Respiratory Flashcards
Causes of clubbing
Resp
- bronchiectasis/CF
- PCD
- empyema/lung abscess
- TB
Cardiac
- cyanotic CHD
- bacterial endocarditis
GI
- cirrhosis
- chronic hepatitis
- IBD
Malignancy
Idiopathic
What causes hyper expansion?
Asthma - without clubbing CF Bronchiectasis Bronchopulmonary dysplasia - without clubbing Recurrent aspiration Repaired TOF
Values in spirometry
Peak flow - best of 3 FVC - reduced in restrictive disease FEV1 - large and medium airways FEV1/FVC - normal in restrictive, reduced in obstructive FEF25-75 - small airways
Differential diagnosis of asthma?
LRTI BPD Bronchiectasis Foreign body CCF GORD Vascular ring
How is CF managed?
Physio BD
Nutrition
- high calorie, high protein diet
- consider NG/PEG
- pancreatic enzyme supplements
- vitamin A/D/E supplementation
Chest infections
- 3 monthly sputum cultures
- flucloxacillin (prophylaxis or Staph colonisation)
- pseudomonas colonisation: nebuliser tobramycin/colomycin
- acutely: PO ciprofloxacin, IV tazocin, tobramycin
- nebuliser DNase
What is bronchiectasis?
Airway obstruction —> infection of retained secretions
Dilated, chronically inflamed airway
Presents like CF
What causes bronchiectasis?
Post infectious
- staph
- strep
- adenovirus
- pertussis
- influenza
PCD
Bronchiolitis obliterans - adenovirus, RSV, pertussis
Asthma
Alpha 1 antitrypsin deficiency
Immunodeficiency
- hypogammoglobinaemia
- IgA deficiency
How is bronchiectasis treated?
Can reverse it early PT Prophylactic abx Bronchiodilators Immunisations
How does PCD present?
Bronchiectasis Nasal polyps Chronic sinusitis Chronic suppurative otitis media -> hearing aid Male infertility
50% have Kartageners
Dextrocardia
Situs inversus
Causes of stridor?
Laryngomalacia
Acute - foreign body, epiglottis, tracheitis, croup, anaphylaxis
Chronic - hypocalcaemia, subglottic stenosis, vascular ring, web
What is Pierre Robin sequence?
Posterior tongue attachment
Small mandible
Glossoptosis
Pseudomacroglossia
May need NPA
