resp stuff to memorise Flashcards

1
Q

define bronchiolitis and extra info

A

inflam of bronchioles, RSV, common in winter, infants under 1

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2
Q

coryzal symptoms ? (bronchiolitis)

A

runny/snotty nose
sneezing
mucus in throat
watery eyes

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3
Q

how to monitor resp distress

A

capill blood gas (arterial to look at blood gas)

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4
Q

manage bronchiolitis

A

supportive
adequate intake - nasogastric tube, orally, IV fluids
saline nasal drops to clear way for feeding
suppl oxygen
ventilation if severe

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5
Q

what you’d hear from chest in bronchiolitis

A

whistling due to airway narrowing

wheeze, crackles, harsh breath sounds

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6
Q

what causes grunting and stridor

A

grunting - exhaling with glottis closed

stridor - high pitch inspiration due to upper airway obstruction

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7
Q

prophylaxis for bronchiolitis

A

monthly injection of palivizumab - monoclonal antib targets RSV - passive protection (doesnt stim immune sys like a vaccine would)

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8
Q

3 brackets of causes of bronchiectasis - 2 causes of each

A
chronic inflam:
- CF auto recess - mucus too sticky/hard to move
- prim ciliary dyskinesia auto recess - cilia move abnormally
airway obstruct:
- tumour
- lodged foreign object
infection:
- TB
- haemophilius influenzae
- staph aureus
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9
Q

define bronchiectasis

A

chronic inflam and dilation of bronchioles = destruction of airways
damage to mucocilliary ‘elevator’ = mucus and bacteria accumulate - excessive mucus production

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10
Q

how is mucus normally cleared

A

mucocilliary ‘elevator’ moves it up and out of resp tract via cilia
cl- channels pump out ions which attracts water = keeps them lubricated/moving

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11
Q

sign of long term hypoxia

A

finger clubbing

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12
Q

signs/symptoms of bronchiectasis

A
wheeze
prod cough
fouls smelling mucus
haemoptysis
dyspnea
recurrent pneumonia
basilar crackles
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13
Q

diag bronchiectasis

A

CT scan - will show dilation
CXR
sputum culture
spirometry - reduced ratio aka obstruction

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14
Q

treat bronchiectasis

A

bronchodilator eg. beta 2 agonist
inhaled corticosteroid
atib for pneumonia
percussion/postural drainage

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15
Q

pleural effusion?

A

collection of fluid in pleural cavity (between lung and chest wall)

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16
Q

exudative?

A

high protein count above 3g

protein moves out of tiss into pleural space

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17
Q

transudative?

A

low protein count below 3g

fluid moving across pleural space

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18
Q

pres of pleural effusion

A

SOB, dullness to percussion (no air), reduced breath sounds, tracheal deviation - fluid has pushed mediastinum

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19
Q

investigate pleural effusion

A

CXR - blunting of costophrenic angle, mediastinal and tracheal deviation
pleural fluid aspiration/chest drain - can check protein

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20
Q

small vs large pleural effusions managements

A

conservative if small

if large: aspirate (needle thru chest wall which may need to be repeated) or drain (prevent reoccurence)

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21
Q

empyema - what is it, investig, treat?

A

infected pleural effusion eg patient has improving pneumonia but ongoing fever
aspirate would show pus, low ph, low gluc, high LDH
treat w chest drain and beta lactam with beta lactamase inhib eg. amoxicillin and Clavulanic acid

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22
Q

3 key conseq of CF

A

thick pancreatic and biliary secretions - lack of digestive enzymes eg. pancreatic lipase due to blockage of ducts
low volume thick airway secretions - reduced airway clearance, bacteria colonisation, susceptible to airway infections
congenital bilateral absence of vas deferens in men - sperm cannot get into ejaculate so infertility

