RESP Flashcards

1
Q

What bacteria most commonly causes pneumonia?

A

Strep pneumoniae- 90%
Staph aureus
Legionella’s

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2
Q

What are signs of a pneumonia infection?

A
A drop in BP
Fever
Fatigue
Pleuritic chest pain
SOB
Headache
Cough with sputum
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3
Q

What is the gold standard test for pneumonia?

A

Chest X-ray

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4
Q

What is used to assess he severity of pneumonia?

A

CURB-65

  • confusion
  • blood urea nitrogen
  • resp rate
  • blood pressure
  • older than 65
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5
Q

What are the antibiotic stages for community acquired pneumonia?

A

Mild- oral amoxicillin
Moderate- oral amoxicillin and clarithromycin
Severe- IV co-amoxiclav and clarithromycin

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6
Q

What are the management of pneumonia steps?

A

Oxygen to maintain PaO2, IV fluids, Antibiotics, Analgesia

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7
Q

What is the treatment for legionella pneumonia?

A

fluoroquinolone and clarithromycin

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8
Q

What is mycobacterium tuberculosis?

A

An aerobic non-motile rod shaped bacteria

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9
Q

What should you do when you have a case of TB?

A

It is a notifiable disease

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10
Q

What are the signs and symptoms of TB?

A

Fever, night sweats, chills, chest pain, anorexia, weight loss, cough >3/52 in a year

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11
Q

What tests do we do for TB?

A

3x sputum test, Manoux skin test, CXR, CT scan, interferon gama release assays

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12
Q

What satin do you use for TB?

A

Ziehl-Neelson stain

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13
Q

What is the treatment for TB?

A
RIPE
Rifampacin
Isoniazid
(2 months intense then 4 months continued)
Pyrazinamide 
Ethambutol 
(2 months intense)
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14
Q

What can be an issue with diagnosing TB?

A

It takes 2-6 weeks to show up in labs

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15
Q

What are the risk factors of TB?

A

HIV+, anorexia, IVDU, born in a high prevalence area, homeless, alcoholic,

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16
Q

What are some examples of beta agonists?

A

Salbutamol and salemeterol

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17
Q

What makes up COPD?

A

Chronic bronchitis, emphysema and COAD

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18
Q

What do you see in type 2 resp failure?

A

High CO2 and low O2

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19
Q

What are signs of emphysema COPD?

A

Pink puffer- weight loss, breathless, maintained pO2

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20
Q

What are the signs of chronic bronchitis COPD?

A

Cough, resp failure, lack of energy, low mood

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21
Q

What are general signs of COPD?

A

Barrel chest, ankle swelling, sputum, chronic cough

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22
Q

How do we diagnose COPD?

A

FEV1/FVC < 70%

CXR

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23
Q

What is the drug pathway for COPD?

A

SABA
LABA
LABA +Corticosteroid
LABA + Corticosteroid+ LAMA

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24
Q

What is the pathophysiology of COPD?

A

Parenchymal destruction meaning less alveolar attachments and less elastic recoil with fibrosis and inflammation

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25
Q

What type of hypersensitivity is asthma?

A

Type 1 -IgE

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26
Q

What are pathophysiological signs of asthma?

A

Bronchoconstriction

Mucus production

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27
Q

When is asthma worse?

A

In the morning

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28
Q

How do we test for asthma?

A

Spirometry FEV1/FVC< 70% and a peak flow diary

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29
Q

What is the drug plan for asthma?

A

SABA, Corticosteroids, Corticosteroid and LABA, higher dose corticosteroid and biological therapy, then add prednisolone

30
Q

What is transudate?

A

Low protein fluid from heart failure, cirrhosis and nephrotic syndrome

31
Q

What is exudate?

A

High protein fluid from bacterial pneumonia, cancer, viral infection and pancreatitis

32
Q

What do you see on a chest X -ray of a pleural effusion?

A

White fluid

33
Q

What are signs and symptoms of pleural effusion?

A

Decreased chest movement , reduced breath sounds, dull percussion
Symptoms- SOB, cough and chest pain

34
Q

What is the treatment for pleural effusion?

