Resp Flashcards
rapid onset SOB and cough, tachypnoea, tachycardia, inspiratory crepitations, bilateral signs
ARDS
episodic wheeze, breathlessness, cough (worse in morning/at night)
asthma
productive cough with purulent sputum/haemoptysis, SOB chest pain, clubbing, crepitations at base
brochiectasis
cough, SOB, wheeze, dec exercise tollerance, hyper resonance, prolonged expiration, dec break sounds, hyperinflation, bounding pulse
COPD
SOBOE, dry cough, fever, clubbing
occupation - keeps pets, farmer, plumber, mushroom picker, malt worker
extrinsic allergic alveolitis
cough, haemoptysis, SOB, clubbing, lymphadenopathy, crackles wheeze, inc vocal resonance
bone pain/fractures, headaches/blurry vision, hepatomeg
Lung cancer
from mets
dry cough, SOB, dec appetite, night sweats, pleural friction rub, pleural thickening on CXR
mesothelioma
chronic fatigue, snoring, unrefreshed post sleep, obese
obstructive sleep apnoea
sudden onset breathlessness and pleuritic chest pain, signs of resp distress , dec expansion/breath sounds, hyperresonance
pneumothorax
dry cough , progressive SOB, fatigue, arthralgia, lymphadenopathy, erythema nodosum, blurred vision, red eyes, photophobia
sarcoidosis
fever, lethargy, cough with green sputum, night sweats, weight loss, haemoptysis, lymphadenopathy, recent travel
TB
Treatment of an acute severe asthma attack
ABCDE, resus, O2 sats, PEFR, ABGs
high flow O2, Salbutamol nebuliser, Ipratropium bromide, IV hydrocortisone (then oral prednisolone for 5 days)
if above measures do not work - IV Mg Sulphate
Indications of a life threatening asthma attack (7)
Silent chest Hypotension Bradycardia Exhaustion/poor respiratory effort PH <7.25 pCO2 of 6KPa Cyanosis
How do you assess the severity of Pneumonia
CURB65
Confusion, Urea >7, RR>30, BP<90/60, Age >65
0-1 = outpatient 2 = inpatient 3-5 = inpatient and consider ICU
Common causes of CAP
Strep pneumonia, haemophillus influenzae B, pneumococcus, mycoplasma
Common causes of HAP
staph aureus, klebsiella, psudonomas aureginosa
Antibiotics for CAP
amoxicillin, co-amoxiclav if severe
Antibiotic if HAP - staph aureus
flucoxacillin + gentamycin
antibiotics for HAP, peudonomas aureg
vancomycin
treatment of atypical pneumonia
metronidazole
how would u classify a PE and then how would you investigate
Wells score P - prev DVT/PE = +1.5 E - evidence of DVT = +3 Stasis = +1.5 Cancer = +1 Opinion is PE = +3 Raised Rhythm (>100bpm) = +1.5 Exsanguination (haemoptysis) = +1
<4 - D-dimer
>4 - CTPA
What would you use to confirm TB
Sputum MCS w/ Ziehl neelson stain
what inv helps distinguish ARDS from HF
BNP <100
management for bronchiectasis
2x IV antibiotics (which cover psudonomas aureginos)
inhaled corticosteroids, bronchodilators, maintain hydration, flu vaccine, physiotherapy
what are the occupational RF for extrinsic allergic alveolitis
keep pets (esp birds), plumber, mushroom picker, malt worker
CXR findings for lung cancer
coin shaped lesions, bi-hilar lymphadenopathy, consolidation
FLAWS, hoarse voice, horners syndrome
pancoast tumour - tumour at lung apex compressing nerves
CXR findings for mesothelima
pleural thickening, Pleural effusion, pleural plaques
management for tension pneumothorax
max O2
large bore needle into 2 ICS at MCL
CXR 2 hours and 2 weeks later
if aspiration fails or fluid in pleural cavity - chest drain
