Respiratory Flashcards
What is bronchitis and how does it present?
- Infection and subsequent inflammation of the bronchi
- Presents as cough, sore throat, wheezing etc.
How is bronchitis managed?
- Fluids
- Simple analgesia
- Antibiotics for those at risk of complications (adults: 100mg doxycycline, children: amoxicillin 500mg)
Name some of the treatment options for an acute exacerbation of asthma
- Oral prednisolone
- SABA relievers
- Nebulised bronchodilators salbutamol and ipratropium
- Oxygen
- IV magnesium sulphate
- IV theophyllines
- Antibiotics
- Correct fluid and electrolyte disturbances
Which class of asthma medication is not used in children?
LAMA
What is the main treatment for otitis media?
Analgesia
How does croup present?
- Coryza
- Stridor
- Hoarse voice
- Barking cough
How is croup managed?
Oral dexamethasone
How does epiglottitis present?
- Stridor
- Drooling
- Unwell child
How is epiglottitis managed?
- Intubation
- Antibiotics
How does bronchiolitis present?
- <1 year old
- Increased work of breathing
- Difficulty feeding
- Wheeze/crackles
- Cough
When should a child with bronchiolitis be admitted to hospital?
- RR > 60
- Less than 50% usual oral intake
- Dehydration
- Cyanosis
- Grunting/marked chest recession
- Known risk factors
How is bronchiolitis managed?
- Oxygen if sats <92% (CPAP can be used)
- Upper airway suctioning
- Fluids by NG tube or IV
- If children are being looked after at home then safety net the red flags
Describe how the severity of COPD can be determined?
FEV1
- Mild >80% predicted
- Moderate 50-79%
- Severe 30-49%
- Very severe <30%
How can COPD be investigated?
- Spirometry
- CXR
- ECG
- FBC
- BMI
- AIAT
Name some of the complications of COPD
- Acute exacerbation
- Pneumonia
- Macro-nutrient deficiency
- Muscle wasting
- Secondary polycythaemia
- Pulmonary hypertension
- Cor pulmonale
- Pneumothorax
- Depression
Describe the management options for COPD in order of use
- SABA
- LAMA or LABA
- Further LAMA or LABA
- Triple therapy (ICS, LABA and LAMA)
When should a COPD patient be started on long term oxygen?
-PaO2 < 7.3 kPa
Or
-PaO2 7.3-8 kPa if polycythaemia, nocturnal hypoxia, peripheral oedema or pulmonary hypertension
How can an acute exacerbation of COPD be managed?
- Short acting bronchodilators
- Steroids
- Antibiotics
- Hospital admission (tachypneoa, sats <90%, hypotension etc.)
Name the four types of lung cancer
- Squamous
- Adenocarcinoma
- Small cell
- Large cell
Name the treatment options for lung cancer
- Surgery
- Radiotherapy
- Chemotherapy
How can obstructive sleep apnoea be managed?
- Information and support
- Lifestyle measures
- CPAP or intra-oral devices
- Advice on driving and informing the DVLA
Which antibiotics can be used in pneumonia
- Amoxicillin
- Clarithromycin if severe
- Doxycycline if penicillin allergic
What is the pleural fluid protein level found in transudate pleural effusions
<30g/l
What are the causes of transudate pleural effusions?
- Liver cirrhosis
- Nephrotic syndrome
- PE
What is the pleural fluid protein level found in exudate pleural effusions?
> 30g/l
What are the causes of exudate pleural effusions?
- Malignancy
- PE
- Rheumatoid arthritis
- Autoimmune
Describe the management of TB
- Rifampicin, Isoniazid, ethambutol and pyrazinamide for 2 months
- Rifampicin and Isoniazid for fourth months
How does bronchiectasis present?
- Persistent productive cough
- Breathlessness
- Haemoptysis
- Chest pain
- Wheeze and course crackles
Which gene is responsible for cystic fibrosis?
-CFTR
How does cystic fibrosis present?
- Antenatal cvs and echogenic bowel
- Neonatal screening
- Meconium ileus
- Recurrent chest infections
- Failure to thrive
- Nasal polyps and sinusitis
- Male infertility
- Pancreatic insufficiency
Name the common respiratory pathogens found in CF
- Staph aureus
- Haemophilus influenzae
- Pseudomonas aeruginosa
Which drug addresses the primary defect in CF?
Ivacaftor
