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Year 6 > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Chronic COPD investigations

A

Bedside - sputum culture
Bloods - FBC (secondary polycythaemia from hypoxia)
Imaging - CXR

Post-bronchodilator spirometry FEV1/FVC ratio <0.7

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2
Q

Chronic COPD management

A

Conservative e.g. prophylactic azithromycin, mucolytics

Medical
1. SABA or SAMA (ipratropium)
2. No asthmatic features: LABA (salmeterol) and LAMA (tiotropium). Asthmatic features: LABA + ICS
3. LABA + (LAMA + ICS)

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3
Q

Signs of Cor pulmonale

A

Lung disease -> right ventricular hypertrophy

Peripheral oedema
Raised JVP
Systolic parasternal heave

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4
Q

Cor pulmonale treatment

A

Loop diuretic

Consider long-term oxygen

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5
Q

Asthma diagnosis

A

Peak flow diary (diurnal variation >20%)

Spirometry with bronchodilator reversibility (FEV1 increase by 12% and 200ml)

Fractional exhaled nitric oxide test - 17+ (biomarker of lung inflammation)

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6
Q

Asthma long-term management

A
  1. SABA
  2. SABA + low-dose ICS
  3. SABA + low-dose ICS + LABA
  4. SABA + medium-dose ICS/ keep dose and + LTRA
  5. Specialist referral
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7
Q

Pneumonia
- expansion
- percussion
- resonance
- auscultation
- trachea

A

Expansion - reduced
Percussion - dull
Resonance - increased
Auscultation - bronchial
Trachea - central (if moved, could be endobronchial lesion causing collapse)

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8
Q

Pneumonia essential investigations

A

Bedside - sputum culture
Bloods - blood culture
Imaging - CXR (including lateral, repeat 6 weeks to check for resolution and underlying malignancy)

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9
Q

CURB-65

A

AMTS 8 or less
Urea > 7
RR 30 or more
BP <90 / <60
Age 65+

1 - home
2 - admit
3 - ITU

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10
Q

Community-aquired pneumonia treatment

A

Mild/moderate - amoxicillin or clarithromycin

Severe - co-amoxiclav + clarithromycin

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11
Q

H. influenzae treatment

A

Co-amoxiclav

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12
Q

Atypical pneumonia treatment

A

Clarithromycin

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13
Q

How to change CAP management if patient becomes septic

A

Different abx but broad-spectrum
IV fluids
Noradrenaline once JVP visible

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14
Q

Tuberculosis CXR finding

A

Upper lobe cavitation

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15
Q

Tuberculosis sputum sample method

A

Lowenstein-Jensen medium for 6 weeks
Ziehl-Neelson stain
Acid fast bacilli (red rods) seen

Auramine stain for screening, also better

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16
Q

What can tuberculin skin test and IGRA show in TB?

A

TST - exposure + BCG
IGRA - exposure alone

17
Q

Side effects of TB antibiotics

A

Rifampicin - orange secretions
Isoniazid - peripheral neuropathy, liver toxicity
Pyrazinamide - liver toxicity
Ethambutol - optic neuritis

18
Q

Acute bronchitis management

A

Conservative: drink fluids, analgesia
Doxycycline (if systemically unwell, high CRP)

19
Q

Causes of exudate and transudate in pleural effusion and the protein level

A

Exudate >30g protein
- Infection
- Malignancy
- Trauma
- Pulmonary embolism

Transudate <30g protein
- Cirrhosis
- Nephrotic syndrome
- Congestive heart failure

20
Q

Management for pleural effusion, and when it is turbid/pH<7.2/+veMC&S

A
  1. USS pleural aspiration
  2. Chest drain
21
Q

Differences on CXR between aspergilloma and ABPA

A

Aspergilloma - round mass with crescent of air
ABPA - pathc shadows, segmented collapse

22
Q

Bronchiectasis diagnostic investigation

A

Hr-CT

23
Q

Bronchiectasis management

A

Exercise + airway clearance

Abx (ciprofloxacin)

24
Q

Which lung cancer is associated with SIADH?

A

Small cell

25
Q

Which lung cancer is the most common?

A

Adenocarcinoma (non-small cell) and also most common in non-smokers

Starts peripherally

26
Q

Which lung cancer releases PTHrp?

A

Squamous cell (non-small cell)

27
Q

Obstructive sleep apnoea diagnosis

A

Polysomnography

15+ episodes of hypo/apnoae during 1 hour of sleep

28
Q

Obstructive sleep apnoea management

A
  1. Weight loss
  2. CPAP
  3. Intra-oral devices
29
Q

Mesothelioma diagnosis

A

Thoracoscopy and histology

30
Q

Lung cancer management

A

Surgery
Radiotherapy
Chemotherapy

31
Q

Condition and treatment for:
Erythema nodosum (tender, swollen fat under skin)
Bilateral hilar lymphadenopathy
Polyarthralgia
Hypercalcaemia

A

Sarcoidosis

Oral corticosteroids

32
Q

CXR in pneumoconiosis

A

Honeycombing

33
Q

Type 1 vs type 2 respiratory failure and examples

A

Type 1 - low O2, normal/low CO2
ARDS, pneumonia

Type 2 - low O2, high CO2
COPD

34
Q

Signs of CO2 retention

A

Flap
Bounding pulse
Narcosis (drowsiness)

Year 6 (19 decks)

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