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resp Flashcards

1
Q

Which drugs should you avoid giving to asthma pts?

A

Aspirin

Beta blockers

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2
Q

What Ix would you do first in a patient suspected asthma?

A

PEF and spirometry

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3
Q

Outline the stages of management for asthma

A

1) SABA
2) SABA + inhaled steroid (beclomethasone dipropionate)
3) SABA + ICS + LTRA/LABA

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4
Q

What are the markers of severe asthma?

A

PEF 33-50
RR > 25
HR >110
Inability to complete sentences

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5
Q

What are the markers of life-threatening asthma?

A 
PEF<33%
SpO2 < 92%
PaO2 < 8kPa
Silent chest
Confusion
Exhaustion
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6
Q

What tx should be considered if an acute exarcerbation of asthma is not responding to inhaler and steroid tx?

A

Single dose magnesium sulphate or IV salbutamol

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7
Q

What would a CXR show in COPD?

A

Flattened diaphragms due to over inflation

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8
Q

What are the management stages for COPD?

A

1) SABA or SAMA
2) No asthmatic features = LABA + LAMA
OR asthmatic features (low FEV1/obstructive) = LABA + ICS
3) Triple therapy (LABA, LAMA + ICS)

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9
Q

What is the tx for acute COPD exarcerbation?

A

SABA + SAMA + pred PO + O2

Only abx if clinically indicated

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10
Q

When do you diagnose HAP instead of CAP?

A

If pneumonia develops greater than 2 days post admission

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11
Q

Outline the CURB 65 score?

A 
Confusion
Urea > 7
Resp rate > 30
BP < 90/60
>= 65
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12
Q

What score in the CURB 65 score corresponds to what?

A

0-1 PO amox at home
2 hospital tx with PO amox and clarith
3-5 - hospital tx with IV co-amox

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13
Q

What test can you do for legionella/pneumococcal?

A

Urinary antigen test

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14
Q

Name two tests for latent TB

A

Tuberculin skin test (Mantoux)

Interferon gamma release assay

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15
Q

How is active TB infection diagnosed?

A

CXR
3 X sputum acid fast bacilli smear
Sputum culture
NAAT of sputum if rapid dx needed

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16
Q

What are the advantages of using NAAT to dx TB?

A

Rapid (useful if immunocompromised pt)

Provides information about drug resistance

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17
Q

What is TB tx?

A

6M Rifampicin and isoniazid

2M pyrazinamide and ethambutol

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18
Q

SEs of TB drugs

A 
Rifampicin = orange secretions , liver enzyme inducer
Isoniazid = peripheral neuropathy
Pyrazinamide = hepatotoxic
Ethambutol = colour blindness/ optic neuritis
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19
Q

What tests are important to do before starting TB tx?

A

LFTs and vision testing

20
Q

How are PEs/DVTs prevented in hospital?

A

Heparin to all immobile pts
Stop HRT and COCP pre-op
Compression stockings

21
Q

What spirometry pattern is seen in restrictive lung disease?

A

FEV1 and FVC less than 80% predicted

FEV1/FVC ratio normal (>0.7)

22
Q

What spirometry pattern is seen in obstructive lung disease?

A

FEV1 < 80% predicted
FVC normal/low
FEV1/FVC less than 0.7

23
Q

What are the features of pulmonary fibrosis? (4Ds)

A

Dry cough
Dyspnoea
Digital clubbing
Diffuse inspiratory crackles

24
Q

What does a CT show in idiopathic pulmonary fibrosis?

A

Honeycombing

25
Q

What drug can help tx IPF?

A

Pirfenidone

26
Q

Name some supportive mx options in IPF

A

o2, PT, exercise, weight loss, vaccinations, smoking cessation
steroids for acute exarcerbations

27
Q

What criteria is used to determine whether a pleural effusion is an exudate or transudate?

A

Lights criteria

28
Q

What are the causes of bilateral hilar lymphadenopathy?

A 
(TIMES)
TB
Inorganic dust (silicosis)
Malignancy
EAA
Sarcoidosis
29
Q

How do you tx a tension pneumothorax?

A

Large bore cannula in second intercostal space mid clavicular
Aim just above rib to miss neurovascular bundle

30
Q

Which bacteria most commonly affects CF sufferers?

A

Pseudomonas aeruginosa

31
Q

What ix for bronchiectasis/

A

Sputum culture
CXR
HRCT chest
Spirometry - obstructive

32
Q

Tx of bronchiectasis

A

Exercise
Airways clearance physio
If culture +ve - always give abx

33
Q

Which 4 conditions can aspergillus cause?

A

Asthma exarcerbation
Allergic bronchopulmonary aspergillosis
Aspergilloma
Invasive aspergillosis

34
Q

What blood test is used to dx CF in neonates?

A

Immunoreactive trysinogen

35
Q

What are the signs on ECG of pulmonary htn?

A

P pulmonale
Right axis deviation
RV hypertrophy

36
Q

What are the types of lung Ca?

A

Small cell

Non-small cell (squamous, large cell, adenocarcinoma)

37
Q

What are the features of goodpastures syndrome?

A

Glomerulonephritis and pulmonary haemorrhage

38
Q

What Ix diagnoses goodpastures syndrome/

A

Anti-GBM Abs

39
Q

What abx would you use for atypical pneumonia such as legionella?

A

Clarithromycin (macrolides)

40
Q

What are the causes of a transudate pleural effusion?

A

Heart failure
Nephrotic syndrome
Liver cirrhosis
Hypoalbuminaemia

41
Q

What is Lofgren syndrome?

A 
BHL 
Erythema nodosum
Arthralgia
Fever
(favourable prognosis of sarcoidosis)
42
Q

Which chromosome carries the gene defect in cystic fibrosis?

A

7

43
Q

What are the components of virchows triad?

A

Circulatory stasis
Hypercoaguble state
Endothelial injury

44
Q

What is the anion gap equation?

A

(sodium + potassium) - (chloride + bicarbonate)

45
Q

What does a normal anion gap in acidosis indicate?

A

Increased bicarbonate losses (e.g. diarrhoea)

Acid ingestion

46
Q

What is the diagnostic test for bronchiectasis?

A

HRCT - signet ring sign

med (25 decks)

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