Resp Flashcards
Causes of Type 2 Resp failure
pulmonary disease (pneumonia, COPD, asthma, obstructive sleep apnoea)
reduced respiratory drive (sedative drugs, CNS tumour, trauma)
neuromuscular disease (cervical cord lesion, diaphragmatic paralysis, myasthenia gravis, Guillain–Barré syndrome)
thoracic wall disease (flail chest, kyphoscoliosis)
How are pleural effusions categorised? Give causes
Transudates - <30g/L protein content
- increased venous pressure (cardiac failure, restrictive pericarditis, fluid overload)
- hypoproteinaemia (cirrhosis, nephrotic syndrome, malabsorption)
- hypothyroidism
- Meig’s syndrome (right pleural effusion coupled with ovarian fibroma)
Exudates - > 30g/L
- result of increased capillary permeability secondary to - - infection (pneumonia, tuberculosis)
inflammation (pulmonary infarction, rheumatoid arthritis, SLE)
- malignancy (bronhogenic carcinoma, secondary metastases, lymphoma, mesothelioma, lymphangitis carcinomatosis)
Once pulmonary embolism is suspected…
treatment dose subcutaneous low molecular weight heparin (e.g. Dalteparin) and warfarin loading
Why dos O2 volume fall during an inspiration with an asthma patient?
with air flow compromise due to the narrowing of airways that occurs in acute asthma exacerbations, this results in a sudden increase in negative intrathoracic pressure which causes dilatation of the pulmonary vasculature. This effect causes pooling of blood in the lungs which results in diminished pulmonary venous return to the left atrium (decreased left atrial filling (E)), hence reducing stroke volume, causing the blood pressure to drop and hence the volume of the pulse thus falls in response. In addition, an increase in negative intrathoracic pressure also causes increased venous return to the right atrium which leads to expansion of the right side of the heart resulting in compromised filling of the left side of the heart.
Positive test for CF
NACL > 60m/L
Organism commonly found in patients with longstanding CF
Pseudomonas aeroginosa
What drugs cause pulmonary fibrosis?
Amiodarone
bulsulfan, nitrofurantoin, methotrexate and sulfasalazine
Main causes of hypersensitivity pneumonitis
farmer’s lung – from mouldy hay (Thermophilic actinomycetes, Aspergillus spp., Saccharopolyspora rectivirgula, Micropolyspora faeni);
bird/pigeon fancier’s lung – feathers and bird droppings (avian proteins);
mushroom picker’s lung – from mushroom compost (T. actinomycetes);
malt worker’s lung
Presentation of pneumonia of L.pneumophilia
Water tank
flu-like symptoms of fever, malaise and myalgia followed by a dry cough and sometimes dyspnoe
Other symptoms include anorexia, diarrhoea and vomiting, hepatitis, renal failure, confusion and coma. The patient also has deranged LFTs which is the second clue in the question. Blood tests may also show lymphopenia and hyponatraemia. Urine analysis may reveal microscopic haematuria and diagnosis is usually made using legionella urinary antigen testing or serology Treatment comprises of high-dose macrolide therapy
Treatment for aspergillosis
amptothercin B + variconazole etc
Exacerbation of COPD
Nebulise (salbutamol + ipratripiom)
then ABG
What lung cancer causes SIADH?
Small cell carcinoma
think the neuroendocrine releaser
Moderate COPD %
50-79%
What asthmatic medication is associated with hypokalaemia?
salbutamol
Management of TB
The use of four drugs initially (e.g. isoniazid, rifampicin, ethambutol and pyrazinamide) for a total of two months.
• This is then followed by four months treatment with isoniazid and rifampicin.
