Respiratory Flashcards
First line treatment for pregnant women trying to stop smoking?
Nicotine replacement patches
Varenicline and bupropion are C/I
“fluid filled area surrounded by focal consolidation” on CXR is what?
Lung abscess
What blood test is important in the work up with someone with worsening SOB with COPD?
Full blood count for RBCs - COPD causes polycythaemia
CO₂ retainer, T2RF on admission, worsening ABGs on 2L. What is the best course of action regarding ventilation?
Non-invasive ventilation (BiPAP)
What pH is an indication for intubation?
7.25 or less
Management of primary pneumothorax <2cm without SOB?
Discharge and follow-up
ENT sx + respiratory sx + kidney sx + weight loss = ?
Wegener’s granulomatosis / granulomatosis with polyangiitis
Test: cANCA
Trauma pt. Acute deterioration following ventilation?
Tension pneumothorax
Is trachea deviated away or towards a pleural effusion?
Away
Treatment for allergic bronchopulmonary aspergillosis?
Oral glucocorticoids (e.g. prednisolone)
A normal pCO2 in acute asthma suggests what level of severity?
Life-threatening. It’s a sign of tiring respiratory efforts.
High respiratory rate driven by hypoxia should cause low CO₂
Impaired expiration by constricted bronchioles ⇒ air trapped in lungs and can’t escape (hyper-resonant) ⇒ hypercapnia
What would the aspirate be in empyema?
- pH
- glucose
- LDH
- Low pH (bacteria produce CO₂ during respiration)
- Low glucose (bacteria use it up for respiration)
- High LDH (lactate dehydrogenase needed for bacteria to respire)
Second line for asthma not controlled by SABA?
Add budesonide (ICS)
Which smoking cessation drug reduces seizure threshold (and is therefore contraindicated in pts with epilepsy)?
Bupropion
Gold standard test for diagnosing mesothelioma?
Thoracoscopic biopsy
Is TLCO raised or reduced in COPD?
Reduced
Alveoli are destroyed in emphysema ⇒ ↓ surface area available for gas transfer ⇒ ↓ TLCO (measure of gas transfer)
When prescribing a LAMA (e.g. tiotropium), what should you do with an already-prescribed SAMA (e.g. ipratropium)?
Discontinue it, and replace with a SABA.
If prescribing a LAMA bc a patient is symptomatic on a SAMA, discontinue the SAMA to prevent anti-muscarinic side effects (e.g. dry mouth, blurred, vision, etc.). However the pt will still need a ‘rescue’ inhaler, so prescribe a SABA instead (e.g. salbutamol).
Ipratropium (SAMA)
Salbutamol (SABA)
Tiotropium (LAMA)
Salmeterol (LABA)
COPD pt, no asthmatic features, still symptomatic on rescue inhaler. What is the next step?
Add a LAMA + LABA.
Discontinue a SAMA if on it, and switch to SABA.
