Resp Flashcards
A 66 year old man is dx with idiopathic pulmonary fibrosis
What would you expect his CXR and HRCT to show?
CXR: Reticular shadowing in lung peripheries and lung bases, shaggy heart border and increase interstitial lung markings
HRCT: Honey combing, reticular shadowing and ground glass appearance
How do you treat someone with idiopathic pulmonary fibrosis? (C+M)
C: physio, pulmonary rehab, exercise and loos weight, stop smoking
M: pirfenidone = immunosuppressant with anti-inflam and anti-fibrinolytic activity
What is sarcoidosis?
Sarcoidosis is a non-caseating granulomatous disease which mainly affects the lungs, skin, eyes and nervous system
How do you treat sarcoidosis?
STEROIDS - inhaled, topical or oral
Then cytotoxics - methotrexate/azathioprine
How would pleural effusion look on examination?
Unilateral reduced chest expansion, stony dull percussion, decreased breath sounds
If they have tracheal deviation it would be away from the midline
What can you do for someone wanting to stop smoking?
Nicotine replacement therapy
- Varenicline
- Bupropion
This should be prescribes as part of a commitment to stop with a target stop date
What is the first line management of smoking cessation in pregnancy?
CBT
Motivational interviewing
Or structured self-help and support from NHS stop smoking services
What are the features of COPD that you would see on an CXR?
Hyperinflation >7 ribs
Bullous emphysema
Flattened diaphragms
Floating heart sign
In patients with COPD, who should you offer LTOT?
long term oxygen therapy
Need 2 ABGs, 3 weeks apart
- PO2 <7.3kPa
Or //
- PO2 7.3-8kPa + secondary polycythemia, nocturnal hyperaemia, peripheral oedema, pulmonary HTN
What is the acute management for COPD?
- Increased bronchodilator ? nebs
- Steroids prednisolone 30mg OD 7-14d
Only give abx if they’re is purulent sputum or clinical signs of pneumonia
