resp renal csv Flashcards
how long course of acute otitis media
4 days
how long course of acute sore throat/acute pharyngitis/acute tonsillitis
1 week
how long course of common cold
1 1/2 weeks
how long course of acute rhinosinusitis
2 1/2 weeks
how long course of acute cough/acute bronchitis
3 weeks
features of severe asthma (PEFR, HR, RR)
PEFR 33-50, hr>100 rr>25
features of mild asthma (PEFR, HR, RR)
PEFR >50, hr<100, rr<25
features of life threatening asthma (PEFR, HR, RR)
PEFR <33, cyanosis
HSP has a degree of overlap with
IgA nephropathy
difference between iga neph and post strep glomerulonephritis
Iga - symptoms 1-2 days after urti, for PSGN 1-2 weeks and has low compelent
squamous cell lung Ca is associated with what syndrome
hypercalcaemia sec to PTH-rp
egg shell calcification of hilar lymph nodes on xray
silicosis
alcoholic has pnemonia, organism?
klebsiella
COPD pneumonia - what organism
haemophilus
Sinusitis, haemoptysis, haematuria - diagnosis?
Granulomatosis with polyangitis
sinusitis, asthma, haematuria, eosinophilia - diagnosis?
Churg-Strauss
Dyspnoea, cough, painful shin lesions, bilateral hilar lymphadenopathy - diagnosis?
sarcoidosis
Small cell lung carcinoma - associated with which paraneoplastic syndrome
hyponatraemia secondary to ADH secretion
Alpha-1 antitrypsin deficiencyassociated with
panacinar emphysema
CKD on dialysis, most likely cause of death
Ischaemic heart disease
recurrent episodes of dyspnoea, cough and fever, chest x-ray taken shows mid-zone fibrosis - diagnosis?
extrinsic allergic alveolitis
nicotine replacement: contraindication to the prescription of bupropion
epilepsy, pregnancy and breast feeding
nicotine replacement: Varenicline contraindication
caution in patients with a history of depression or self-harm; contraindicated in pregnancy and breastfeeding
paraneoplastic: Which type of cancer is most associated with hypercalcaemia secondary to PTH-rp?
Squamous cell
squamous cell lung Ca paraneoplastic features
parathyroid hormone-related protein (PTH-rp)secretion causing hypercalcaemia; clubbing; hypertrophic pulmonary osteoarthropathy (HPOA); hyperthyroidism due to ectopic TSH
small cell lung Carcinoma paraneoplastic features
ADH
ACTH - not typical, hypertension, hyperglycaemia, hypokalaemia, alkalosis and muscle weakness are more common than buffalo hump etc
Lambert-Eaton syndrome
adenocarcinoma paraneoplastic features
gynecomastia
Asthmatic features/features suggesting steroid responsiveness in COPD:
previous diagnosis of asthma or atopy
a higher blood eosinophil count
substantial variation in FEV1 over time (at least 400 ml)
substantial diurnal variation in peak expiratory flow (at least 20%)
what in FBC would support diagnosis of lung cancer
raised platelets
What is the main therapeutic benefit of inhaled corticosteroids in patients with COPD?
Reduced frequency of exacerbations
recurrent collapse during exertion presents with progressive shortness of breath
aortic stenosis
FVC, FEV1/FVC for pulmonary fibrosis
FVC - reduced, FEV1/FVC - normal
FVC, FEV1/FVC for COPD
FVC - reduced, FEV1/FVC - redued
Varenicline mechanism of action
nicotinic receptor partial agonist
Bupropion mechanism of action
a norepinephrine-dopamine reuptake inhibitor and nicotinic antagonist
Additional med to prescribe for end stage COPD to control symptoms
Opioids such as liquid morphine
what is the minimum number of salbutamol prescriptions in the past 12 months that should prompt an urgent review of a patient’s asthma control?
12
lung cancer for parients who do not smoke, exposure to?
passive smoking
marker most useful for monitoring the progression of patients with chronic obstructive pulmonary disease?
FEV1
haemoptysis and flat nose
Granulomatosis with polyangiitis
Chest x-ray shows a rounded opacity in the right upper zone surrounded by a rim of air.
Aspergilloma
haemoptysis is associated with what heart sounds
mitral stenosis
medication to prevent mountain sickenss
acetazolamide
Indications for LTOT for COPD
a pO2 of < 7.3 kPa or to those with a pO2 of 7.3 - 8 kPa and one of the following:
secondary polycythaemia
peripheral oedema
pulmonary hypertension
bronchodilator reversibility testing in adults - which parameters show reversibility
improvement in FEV1 of 12% or more, together with an increase in volume of at least 200 mL (Note FEV1 so FEV1/FVC or FVC alone not important)
next step for a patient with new diagnosis of occupational asthma
refer to respiratory
most important in the long term control of symptoms of bronchiectasis
postural drainage
smoking cessation: interventions that may be offered to pregnant women is most efficacious
CBT
first-line antibiotic for acute bronchitis unless pregnant/child
doxycycline
COPD on prophylactic azithromycin started smoking again - next step
stop azithromycina nd refer to respiratory
Patients receiving LTOT should breathe supplemental oxygen for at least how many hours per day
15 hours
pulmonary fibrosis average life expectancy
3-4 years
how many measurements of PO2 needed to determine LTOT
2
how is o2 ordered for LTOT on COPD
Home oxygen order form
dose of steroid for acute COPD exacerbation
3mg for 5 days
requirements for prophylactic abx for COPD
not currently smoker, had CT scan to exclude bronchiectasis, had sputum culture, had 5 exacerbations in 1 year
what number of courses of oral or intravenous steroids in the past 12 months should prompt referral to secondary care for optimisation of asthma treatment?
more than 2
