Resp Overall Flashcards
Empirical treatment for pneumonia?
Community acquired: Amoxycillin (Doxacyclin if allergic), Co-amoxiclav if severe
Hospital acquired: Amoxicillin + Metronidazole (+ Gentamicin if severe)
General empirical treatment for sputum?
Amoxicillin/Doxacyclin
What are some Asthma symptoms?
Non-productive cough that is variable in the day, SOB
What drugs can you use to help with bronchial constriction?
SABAs, LABAs, CysLT1 receptor antagonists, methylxanthines
What are the two types of COPD?
Chronic Bronchitis (Mucus hypersecretion) and Emphysema (Alveolar destruction)
What are some symptoms of COPD?
Daily productive cough, progressive breathlessness, wheezing
What is Asthma?
recurrent and reversible obstruction in the airways in response to stimuli that are not necessarily noxious
What happens in the inflammatory cascade in asthma?
o Genetic Predisposition
o Eosinophilic
inflammation
o Mediators/TH2
cytokines
o Twitchy smooth muscle
(hyper reactivityHow do you treat Asthma?
- SABAs
- Inhaled steroids
- +LABA/LAMA or oral steroids, anti-IgE, etc
What are some diagnostic signs that point to COPD?
Chest expansion - doesn’t relax properly in emphysema
Reduced Breath sounds
Reduced FVC and TLCO
How do you treat COPD?
LAMAs eg tiotropium & PDE4 inhibitors eg Rofumilast
What are the two main types of Lung cancer?
Small cell and non small cell (most common, and includes Adenocarcinoma, Squamous cell and large cell)
What are some symptoms of Lung cancer?
Haemoptysis, Breathlessness, possible chest pain from mass invading chest wall, unexplained weight loss, 3+ weeks cough
What are some diagnostic signs of Lung cancer?
Recurrent pneumonia, stridor, Pleural effusion, tracheal deviation, finger clubbing, Hypercalcaemia (stones, bones, groans, thrones, psychiatric overtones)
How can you treat lung cancer?
Depends on patient factors, but chemo is usually good for small cell, and procedures eg curative surgery and radiotherapy are used for non small cellncer?
What are some symptoms of TB?
3+ weeks productive cough, haemoptysis, breathlessness, fever, etc
How do you diagnose TB?
Sputum microscopy, PCR and Liquid culture (results come back in that order)
What’s the treatment for TB?
2 months RIPE, 4 months RI where RIPE = Rifampicin, Isoniazid, Pyrazinamide, Ethambutol
What’s the scoring system for community aquired pneumonia?
CURB65, where C = New confusion U = Urea > 7 R = Resp rate > 30/min B = BP – Systolic <90 OR diastolic <61 65 = age 65+
How do you treat a pneumothorax?
Needle aspiration/chest drain
How can you treat a tension pneumothorax?
Large bone cannula inserted into 2nd intercostal space, then chest drain inserted into the 5th intercostal space
How can you test for a VTE (Venous Thromboembolism) eg DVT or PE?
Blood test to look for presence of D-dimer protein
Leg vein US
Scoring system = DASH - D-dimer, Age, Sex, Hormones
What does the bohr effect do to tissues and the Hb sat curve?
It results in increased O2 to tissues and results in right-shift of curve
What is myoglobin?
a protein that temp stores O2. presence in blood indicates muscle damage
