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4th year revision > Respiratory > Flashcards

Respiratory Flashcards

1
Q

What is the treatment for asthma?

A
  1. SABA
  2. SABA + ICS
  3. SABA + ICS+ LABA
    • LTRA
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2
Q

what is the treatment for COPD?

A
  1. SABA (+/- ICS)
  2. LABA + LAMA OR LABA + ICS
  3. LABA + LAMA + ICS
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3
Q

fine end inspiratory crackles

A

pulmonary fibrosis

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4
Q

what things cause upper zone fibrosis?

A 
C - coal workers lung 
H - histiocytosis 
A - ankylosing spondylosis
R - radiation
T - TB
S - sarcoidosis/silicosis
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5
Q

what things cause lower lobe fibrosis?

A
  • interstitial lung disease
  • asbestosis
  • connective tissue disorder
  • drug induced
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6
Q

what are side effects of the the 4 TB drugs?

A

Rifampicin - orange secretions

Ethambutol - eye issues

Pyramidazole - gout and hepatitis

Isoniazid - liver issues and peripheral neuropathy

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7
Q

what is the management of community acquired pneumonia?

A

mild (0-2) = oral amoxicillin 5 days

severe (3+) = IV co-amoxiclav and doxycycline

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8
Q

what is the managment of hospital acquired pneumonia?

A

non severe = amoxicillin 5 days

severe = IV amox and gent 7 days

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9
Q

what is the most common organism in CAP

A

h influenzae

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10
Q

what is the most common organism in HAP

A

pneumococcus, h influenzae

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11
Q

what syndromes are associated with small cell lung cancer

A

ACTH secreting

lambert eaton myasthenia

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12
Q

what syndrome is associated with squamous cell lung cancer

A

hypercalcaemia

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13
Q

what is the management of PE

A

haemodynamically unstable = thrombolysis

haemodynamically stable = DOAC (3 months if provoked, 6 months if unprovoked)

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14
Q

what is the investigation for active and latent tuberculosis

A 
active = sputum culture is gold standard 
latent = mantoux test
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15
Q

what is bronchiectasis

A

chronic dilatation of the bronchi and bronchioles due to chronic infection

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16
Q

what is the managment of bronchiectasis?

A

lung physio, antibiotics, bronchodilators (SABA)

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17
Q

what is the best investigation for bronchiectasis

A

high resolution CT

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18
Q

what spirometry pattern is seen on bronchiectasis

A

obstructive

19
Q

what is the genetic mutation seen in CF

A

AR - cystic fibrosis transmembrane conductance regulator gene on chromosome 7

20
Q

what are the key features of CF

A

meconium ileus, recurrent chest infections, malabsorption, liver disease

21
Q

how is CF diagnosed?

A

day 5/7 heel prick

sweat test

22
Q

what is the managment of CF

A
  • twice daily chest physio
  • high calorie diet
  • avoidance of other patient with CF
  • pancreatic enzyme replacement
23
Q

how do you differentiate between a exudate and transudate in the context of pleural effusion

A

Exudate = >35g protein + high LDH (often unilateral)

Transudate = <35g protein (often billateral)

24
Q

what are examples of exudative causes of pleural effusion

A

infection, malignancy, PE, inflammation

25
Q

what are examples of transudative causes of pleural effusion

A

congestive cardiac failure, cirrhosis, nephrotic syndrome, CKD, coeliacs

26
Q

whats the difference between primary and secondary pneumothorax

A

secondary is when the person has an underlying lung disease

27
Q

whats the management of primary pneumothorax

A
  • <2cm and no SOB = discharge and follow up

- >2cm/ SOB = aspirate (and if doesnt work chest drain)

28
Q

whats the management of a secondary pneumothorax

A
  • > 50y/old and >2cm/SOB = chest drain
  • 1-2cm = aspirate
  • <1cm = admit and O2
29
Q

where is a chest drain inserted

A

5th intercostal space mid axillary line

30
Q

where is an chest aspirate inserted

A

2nd intercostal space mid clavicular line

31
Q

give an example of a SABA

A

salbutamol

32
Q

give an example of a SAMA

A

ipratropium

33
Q

Give an example of a LABA

A

salmeterol

34
Q

Give an example of a LAMA

A

tiotropium

35
Q

pneumonia seen in alcoholics?

A

klebsiella pneumonia

36
Q

pneumonia seen post influenza infection

A

staph aureus pneumonia

37
Q

what are complications of mycoplasma pneumonia?

A
  • haemolytic anaemia and thrombocytopenia (caused by cold agglutins)
  • erythema multiforme
38
Q

what is the management of mycoplasma pneumonia?

A

doxycycline or macrolide

39
Q

what test is used to differentiate between severe and life threatning asthma?

40
Q

what are the criteria for life threatning asthma?

A
  • PEFR <33%
  • O2 <92%
  • normal pCO2
  • silent chest, cyansosis, feeble resp effort
41
Q

what are the criteria for severe asthma?

A
  • PEFR 33-50%
  • cannot complete full sentence
  • RR >25
  • HR >110
42
Q

what are the criteria for moderate asthma?

A
  • PEFR 50-75
  • normal speech
  • RR <25
  • HR <110
43
Q

which lung cancer is associated with SIADH?

A

small cell lung cancer

44
Q

which antibiotic is used in COPD prophylaxis?

A

azithromycin

4th year revision (32 decks)

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