A

Aspirate/ chest drain

Pleurodesis

35
Q

What is pneumothorax?

A

A build up of air in the pleural space

36
Q

What can cause pneumothorax?

A

Trauma (ie rib fracture, gunshot)

Damage from underlying lung pathology

37
Q

What are the signs of pneumothorax?

A

Low blood pressure, low oxygen levels, lose breathe sounds on the affected side

38
Q

What are the symptoms of pneumothorax?

A

SOB, sharp, ONE SIDED chest pain and altered consciuosness

39
Q

What is the gold standard test for pneumothroax?

A

CXR

40
Q

What is tension pneumothorax?

A

EMERGENCY where the trachea is deviated away from the lung and a chest drain must be inserted

41
Q

What causes meothelioma?

A

asbestos

42
Q

What type of cancer is non small cell lung cancer?

A

Squamous and adenocarcinoma (asbestos)

43
Q

What are the red flag signs for lung cancer?

A

Haemoptysis and weight loss

44
Q

What is the treatment for stage 1/2 lung cancer?

A

Surgical excision and radical deep x ray therapy

45
Q

What is the treatment of stage 3/4 lung cancer?

A

Palliative chemo and radio and palliative day

46
Q

What does CF affect?

A

CTFR channel protein

47
Q

Signs of CF in kids?

A

Finger clubbing, rectal prolapse, steatorrhea

48
Q

What is the test for CF?

A

Sweat test (NaCl) and genetic testing

49
Q

What gene is CF?

A

DF508

50
Q

How do we investigate bronchiectasis?

A

High resolution computed tomography and a sputum culture

51
Q

How do we treat brochiectasis?

A

Stop smoking, airway clearance exercise

Bronchodilators, steroids and antibiotics

52
Q

What is accute symptom relief for ocupational lung disorders?

A

corticosteroids

53
Q

What are some examples of hypersensitivity pneumonitis?

A

Farmer’s lung, bird fancier’s and wine makers

54
Q

Where does Wegener’s granulomatosis affect?

A

Ears, nose, kidney and lungs and is from blood vessel inflammation

55
Q

How do we treat Wegener’s granulomas?

A

Cyclophosphamide, steroid injections and plasma exchange

56
Q

What is the centor criteria?

A

Helps guide as to whether pharyngitis has a viral of bacterial cause.
0-2 viral infection
3-4 50% bacterial

57
Q

What are the chest x ray signs of COPD?

A

Hypertnflation
flat hemi-diaphragms
large pulmonary arteries

58
Q

What are the results of CT for COPD?

A

Bronchial wall thickening, enlarged space air spaces

59
Q

How does eosinophilic asthma occur?

A

Allergens activate Th2 leading to mast cell/basophil.

An influx of eosinophils/T cells into the lumen

60
Q

How does non eosinophilic asthma occur?

A

Irritants activate Th1 and NUETROPHOLS, MACROPHAGES and MAST CELLS leading to an allergic reaction

61
Q

Normal signs of asthma?

A

Tachypnoea, audible wheeze, widespread polyphonic wheeze

62
Q

Tests for acute asthma attack?

A

ABG, CXR, bloods

63
Q

Where do lung cancers metastasis to?

A

Lymph nodes, bone, brain, liver, adrenal gland

64
Q

What cells are seen in small cell carcinoma?

A

Kulchistky cells

65
Q

What is pneumonia?

A

Inflammation of the lung parenchyma

66
Q

What are community causes of pneumoniae?

A

S. Pneumoniae
H. Influenzae
Stah aureus
Klebsiella pneumonia

67
Q

What are late onset causes of hospital pneumoniae?

A

M. pneumoniae
Legionella pneumophila
Chlamydophila pneumoniae

68
Q

What causes rusty sputum in pneumoniae?

A

S. Pneumoniae

69
Q

What CURB65 score indicates immediate transferal to ICU?

A

5

70
Q

What is the TB vaccine called?

A

BCG vaccine

71
Q

What can cause pulmonary hypertension?

A

SLE, sclerloderma, septal defects, HIV