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GP Exams > Resp > Flashcards

Resp Flashcards

1
Q

4 immediate management options for severe asthma exacerbation in young adult

A
  1. Salbutamol MDI via spacer 12 puffs
  2. Ipratropium MDI via spacer 8 puffs
  3. Prednisolone PO 1mg / kg
  4. Supplemental oxygen to titrate saturations 92-94%
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2
Q

Classification / severity scale of asthma

A
  1. Mild / Moderate
  2. Severe
  3. Life threatening
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3
Q

Mx pertussis

A
  1. Notify the case to the department of health
  2. Tx with Azithromycin 500mg on day 1 followed by 250mg daily days 2-5
  3. Immunise with dTpa vaccination
  4. Tx all household members
  5. Keep home until completed 5 days abx
  6. Vaccinate all household contacts who have not had dTpa booster within last 10 years
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4
Q

Hx questions for cough

A
  1. Preceding URTI
  2. Paroxysmal cough
  3. Post-tussive vomiting
  4. Onset of cough - gradual vs sudden
  5. Exposure to contacts with similar sx
  6. Recent overseas travel
  7. FMHx asthma or atopy
  8. Wheeze / stridor
  9. Nocturnal cough
  10. Possibility of FB inhalation
  11. Fever / rash / systemic sx
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5
Q

Mx acute rhinosinusitis

A
  1. Regular simple analgesia - Panadol / Nurofen
  2. Saline nasal irrigation
  3. Intranasal corticosteroid spray Nasonex
  4. Intranasal ipratropium
  5. Intranasal decongestant for max 3-5 days
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6
Q

Mx acute bacterial sinusitis

A

Self limiting condition
Supportive care
Abx rarely make a difference to recovery time
Shared discussion with pt

  1. Amoxicillin 500mg TDS for 5 days
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7
Q

Optimisation of lung function in bronchiectasis

A
  1. Early tx of infective exacerbation with abx
  2. Immunisation - influenza / pneumococcal
  3. Minimise exposure to cases of resp infections
  4. Pulmonary rehab
  5. Regular 30 minutes exercise / daily
  6. Improving mucous clearance with chest physio
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8
Q

Obstructive spirometry pattern

A

Reduced FEV1

FEV1/FVC below predicted range

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9
Q

Restrictive spirometry pattern

A

Reduced FEV1

FEV1/FVC normal or increased

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10
Q

Sarcoidosis features on physical examination

A
  1. Erythema nodosum
  2. Peripheral lymphadenopathy
  3. Acute polyarthritis / migratory polyarthritis
  4. Uveitis
  5. Splenic enlargement
  6. Parotid gland swelling
  7. Hepatomegaly
  8. Heart failure
  9. Sinusitis
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11
Q

Classic CXR finding for sarcoidosis

A

Bilateral hilar lymphadenopathy

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12
Q

DDx for restrictive lung disease

A
  1. Asbestosis
  2. Bronchitis
  3. Coal worker’s pneumoconiosis
  4. Hypersensitivity pneumonitis
  5. Idiopathic pulmonary fibrosis
  6. Lymphocytic interstitial pneumonia
  7. Obesity
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13
Q

Physical examination findings for restrictive lung disease

A
  1. Crackles or velcro rales

2. Clubbing of digits

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14
Q

Contraindications to spirometry

A
  1. Haemoptysis of unknown cause
  2. Bronchodilator use prior to assessment
  3. Pneumothorax
  4. Unstable angina
  5. Recent MI
  6. Recent eye surgery
  7. Active TB
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15
Q

Other than CXR, 2 investigations to confirm dx of TB

A
  1. Sputum culture or PCR for mycobacterium tuberculosis

2. Sputum acid-fast bacilli smear

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16
Q

What are the 4 questions used to assess asthma control level?

A
  1. Daytime symptoms
  2. Need for SABA reliever
  3. Any limitation of activity
  4. Symptoms during night or on waking
17
Q

Reasons for poor response to asthma medication / mx

A
  1. Correct inhaler technique
  2. Is the current tx appropriate
  3. Is there a written Asthma Action Plan that the patient is able to appropriately follow?
  4. Are the symptoms due to ashtma?
  5. Is the person exposed to unidentified triggers?
18
Q

Other than medication adjustment, long term mx features to improve asthma control

A
  1. Assure proper inhaler technique
  2. Avoid exposure to triggers
  3. Maintain optimal body weight
  4. Regular exercise, 30 minutes daily
  5. Regular review to assess control and perform spirometry
  6. Keep diary of PEFR
  7. Encourage compliance with medications
  8. Annual influenza immunisation
  9. Prepare Asthma Action Plan
19
Q

Physical examination findings to assess level of asthma severity

A
  1. Ability to speak full sentences
  2. Conscious state
  3. Use of accessory muscles of respiration
  4. Oxygen saturations
  5. Cyanosis
  6. Absence of breath sounds on auscultation
  7. HR
20
Q

Immediate steps in asthma mx

A
  1. Salbutamol MDI with spacer 6-12 puffs
  2. Ipratropium MDI with spacer 4 puffs
  3. Prednisolone 1mg/kg daily
  4. Supplemental oxygen to maintain sats >94%
  5. IV access
  6. Sit upright
21
Q

Features in hx that would prompt you to prescribe a preventer to manage asthma

A
  • episode of life threatening asthma requiring hospitalisation or ICU
  • more than 2 ED presentations due to asthma
  • requiring oral steroid > twice for control
  • flare up of asthma more than once / 6 weeks
  • night symptoms > twice / month
  • asthma symptoms disrupting activity
  • asthma symptoms disrupting sleep

GP Exams (15 decks)

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