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23
Q

lack of pancreatic lipase presence in CF leads to…

A

malabsorption = weight loss, short AKA FTT, loose greasy stool

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24
Q

clinical signs of CF

A

nasal polyps, finger clubbing, crackles, wheezes, abdo distention

25
Q

microbes that colonise in CF

A

staph aureus, haemophilus influenzae, pseudonomas

26
Q

prophylactic treatment in CF

A

flucloxacillin for staph aureus

27
Q

CF patients screened for which linked conditions

A

DM, osteoporosis, vit D def, liver failure

28
Q

avg life expectancy for CF

A

47

29
Q

manage CF

A
chest physiotherap
exercise
high cal diet
CREON tablets for pancreatic insuff
nebulised DNAse
salbutamol
30
Q

sarcoidosis?

A

granulomatous (macrophages) inflam condition

31
Q

typical sarcoidosis patient

A
young adult OR 60
black woman
dry cough
SOB
nodules on skin
32
Q

tests in sarcoidosis

A

screening test - serum ACE
Raised serum soluble interleukin-2 receptor
raised calcium
raised CRP
raised immunoglob
CXR - bilateral hilar lymph
GOLD histo biopsy showing non-caseating granulomas with epithelioid cells

33
Q

fatal comp of sarcoidosis

A

arrythmias

CNS disorder

34
Q

manage/treat sarcoidosis

A

no symp = no treat
1st oral steroids and bisphos
2nd immunosupp eg. methotrexate
severe - lung trans

35
Q

right ventricular hypertroph on ecg

A

r.axis deviation
rbbb
s waves
large r waves

36
Q

causes of pul hypertension

A
SLE
LHF
COPD
pul emobolism
sarcoidosis
37
Q

primary treatement for pul hypertension

A

IV prostanoids
endothelin receptor anatgonists
phosphodiesterase-5-inhib

38
Q

treat pneumothorax

A
>2cm/SOB = aspiration (if fails twice then chest drain)
tension = large bore cannula into 2nd intercostal space at midclavicular line
39
Q

tension pneumothorax

A

one way valve - air gets in but not out, increasing pressure, mediastinal deviation, cardioresp arrest

40
Q

investig pneumothorax

A

erect CXR 1st

CT thorax GOLD

41
Q

most common place for TB

A

lungs bc high o2 supply

42
Q

vaccine for TB

A

BCG - intradermal, live attenuated
protection against severe & complicated TB
less effective against pul TB

43
Q

test before TB vaccine

A

Mantoux needs to be neg, text for hiv, eliminate live vaccine risk

44
Q

at risk ppl for tb

A

neonate w/ fam hist or in area
unvacc older kids or have arrived from tb country
healthcare worker

45
Q

latent tb treat

A

isoniazid

rifampicin

46
Q

active/acute tb treat

A
rifampicin
isoniazid
pyrazinamide
ethambutol
\+pyridoxine vit b6 to reduce periph neurop
47
Q

asbestos is…

A

oncogenic
fibrogenic
= adenocarcinoma, mesothelioma, lung fibrosis

48
Q

high res CT thorax of ILD would show

A

ground glass appearance

49
Q

invest for hypersen penumonitis

A

broncheolar lavage - bronchoscopy washing up airways with fluid = high lymphocytes and mast cells

50
Q

treat whooping cough

A

ezithromycin (or cotrimoxazole if not)

51
Q

cause of whooping cough

A

bordetella pertussis

52
Q

pneumonia on CXR

A

consolidation

53
Q

treat pneumonia

A

amoxicillin

clarithromycin

54
Q

auscultation of pneumonia

A

bronchial breath sounds
focal coarse crackles
dullness to percussion

55
Q

fungal pneumonia treatment

A

co-trimoxazole

56
Q

2 red flag symp for lung cancer

A

finger clubbing

lymphadenopathy =urgent CXR

57
Q

cxr in lung cancer

A

hila enlargement
peripheral opacity
pleural effusion

58
Q

invest lung cancer

A

urgent cxr
then staging contrast enhanced CT
then bronchoscopy and biopsy for diag