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MURMURS > resp Acc > Flashcards

resp Acc Flashcards

1
Q

pt on 15 L NRB what should their sats be

A

98% but youve got ot take 10 from that to get the actual sats

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2
Q

pt on 15 L NRB what should their sats be

A

98% but youve got ot take 10 from that to get the actual sats

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3
Q

Meds used in acute severe asthma management

A

salbutamol,
ipatropium bromide,
hydrocortisone
magnesium sulphate

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4
Q

Features of life threatening asthma and Mx

A

silent chest, exhaustion hypotension resp failure pEFR 33%

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5
Q

Features of acute severe asthma

A

inability to complete sentences PEFR 33-55

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6
Q

Features of mod asthma

A

PEFR >55

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7
Q

stepwise managment of asthma

A 
SABA 
SABA and LICS 
SABA and LICS and LABA 
SABA HICS/LICS LABA and LRA (theophyline)
SABA HICS and OCS
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8
Q

Spirometry result in asthma

A

low FEV1

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9
Q

3 Features of asthma

A

Triad- sob wheeze cough
Triggers
Atopy

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10
Q

MRC dyspnoea scale

A

Activity required to induce breathlessness

  1. no problems
  2. probs going up hill
  3. probs walking on flat surface
  4. cannot walk 100m w/o stop
  5. cannot leave house
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11
Q

Blue bloater features 3

A

brocholitis crackles odema, cyanosis

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12
Q

pink puffer 3 features

A

pursing lips cahcexic barrelches withaccessory muscle us

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13
Q

What is used to calculate prognosis in COPD and what does a 0-2 score indicate

A

BODE- BMI, airflow obstruction, dysnoea and excersize capacity
means a 4 year survival

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14
Q

which level of MRC would you recommond pulmonary rehabilitation

A

level 3 enables them to achieve better phsyical and social outcomes

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15
Q

Management of exacerbation of COPD

A

1, VENTURI start at 28% at 4L

  1. salbutamol nebs with the o2
  2. prednisolone - IV or oral
  3. Antibiotics
  4. iv fluids
  5. vte prophylaxis
  6. theophylline if salbutamol doesnt work
IPAD 
INC FREQ SABA
PRED PO
AMOXICILLIN 
DOXYCYCLIN
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16
Q

what should you consider in a patient with recurrent exacerbations requiring steroids

A

osteoporsis prophylaxis

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17
Q

what does curb mean

A 
confusion - amts <7 
urea - > 7 
rr >30
b - 90/60
65 y/o
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18
Q

curb of 0 what does it mean

A

Three day amoxicillin should be given and reviewed at three days and if needed prescribe 7-10 days and clarithromycin if alergic

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19
Q

CURB 1-2

A

dual therapy
amox and claritho
OR
Doxycycline if pregnant or BF

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20
Q

crb 3 what does it mean

A

admit and buffalo

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21
Q

Management of acute pul odema

A

OLDMAN
OXYGEN
LOOP DIURETIC - FUROSEMIDE

BALANCE FLUID - urinary catheter
ANALGESIA Morphine
GTN

Metaclopramide
CPAP may be needed

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22
Q

Managament of oral oneumothroax and who gets it

A

thin tall men
1. chest aspirate to force the air out fron 2 ics mcl

5th intercoastal midaxillary is the chest drain

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23
Q

Managment of tension pneumothorax

A

needle decompression needs to be large bore cannulae

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24
Q

difference between primary and secondary pneumothorax

A

primary tall man young

secondary is secondary to a pulmonary condition making it more likely to get this.

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25
Q

What is flail chest?

A

2 ribs fractured in 2 places

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26
Q

What resp condition has RBBB

A

pe

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27
Q

what resp condition has t wave inversion

A

pe

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28
Q

what resp condition has S1Q3T3

A

Massive PE

29
Q

things that would warrent immediate admission in pe

A

if gave birth in last 6 weeks have 4 points on wells

30
Q

What happens is wells less than 4

A

D- dimer
if D-dimer is +ve then LMWH and CTPA
if d-dimer -ve then consider alternative diagnosis
Doopler USS of legs

