Respiratory Flashcards
What is first-line for newly diagnosed COPD?
SABA/SAMA
What is the second step in COPD management if SABA/SAMA not controlling COPD?
Add LABA + ICS (asthmatic features) OR
Add LABA + LAMA if no asthmatic features
What is the most common type of lung cancer in non-smokers?
Adenocarcinoma
What is the most important piece of advice for reducing the risk of recurrent pneumothorax?
Stop smoking
What follow-up is recommended for patients with pneumonia?
CXR 6 weeks post-resolution
Anion-gap metabolic acidosis occurs due to…
Impaired H+ excretion
Metabolic acidosis without anion gap occurs due to…
Loss of HCO3 eg. vomiting
Give examples of LABA’s.
Salmeterol or Formoterol
Give an example of a SAMA.
Ipratropium
Give an example of a LAMA.
Tiotropium
Give features of a moderate asthma attack.
PEFR > 50% expected/best
Dyspnoea limiting activity
SpO2 > 92%
HR < 110
Give features of a severe asthma attack,
PEF 33-50% Dyspnoea at rest Talks in words RR > 30 HR > 110
Give features of a life-threatening asthma exacerbation
PEF < 33% SpO2 < 92% Silent chest Cyanosis Arrythmia Exhaustion
What is the management of an acute asthma attack?
OSHITMAN Oxygen Salbutamol Hydrocortisone Ipratropium Theophylline Magnesium Sulphate ANaesthetist
What is the asthma treatment ladder in adults?
SABA SABA + ICS SABA + ICS + LABA Consider increasing ICS dose or LTRA Specialist
What is the asthma treatment ladder in children?
SABA SABA + Very low-dose ICS SABA + Very low-dose ICS + LTRA if < 5 or LABA if > 5 Increasing ICS or LABA/LTRA Specialist
Which ABG finding suggests near-fatal asthma?
Normal PCO2 (suggests exhaustion)
What is bronchiectasis?
Condition in which there is permanent dilation of the bronchi
What are the main treatment options for bronchiectasis?
Airway clearance techniques
Treating exacerbations
Pneumococcal vaccine
What are the main treatment options for bronchiectasis?
Airway clearance techniques
Treating exacerbations
Pneumococcal vaccine
What is the investigation of choice for bronchiectasis?
High-resolution CT
Give causes of apical pulmonary fibrosis.
Silicosis
Sarcoidosis
TB
Ank Spon
Give causes of basal pulmonary fibrosis.
Idiopathic pulmonary fibrosis
Autoimmune-related
Medication-related
What is the treatment for pulmonary fibrosis?
Anti-fibrotic medications like nintedanib and pirfenidone
What is the management for pneumothorax < 2cm?
Discharge and advise
What is the treatment for pneumothorax > 2cm?
Chest drain
What is the treatment of choice for allergic bronchopulmonary aspergillosis?
Oral steroids
What is the treatment of choice for allergic bronchopulmonary aspergillosis?
Oral steroids
The severity of COPD is based on…
FEV1
What follow-up should be given to all patients with pneumonia?
CXR 6 weeks after resolution
What does CURB65 stand for?
Confusion Urea > 7 RR > 30 BP < 90/60 Age > 65
What CURB65 score suggests mild-mod CAP?
0-2
What CURB65 score suggests severe CAP?
3-5
What is the treatment for mild-mod CAP?
- Amoxicillin 5/7
2. Doxycycline 5/7
What is the treatment for severe CAP?
IV Co-amoxiclav and PO Doxycyline
What is the treatment for HAP?
Non-severe - PO Amoxicillin 5/7
Severe - IV Amoxicillin & Gentamicin 7/7
What is the treatment for aspiration pneumonia?
Non-severe - PO Amoxicillin and Metronidazole
Severe - IV Amox, Met & Gent
Aspiration pneumonia is most likely to occur in which lobe?
R lower lobe
What is the treatment for mycoplasma pneumonia?
Erythromycin
What is the gold-standard test for COPD?
Spirometry
Which prophylactic antibiotic may be given in some patients with recurrent IE of COPD?
Azithromycin
Whiteout with trachea deviated away suggests..
Pneumothorax/Pleural effusion
Whiteout with trachea deviating towards it suggests…
Collapse
What is the most common organism in pneumonia in alcoholics?
Klebsiella
TLCO is a measure of…
Gas transfer
Pneumonia + lymphopaenia + hyponatraemia suggests…
Legionella
What is the management for TB?
2RIPE4RI
2 months rifampicin, izoniazid, pyrazinamide and ethambutol
Then 4 months rifampicin & isoniazid
Which anti-tuberculous agent is associated with red/orange urine?
Rifampicin
Which anti-tuberculous agent is associated with peripheral neuropathy?
Isoniazid
Which anti-tuberculous agent is associated with joint pains?
Pyrazinamide
Which anti-tuberculous agent is associated with visual loss?
Ethambutol
Which type of pneumonia is associated with desaturation on exercise?
Pneumocystis jirovecci
