resp DPD Flashcards
A 45 year old patient complains that they cough up a pot of purulent sputum every day. Examination reveals course crackles. What is the likely diagnosis?
bronchiectasis (bronchi dilation)
Congenital causes of bronchiectasis
Cystic fibrosis Young's syndrome Primary ciliary dyskinesia Kartagner's syndrome Ig deficiency
Acquired causes of bronchiectasis
Infection (pertussis, bronchiolitis, pneumonia, ABPA, post-measles, rarely TB and HIV)
Bronchial obstruction (tumours, foreign bodies)
Inflammation (RhA, UC)
Hypogammaglobulinaemia
Low PO2 <8kPa, normal PCO2 suggests
Type I resp failure - hypoxaemic
Caused by V/Q mismatch including pneumonia, pulmonary oedema, PE
Low PO2 <8kPa, high PCO2 suggests
Type II resp failure - hypercapnic
Caused by alveolar hypoventilation ±V/Q mismatch in pulmonary disease e.g. COPD, drug overdose, severe asthma, NMJ disorders.
Isoniazid used in pulmonary TB can lead to peripheral neuropathy because…
it depletes vitamin B12
ACEi electrolyte side effect
Hyperkalaemia
Salbutamol electrolyte side effect
Hypokalaemia
COPD step wise treatment
- SABA
- SABA + LABA or only LAMA
- SABA + LABA + ICS or only LAMA
- All
Mucolytic therapy e.g. carbocysteine can be given to…
COPD patients with chronic productive coughs
Oxygen therapy is given to those with…
PaO2 <7.3kPa on room air during clinical stability OR
PaO2 7.3-8kPa and one of: nocturnal hypoxaemia polycthaemia peripheral oedema pulmonary HTN
Exacerbation of COPD, what is the most appropriate initial test?
ABG
Cavitating lung lesion on CXR could be…
Infection (TB, staph, Klebsiella in alcoholics)
Inflammation (WG, RA)
Infarction (PE)
Malignancy
Acute onset SOB (secs) DDx
Pneumothorax (alveoli)
PE (venous)
Foreign body (airway)
Anxiety
Sub-acute onset SOB (mins-hours) DDx
Airways (inflammation/obs)
Infection (pus)
Acute heart failure (fluid)