31
Q

what happens is wells more than 4

A
  1. anticaog LMWH
  2. CTPA
  3. doopler USS of legs
32
Q

Criteria in PERC score

A 
H- Hormone use 
A- age >50 
D - DVT/PE hx 
C - coughing up blood 
L - leg swelling unilateral 
O- oxygen if <95% 
Tachy >100 
S- surgery or trauma
33
Q

if haemodynamically stale and high risk and anticoaglated with LMWH

A

500mg bolus alteplase

34
Q

what condition do you see air bronchogram

A

consolidation

it is absent in pleural efflusion as its filled with water so you cant see it

35
Q

what direction does the trachea move in tension pneumo and collapse

A

collapse it goes to

tension it goes away from the unhealthy lung

36
Q

Meds used in acute severe asthma management

A

salbutamol,
ipatropium bromide,
hydrocortisone
magnesium sulphate

37
Q

Features of life threatening asthma and Mx

A

silent chest, exhaustion hypotension resp failure pEFR 33%

38
Q

Features of acute severe asthma

A

inability to complete sentences PEFR 33-55

39
Q

Features of mod asthma

A

PEFR >55

40
Q

stepwise managment of asthma

A 
SABA 
SABA and LICS 
SABA and HICS and LABA 
SABA, HICS/LICS, LABA and LRA(theophylline)
SABA HICS LABA and OCS
41
Q

Spirometry result in asthma

A

low FEV1

42
Q

3 Features of asthma

A

Triad- sob wheeze cough
Triggers
Atopy

43
Q

MRC dyspnoea scale

A

Activity required to induce breathlessness

  1. no problems
  2. probs going up hill
  3. probs walking on flat surface
  4. cannot walk 100m w/o stop
  5. cannot leave house
44
Q

Blue bloater features 3

A

brocholitis crackles odema, cyanosis

45
Q

pink puffer 3 features

A

pursing lips cahcexic barrelches withaccessory muscle us

46
Q

What is used to calculate prognosis in COPD and what does a 0-2 score indicate

A

BODE- BMI, airflow obstruction, dysnoea and excersize capacity
means a 4 year survival

47
Q

which level of MRC would you recommond pulmonary rehabilitation

A

level 3 enables them to achieve better phsyical and social outcomes

48
Q

Management of exacerbation of COPD

A

1, VENTURI start at 28% at 4L

  1. salbutamol nebs with the o2
  2. prednisolone - IV or oral
  3. Antibiotics
  4. iv fluids
  5. vte prophylaxis
  6. theophylline if salbutamol doesnt work
49
Q

what should you consider in a patient with recurrent exacerbations requiring steroids

A

osteoporsis prophylaxis

50
Q

what does curb mean

A 
confusion - amts <7 
urea - > 7 
rr >30
b - 90/60
65 y/o
51
Q

curb of 0 what does it mean

A

Three day amoxicillin should be given and reviewed at three days and if needed prescribe 7-10 days and clarithromycin if alergic

52
Q

CURB 1-2

A

dual therapy
amox and claritho
OR
Doxycycline if pregnant or BF

53
Q

crb 3 what does it mean

A

admit and buffalo

54
Q

Management of acute pul odema

A

OLD BAG and a M

Oxygen
Loop Diuretic - furosemide

Balance - monitor fluid -restrict Analgesia - Morphine
GTN

Metaclopramide
dobutamine if severe
salbut if wheeze
DVT prophylaxis

55
Q

Managament of oral pneumothroax and who gets it

A

thin tall men
1. chest aspirate to force the air out fron 2 ics mcl

5th intercoastal midaxillary is the chest drain

56
Q

Managment of tension pneumothorax

A

needle decompression needs to be large bore cannulae

57
Q

difference between primary and secondary pneumothorax

A

primary tall man young

secondary is secondary to a pulmonary condition making it more likely to get this.

58
Q

What is flail chest?

A

2 ribs fractured in 2 places

59
Q

What resp condition has RBBB

A

pe

60
Q

what resp condition has t wave inversion

A

pe

61
Q

what resp condition has S1Q3T3

A

Massive PE

62
Q

things that would warrent immediate admission in pe

A

if gave birth in last 6 weeks have 4 points on wells

63
Q

What happens is wells less than 4

A

D- dimer
if D-dimer is +ve then LMWH and CTPA
if d-dimer -ve then consider alternative diagnosis
Doopler USS of legs

64
Q

what happens is wells more than 4

A
  1. anticaog LMWH
  2. CTPA
  3. doopler USS of legs
65
Q

Criteria in PERC score

A 
H- Hormone use 
A- age >50 
D - DVT/PE hx 
C - coughing up blood 
L - leg swelling unilateral 
O- oxygen if <95% 
Tachy >100 
S- surgery or trauma
66
Q

if haemodynamically stale and high risk and anticoaglated with LMWH

A

500mg bolus alteplase

67
Q

what condition do you see air bronchogram

A

consolidation

it is absent in pleural efflusion as its filled with water so you cant see it

68
Q

what direction does the trachea move in tension pneumo and collapse

A

collapse it goes to

tension it goes away from the unhealthy lung

MURMURS (16 decks)

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