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Y1&2 Medicine Zoe Veary > RESP 219 Haemoptysis 2 > Flashcards

RESP 219 Haemoptysis 2 Flashcards

1
Q

Name some main causes of haemoptysis

A 
Acute/chronic bronchitis in smokers
Bronchogenic carcinoma
Bronchiectasis
Infection: TB, pneumonia, abscess and aspergilloma (ABPA)
Granulomatous disorders: Wegners and Sarcoidosis
Pulmonary infarction
Increase pulmonary venous pressure
Atrio-venous malformations
Pulmonary veno-occlusive disease
Trauma
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2
Q

What is sarcoidosis?

A

A Multi system granulomatous disorder

Granulomas form in body organs

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3
Q

What is Kaposi’s sarcoma?

A

A connective tissue cancer

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4
Q

What is Wegners disease?

A

A granulomatosis with vasculitis affecting small arteries and associated with ANCA

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5
Q

What can cause increased pulmonary venous pressure?

A

Heart failure and mitral stenosis

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6
Q

What is Virchows triad?

A

Factors that predispose to thrombosis:

venous stasis, injury to vessel wall and increased coagulability of blood

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7
Q

What can chronic thromboembolism result in?

A

pulmonary hypertension and right sided heart failure

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8
Q

What are some risk factors for thromboembolism?

A 
Pregnancy
Post surgery
Malignancy
Immobility
Family hx/prev hx
OCP
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9
Q

What are some signs of a DVT?

A 
Local pain/tenderness
Fever
Swelling
Pain in calf on dorsiflexion (homans sign)
but can be asymptomatic
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10
Q

What are some signs of a PE?

A

Sudden onset chest signs: pleuritic pain, dyspnoea, haemoptysis
Hypoxia - agitation, cyanosis, reduced consciousness
Tachycardia
Pleural rub
Coarse crackles
fever

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11
Q

What are the signs of a massive PE?

A 
Raised JVP
Tachypnoeic 
Tachycardic
Hypotension
Right ventricular heave
Shocked, pale and sweaty
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12
Q

Where does a pulmonary embolus usually arise from?

A

Embolised DVT - small clots that move distally in the lung or large clots that lodge early

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13
Q

What may be seen on ECG with a small/med clot and a large clot (PE)

A

small/med : usually normal, sinus tachycardia, RV strain

large: Tall peaked waves in lead II, right axis deviation

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14
Q

What may be seen with a small/med clot on CXR? (PE)

A

Linear atelectasis
Small effusion
Raised hemi-diaphragm

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15
Q

What may be seen with a large clot on CXR? (PE)

A

Pulmonary arterial dilatation in hilum

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16
Q

What is the treatment for a PE?

A

LMWH immediately
Warfarin long term till INR 2-3
Thrombolysis - in haemodynamically unstable

17
Q

When would an IVC filter be used to treat DVT?

A

When anticoagulation is contraindicated or recurrent VTE

18
Q

Name a FXa inhibitor?

A

Apixaban, rivoroxaban

19
Q

What is dabigatan and when can it be used?

A

A direct thrombin inhibitor - anticoag for AF only

20
Q

Describe bronchiectasis

A

Chronic bronchial sepsis - abnormal and permanent dilatation of one or more bronchi

21
Q

What are some inherited causes of bronchiectasis?

A

Cystic fibrosis

Immotile cillia

22
Q

What are some acquired causes of bronchiectasis?

A

Childhood pneumonia
Chronic bronchial obstruction or aspiration
ABPA (allergic bronchopulmonary aspergillosis)
Immunoglobulin deficiency/HIV

23
Q

What is ABPA?

A

Allergic bronchopulmonary aspergillosis

Eosinophillic and fungal infection in lung - hypersensitivity reaction - usually in asthmatics of CF

24
Q

What are the clinical features of bronchiectasis?

A 
Yellow/green sputum
Persistent halitosis
Fever/malaise
Pneumonia
Clubbing
Coarse crackles
Breathlessness/wheeze
Haemoptysis
Rhinosinusitis
25
Q

What will be seen on CXR/CT with bronchiectasis?

A

Dilated bronchi, thickened wall/ cysts

26
Q

What are the main pathogens found in the sputum of patients with bronchiectasis?

A

Staph Aureus
Pseudomonas Aeroginosa
Haemophillus Influenza

27
Q

What is the treatment for Bronchiectasis?

A 
Physio
Antibiotics
Inhaled steroids
Bronchodilators
Treat any respiratory failure
28
Q

What are the main associated causes of pulmonary arterial hypertension?

A 
Collagen vascular disease
Congenital defects
Portal hypertension
HIV
veno-occlusive disease
29
Q

What is the pathophysiology behind pulmonary arterial hypertension?

A

There is endothelial dysfunction and remodelling:
Cellular proliferation causing hyperplasia of artery wall –>narrowing and eventually fibrosis with possible obstructions in the small pulmonary arteries
= increased resistance therefore increased pressure

30
Q

What is the diagnostic level for pulmonary arterial hypertension?

A

A PAP >25mmHg at rest

31
Q

What are the symptoms of pulmonary arterial hypertension?

A 
Progressive dyspnoea
Fatigue
Chest pain and palpitations
cough/haemoptysis
presyncope/syncope

Y1&2 Medicine Zoe Veary (60 decks)

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