Resp Flashcards
CF: specific test in suspected infection (3)
RATS to aspergillus
pseudomanas precipitants
sputum/cough swab for Burkholderia cepacia
CF: management principles
Pulmonary: physio, abx prophylaxis (flucloxacillin/macrolide), chronic pseudomonas (ciprofloxacin 3 wks and colistrin nebs 3m), salbutamol inh, acetylcysteine neb (mucolytic), annual influenza and pneumococcal vaccine
GI: oral acetylcysteine (prophylaxis for obstructions), lactulose
Nutrition: pancreas (creon, ranitidine), calorie supplements, vitamin supplements (fat soluble)
CF: clinical features in infancy (2)
meconium ileus
neonatal jaundice
CF: clinical features in childhood (4)
nasal polyps
sinusitis
bronchiectasis
rectal prolapse
CF: clinical features in adults
psychological symptoms aspergilisis, pneumothorax cirrhosis, portal HTN Diabetes distal intestinal obstuction male sterility
CF: investigations
antenatal screening, neonatal blood spot screening
sweat test-> chloride >60mmol/l
CXR: hyperinflation, inc. AP diameter, bronchial dilatation, cysts
Lung function: obstructive pattern
Small cell lung carcinoma: usual spread to
liver bones bone marrow brain adrenals
Endocrine disorders in lunch cancer
non-small cell: hypercalcaema from PTH secretion from adenoma
small cell: SIADH w/ hyponatraemia
PET scan: what is it and what does it show?
Position emission tomography scan
uses radiolabelled FDG
metabolically active tissues show increased uptake of radiolabelled FDG
-> local and distant mets detection
Pseudomonas cover
Ciproflaxin/ meropenem/ tazocin/ gentamycin/ colistin
Pseudomonas: define
gram -ve aerobic bacilli
ILD: intersitial pulmonary fibrosis management
supportive management: O2 therapy, pulmonary rehab, opiates, antireflux, withdrawal of steroids and other immunosuppresnants
Prednisolone + azathioprine + N-acestylcsteine trial- some effect
lung transplant if <65yr, no co-morbidities and has advanced/progressive disease
ILD: cryptogenic organising pneumonia (COP) features
alveoral spaces with franulation tissue, which backs p to bronchioles
ILD: cryptogenic organising pneumonia (COP) management
corticosteroid therapy -> weaning over 6-12 months
Connective tissue disease associated ILD
corticostaroids with immunosuppressive agents (except in systemic sclerosis)
Long term asthmatics, with control deterioration and CXR changes: suspect what?
Aspergillus
Latent TB testing
Montoux test
+ve -> interferon gamma testing (Quantiferon TB Gold)
Active TB testing
CXR suggestive of TB
-> 3+ early morning sputum samples -> MC&S for acid fast bacili
Non pulmonary TB testing
sputum, pleura, pleural fluid, urine, pus, ascites culture
up to 12 wks to grow
TB histology
caseating granuloma
Hydatid disease: define
tapeworm infection
ingesion of eggs -> small intestine -> wall penetration and spread to organs via circulation -> usually lungs and liver -> cysts
Hydatid disease: ix and rx
Ix: serology or sputum analysis (liver cysts support the Dx)
Ex: excision or albendaole if unfit/disseminated
Amoebic life cycle
ingestion of contaminated food/water with Entamoeba histolytica
excystation in small intestine
multiply in large intestine
-> exit in stools or
-> invade the interstitial mucosa -> spread via circulation/direct/lymphatic -> liver, brain, lungs
