Respiratory Flashcards
1
Q
Treatment of pleural effusion
A
dependent on cause
- congestive HF → loop diuretics
- infective → Abs
- malignant → therapeutic thoracocentesis
- large effusions often need aspiration or drainage
2
Q
What is interstitial lung disease?
A
- umbrella term for conditions that affect lung parenchyma
- cause inflammation and fibrosis
3
Q
Diagnosis of interstitial lung disease
A
- clinical features
- high resolution CT thorax → ground glass appearance
- lung biopsy if unsure
4
Q
Treatment of interstitial lung disease
A
supportive, prevent progression
- remove/treat underlying cause
- home O2 if hypoxic at rest
- stop smoking
- physiotherapy
- pneumococcal/flu vaccine
- lung transplant
5
Q
What are the three types of interstitial lung disease?
A
- idiopathic pulmonary fibrosis
- occupational lung disorders
- systemic disease → Wegner’s, Goodpasture’s
6
Q
What is pulmonary HTN?
A
- disease of small pulmonary arteries
- vascular proliferation and remodelling
- progressive increased in PVR
7
Q
What are the main vascular changes in pulmonary HTN?
A
- vasoconstriction
- smooth muscle cell and endothelial cell proliferation
- thrombosis
8
Q
Symptoms of pulmonary HTN
A
- exertional dyspnoea
- lethargy, fatigue
- ankle swelling
9
Q
Signs of pulmonary HTN
A
- accentuated component to 2nd heart sound
- tricsupid regurgitation murmur
- fatigue, peripheral oedema, cyanosis
10
Q
Diagnosis of pulmonary HTN
A
initial tests
- chest xray → enlarged main pulmonary artery/hilar vessels
- ECG
- trans-thoracic echo
GOLD STANDARD = right heart catheterisation
11
Q
Treatment of pulmonary HTN
A
supportive
- treat underlying cause
- oral anticoagulants
- if fluid retention, diuretics
- supplemental O2
- supervised exercise training
- avoid pregnancy
treatment-resistant patients
- balloon atrial septostomy
- lung transplantation
12
Q
What are the two types of bronchial carcinoma?
A
- small cell lung carcinoma → worse prognosis
- non-small cell carcinoma → more common
13
Q
Why is it useful to identify different types of lung cancer?
A
- different types differ in histology and behaviour
- helpful for providing prognosis and determining treatment
- presentations are similar
14
Q
Risk factors of lung cancer
A
- smoking
- asbestos
- coal and products of coal combustion
- radon exposure
- pulmonary fibrosis
- HIV
- genetic factors
15
Q
Symptoms of local disease in lung cancer
A
- persistent cough
- SOB
- haemoptysis
- weight loss
- chest pain
- wheeze
- infections
