Resp Flashcards
Asthma management cascade
check notes
copd management cascade
check notes
acute asthma management
Oxygen
Salbutamol 5mg NEB
Hydrocortisone 100mg Iv/Pred 40mg PO
Ipratropium 500mcg NEB
Magnesium sulphate 2g IV
primary pneumothorax = < 2cm and asymptomatic
discharge
primary pneumothorax = >2cm and symptomatic
admit for aspiration
if that fails chest drain
secondary pneumothorax = 0-1cm and asymptomatic
oxygen and admit for 24 hours
secondary pneumothorax = 1-2cm and asymptomatic
aspiration
secondary pneumothorax = >2cm OR symptomatic
chest drain
mx of tension pneumothorax
STAT Needle decompression, 2nd intercostal space, midclavicular line, then CXR, then chest drain
level of carina
4th thoracic vertebra
what are the borders of the chest drain site
lateral border of pectorals major
5th intercostal space
base of axilla
Lateral latissimus dorsi
what is components of CURB 65
new confusion urea > 7 RR > 30 BP systolic < 90 or diastolic < 60 age 65 or over
treatment of legionella pneumonia
levofloxacin 500mg bd for 10-14 days
OR
clarithromycin 500mg plus rifampicin 600mg bd for 10-21 days if allergic
bacteria seen in immunocompromised and IVDU patients and Ix for it and specific Tx
pneumocystis jivovecii
ix = BAL
tx = co-trimoxazole
Ix for legionella
urinary antigen
bug that presents as atypical pneumonia and “4 year cycle” with erythema multiform - and Ix and Tx
mycoplasma
Ix = serology
Mx = clarithromycin
bug associated with alcoholics, diabetics and “red jelly sputum” and specific tx
klebsiella
tx = cefotaxime
bug associated with pneumonia post influenza A
staph aureus
4 features of interstital lung disease
dru cough
sob
clubbing
diffuse inspiratory crackles
what is seen on CT in ILD
ground glass opacification
CXR suggestive of coal workers pneumoconiosis
small round opacities in upper zones
what is the most dangerous types of asbestos
blue asbestos
what is the long term management for a provoked PE
3 months of rivaroxiban
what is the long term management for a unprovoked PE
6 months of rivaroxiban
consider Ix for malignancy
suspect PE + hypotension = Mx?
thrombolyse»_space; alteplase
blood gas seen in PE
respiratory alkalosis
what is type 1 and type 2 resp failure
1 = hypoxia [with normal or low co2]
2 = hypoxia with hypercapnia
treatment for CAP = CURB65 score 0-2
1st line = Amox 1g tds 5 days
If pen allergic = Doxy PO 200mg day 1, 100mg od for 5 days
If n-b-m = IV clarithromycin 5 days
treatment for CAP = CURB65 score 3-5
1st line = IV Co-Amox + PO Doxy bd
If pen allergic = IV Levofloxacin 500mg BD
Step Down = PO Doxy BD
if n-b-m or ICU/HDU = IV Co-Amox + IV clarithromycin
Total = 7 days IV/PO
treatment for HAP = non-severe
PO Amox
if pen allergic = PO Doxy 100mg bd
5 days of Tx
treatment for HAP = severe
IV amox + gent
If pen allergic = IV Co-Trimox + Gent
Step down = PO Co-trimox
7 days of Tx
treatment for aspiration pneumonia = non-severe
PO Amox + Metronidazole
If pen allergic = PO Doxy + Metronidazole
5 days treatment
treatment for aspiration pneumonia = severe
Iv Amox + Met + Gent
Step Down = PO Amox + Met
If pen allergic = PO Doxy/IV clarithromycin + Met + Gent
Step Down = PO Doxy + Met
7 days Tx
cascade of Ix for PE
1st = CXR to exclude other pathology
2nd = WELLS Score
If WELLS score > 4 = P.E. likely
If WELLS score < 4 = P.E. unlikely
3rd = P.E. likely = CTPA
if P.e. unlikely = D-Dimer
4th If D-Dimer positive = CTPA
what should patients who cannot have a CTPA be scanned with
V/Q scan
tx of PE
LMWH or fondaparinux immediately
within 24 hours = warfarin [for 3 months]
how long should LMWH/fondaparinux be continued in PE treatment
for 5 days or until INR 2 or above
cascade of Ix for lung cancer
1st line = CXR
2nd line = CT with contrast
3rd line = Bronchoscopy
4th line = PET scan
what lung cancer is most chemosensitive
SCLC
mx of NSCLC
Stage I - II = surgery/curative radiotherapy
Stage III - IV = palliative radiotherapy +/- chemotherapy
TB treatment plan
Initial phase = 2 months of RIPE
Continuation phase = 4months of RI
side effects of rifamipicin
hepatitis
orange sweat/tears/urine
side effects of isoniazide
hepatitis
agranulocytosis
peripheral neuropathy
side effects of pyrazinamide
gout
arthralgia
myalgia
hepatitis
side effects of ethambutol
optic neuritis
pneumonia that causes a rusty sputum
pneumococcal pneumonia
where is the problem in the lung in workers disease
apex of lung
where is the problem in asbestosis
base of the lung
causes of resp acidosis
severe asthma
pneumonia
hypoventilation
opioids
causes of resp alkalosis
hyperventilation/panic attack
PE
CNS problems
pregnancy
causes of metabolic acidosis
DKA
lactic acidosis
alcohol
causes of metabolic alkalosis
severe vomiting
