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Management > Resp - recap > Flashcards

Resp - recap Flashcards

1
Q

asthma - Ix

A 
resp exam
bloods - FBC, WCC
FEV1 (reduced)/ FVC - <0.7
PEF - reversibility with bronchodialtor
FeNO
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2
Q

asthma - Mx

A 
SABA 
SABA + ICS
SABA + IN ICS
SABA + IN ICS + LABA
SABA + IN ICS + LABA + LTRA
SABA + IN ICS + LABA/ LTRA + oral steroid
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3
Q

acute asthma - Ix

A

A-E
obs - HR, RR, BP
cardio/ resp exam
ABG

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4
Q

acute asthma - Mx

A 
oxygen
salbutamol neb
ipatropium neb
hydrocrotisone IV
magnesium sulphate IV
aminophylline IV
intubation and ventilation,extracorporeal membrane oxygenation (ECMO)
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5
Q

bronchiectasis - Ix

A

obs, resp exam
bloods - FBC, WCC, CRP, ESR
imaging - CXR (thick, cysts), high res CT (signet rings)
specialist - sputum culture, spirometry (obstructive), bronchoscopy
cause - serum Ig (hypogammgloulinaemia), CF sweat test, aspergillus precipitins/ skin prick test, RF/ ANA

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6
Q

bronchiectasis - Mx

A

mx underlying cause, stop smoking
physio - inspiratory mm
postural draining b.d
dyspnoea and wheeze - salbutamol
carbocysteine - mucolytic
abx if exacerbation - MCS (commonly haemophilus but also kleb, pseudo, strep pneumoniae)
surgery - lobectomy - rare, lung transplant

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7
Q

lung cancer - Ix

A

cardio, resp exam
bloods - FBC, UE (calcium), LFT, VGCC ab
CXR - cavitating (squamous), perihilar/ central (SCLC), peripheral (adenocarcinoma), pleural effusion, lung collapse (squamous)
bronchoscopy and biopsy - histology
Endobronchial uss and transbronchial needle aspiration - LN, paratracheal, bronchial lung lesions
PEF, lung function tests - surgrical mx

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8
Q

lung cancer - Mx

- SCLC

A

chemotherapy
+- radiotherapy

generally palliative, worse prognosis

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9
Q

lung cancer - Mx

- NSCLC

A

surgery - lobectomy
- >2cm carina, good reserve, no LN, peripheral
radiotherapy - stage I and II
chemo - stage III and IV

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10
Q

lung cancer - Mx

- palliative

A

chemotherapy - improve symptoms and QoL

endobronchial - stent, debulking

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11
Q

Cystic fibrosis - Ix

A

cardio, resp exam
bloods- FBC, UE, CRP, LFT, clotting, trypsin, faecal elastase
sputum cultures
heel prick test - 8 days
sweat test - pilocarpine, Cl>60 dx for CF
CXR - bronchiectasis
sputum cultures
abdo USS - gallstones, pancreatitis, cirrhosis

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12
Q

cystic fibrosis - Mx

- general

A

genetics
growth
DM
infertility

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13
Q

Cystic fibrosis - Mx

- medical

A

GI - CREON, ADEK, insulin

resp - fluclox, neb salbutamol, neb DNase (mucolytic)

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14
Q

cystic fibrosis - Mx

- surgery

A

lung and liver transplant in failure and cirrhosis

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15
Q

COPD - Ix

A

resp, cardio exam
bloods - FBC (polycythaemia), WCC, ESR, CRP
CXR, ECG (RA/ RV hypertrophy)
sputum sample, post-bronchodilator spirometry FEV1/FVC

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16
Q

COPD - mx

- medical

A

SABA/ SAMA

  • asthma - LABA + ICS (+LAMA)
  • no asthma - LABA + LAMA
  • all failed - po aminophylline

carbocysteine
prophylactic abx - azithromytcin

17
Q

COPD - mx

- specialist

A

pulmonary rehab - 3/w for 6Wks if functional disability
vaccinations - pneumococcal, influenza
roflumilast - PDE4 inhibitor
LTOT - PO2<7.3 or PO2<8 + polycythaemia/ pulomonary HTN/ peripheral oedema

18
Q

COPD - mx

- acute

A 
O2 aiming for 88-92%
neb salb, ipratropium
steroids - oral pred, iv hydrocortisone
abx - amoxicillin, clarithromycin or doxycycline
bipap
19
Q

EAA - Ix

A

resp exam - wheeze, dyspnoea
bloods - IN neutrophils
bronchoalveolar lavage - raised lymphocytes and mast cells
CXR/ CT - ILD

20
Q

EAA - Mx

A

acute - O2
prevent - mask, LT pred
ILD - untreatable
compesnation for farmer’s lung (mouldy spores in hay)

21
Q

Idiopathic pulmonary fibrosis/ ILD- Ix

A

resp exam - fine end bi-basal insp crackles
bloods - FBC, UE, ANA, RF,
ABG
CXR - bi reticulo-nodular shadowing, ground glass
high res CT - honeycombing

22
Q

IPF - Mx

A

pirefenidone - anti-inflam

nantedanib - tyrosine kinase inhibiator

23
Q

ILD - Mx

A

C - wt loss, exercise, stop smoking
M - anti-fibrinolyics, LTOT
S - lung transplant

24
Q

sarcoidosis - mx

A

analgesia
nsaids
occasional steroids if progressive lung fibrosis

25
Q

obstructive sleep apnoea - Ix

A

epsworth sleepiness scale
home pulse oximeter, endoscopy
polysomnography - gold

Dx - >15 episodes in 1hr sleep

26
Q

OSA - mx

A

wt loss, avoid alcohol/ smoking

CPAP via nasal (or oral)

27
Q

emypema - Mx

A

chest drain and IV abx

28
Q

empyema - Ix

A

pleural aspirate - pH<7.2, yellow and turbid, low glucose, IN LDH

29
Q

pleural effusion - Ix

A

cardio, resp exam - DE chest expasion, dull to percussion, DE breath sounds, DE vocal resonance
CXR - pleural effusion, meniscus
- uni - ?malignancy
pleural aspiration + USS - 21G needle + 50ml syringe - cytology, micrscopy, LDH, protein, glucose
CT contrast - malignancy

30
Q

pleural effusion - Mx

A

conservative if small
treat underlying cause
pleural aspirate - small
chest drain - large or recurrent

31
Q

pneumonia

A

a

32
Q

pneumothorax

A

a

33
Q

TB

A

a

34
Q

causes of restrictive lung disease

A 
pulmonary fibrosis
asbestosis
sarcoidosis
acute resp distress
AS
NMD
severe obesity
35
Q

mesothelioma dx

A

thoracoscopy and histology

Management (8 decks)

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