration of abx
5 days
pneumonia complications
sepsis
ARDs
pleural effusion
empyema
lung abscess
bicarbonate level in chronic co2 retainers
high
hyperventilation causes was resp imbalance
alkalosis
raised aldosterone causes what on blood gas
metabolic alkalosis
H+ is secreted
resp system support from least to most invasive
oxygen therapy
high flow nasal cannula
NIV
intubation and mechanical ventilation
ECMO
different methods of oxygen therapy
nasal cannula
simple face mask
venturi mask
non rebreather mask
what is used to connect lungs to ventilator in mechanical ventilation
endotracheal tube
tracheostomy
what does low FVC and low FEV1:FVC indicate?
combination of restrictive and obstructive lung disease
how is peak flow measured
3 attempts and take the highest one
what wheeze is heard in asthma
widespread polyphonic expiratory wheeze
what is reversibility in asthma testing
> 12% increase in FEV1
FeNO diagnostic of asthma
above 40 ppb
peak flow variability for asthma
more than 20%
how to diagnose asthma
- FeNO and spirometry with bronchodilator reversibility
- if uncertain after this, peak flow variability
- if uncertain after this direct bronchial challenge test
LAMA example
tiotropium
LABA example
salmeterol
LTRA example
montelukast
peak flow in moderate asthma exacerbation
50-75% best or predicted
peak flow in severe asthma exacerbation
33-50% best or predicted
unable to complete sentences indicates what grade asthma attack
severe
peak flow in life threatening asthma
<33%
features of life threatening asthma attack
silent chest
peak flow <33%
o2 sats <92%
tired
confused or agitated
haemodynamic instability
severe asthma attack mx
oxygen therapy
nebulised salbutamol
nebulised ipatropium bromide
IV mag sulf
IV salbutamol
IV aminophylline
how does salbutamol affect potassium levels
hypokalemia
after how many attacks does someone with asthma need to be referred to a specialist
2 attacks in 12 months
3 pathologies in COPD
airway obstruction
chronic bronchitis
emphysema
MRC dyspnoea scale
1= breathless on strenuous exercise
2= breathless on uphill
3= breathless on flat
4= breathless over 100m on flat
5= cant leave house due to breathlessness
how is severity measured in COPD
FEV1
stage 1= >90% predicted
stage 2= 50-79% predicted
stage 3= 30-49% predicted
stage 4= <30% predicted
COPD initial medical management
SABA and SAMA
second line COPD mx no asthma features
LABA and LAMA
second line COPD mx with asthma features
LABA and ICS
what is carbocistine
mucolytic agent
what should be monitored in COPD patients taking prophylactic abx
ECG
liver function
cor pulmonale pathophysiology
pulmonary hypertension causes RV to pump less blood
this causes back pressure into the right atrium, then vena cava then the systemic venous system
what is cor pulmonale causes by
respiratory disease
what murmur can you get in cor pulmonale
tricuspid regurgitation
contraindications to NIV
untreated pneumothorax
any structural abnormality affecting the face, airway or GI tract
