Respiratory Flashcards
What things to ask for in a respiratory history?
- Patient details
- Clinical details
- Symptoms
- Exposure history
Patient details
- Age
- Gender
Clinical details
- Symptoms: breathlessness, cough, fever, chest pain - pleuritic?
- Duration
- Underlying disease - any existing respiratory conditions?
- Immunosuppression
Exposure history
- Occupation
- Smoking history
- Asbestos exposure
- Pets/birds at home
- Travel history
- Hospital, res home, ventilator use
What signs to look for in general examination on a respiratory exam?
Where are the respiratory centres in the brain?
Where do these respiratory centres get info from?
Medulla and pons
What is pneumonia?
Symptoms?
Causes?
How is it different from pneumonitis?
Explain the pathophysiology of pneumonia
Leads to what in the lung tissues?
Where in the lungs is
- Pneumonia
- Bronchitis
- Bronchiolitis
What lymph node groups are associate with the respiratory tract
What are the two most common causative organisms of CAP? (community acquired pneumonia)
Streptococcus pneumoniae
Haemophilus influenza
What is the most common presenting symptom of bacterial pneumonia?
Sudden onset of symptoms and rapid progession is associated with bacterial or viral pneumonia?
Slow onset URTI and wheezing is associated with bacterial or viral pneumonia?
Productive cough
What is the CURB-65?
What are the criteria
To assess risk of mortality in pneumonia
Antibiotics for pneumonia?
Symptoms of PCP pneumonia?
Appearance on CXR?
Tuberculosis
Symptoms?
Signs on CXR?
Treatment?
Investigation?
Symptoms
- Productive cough
- Fever
- Night sweats
- Weight loss
- Haemoptysis
Investigation
- sputum sample (LUNG SECRETIONS not saliva) collect 3 specimens on 3 different days. Spontaneous morning sputum best, BEFORE initiating treatment.
Antibiotics for CAP
Antibiotics for HAP
HAP, non severe: Doxycycline
HAP, severe: Co-amoxiclav
What gene is faulty in cystic fibrosis?
What is the method of inheritance?
CFTR gene. Delta F508 mutation.
Autosomal recessive.
What organs are commonly affected in cystic fibrosis and how?
Sweat glands - abnormally high sodium and chloride concentration. Babies taste ‘salty’ when kissed.
Pancreas, small intestine, liver, gallbladder - Obstructions by thick mucus, steatorrhoea, constipation, bowel obstruction, pancreatic insufficiency, diabetes.
Sinuses, bronchial airways - blocked by mucus, thick secretions, bronchiectasis.
What is the presentation of cystic fibrosis on CXR?
Hyperinflation
Bronchiestasis
What is consolidation?
Clinical signs?
Filling of the alveolar spaces with fluid
What is consolidation?
What is a collapse (lung)? How does it appear on CXR?
5 signs on a CXR of collapse / loss of volume?
What is the abnormality in this CXR?
Right upper lobe collapse.
Golden’s S sign.
What is the abnormality in this CXR?
Right upper lobe pneumonia
What is the abnormality in this CXR?
Left lower lobe collapse.
See white triangle or sail sign in front of heart.
What is the abnormality in this CXR?
Right lower lobe collapse.
Increased density in the right lower zone medially. Looks triangular and obscures the heart border completely.
Medial part of the right hemi diaphragm not seen.
What is the abnormality in this CXR?
Lingula consolidation
(lingual is the area on lower medial corner of left lung).
Increased density left mid/lower zone
L heart border very indistinct
What is the abnormality in this CXR?
Tracheal deviation to the right
L lung hyper expanded across midline
R main bronchus abruptly cut off
→ Complete collapse of R lung, due to obstruction of R main bronchus.
Lung borders. What lobes correlate to each colour?
Dark blue - Upper lobes
Light blue - Lingula (L)
Red - Middle lobe (R)
Green - lower lobes
