Respiratory Flashcards
Resp signs of granulomatosis with polyangiitis
upper respiratory - epistaxis, sinusisis, nasal crusting;
lower respiratory - dyspnoea, haemoptysis;
Saddle-shape nose deformity
Examination findings - pulmonary oedema
bibasal crackles;
S3
ABG in chronic CO2 retention
- normal pH
- High pCO2
- High HCO3
Step 3 for paeds asthma tx
SABA + paeds low-dose ICS + leukotriene receptor antagonist
Step 4 paeds asthma tx
SABA + paeds low-dose ICS + LABA
non resp fts of sarcoidosis
- erythema nodosum (painful rash in shin/thigh/forearm)
- hypercalcaemia (kidneys)
- lymphadenopathy (b/l hilar)
- uveitis
- polyarthralgia
- lupus pernio
lung Ca heavily associated with smoking
SCC
Commonest organism for pneumonia, common fts
streptococcus pneumoniae (pneumococcus)
high fever, rapid onset, herpes labialis
Causative organism for pneumonia - COPD pts
Haemophilus influenzae
Common presentation of staphylococcus aureus pneumonia
following influenza infection
Common fts of mycoplasma pneumonia
Atypical pneumonia
- dry cough
- atypical chest signs/xray
+/- autoimmune haemolytic anaemia
+/- erythema multiforme
Common fts of legionella pneumophilia pneumonia
Atypical
- hyponatraemia
- lymphopoenia
Classically = infected via air conditioning units (water droplets)
Pt group classically affected by klebsiella pneumoniae pneumonia
alcoholics
Pt group classically affected by penumocystis jiroveci pneumonia
HIV pts
Classic fts of pneumocystis jiroveci pneumonia
- immunosuppressed pts
- dry cough
- exercise-induced desaturation
- absence of chest signs
1st step bronchodilator therapy COPD
SABA or SAMA
2nd step bronchodilator therapy COPD
asthmatic fts/steroid responsiveness: LABA + ICS
other: LABA + LAMA (if SAMA, stop and swtich to SABA)
3rd line bronchodilator therapy COPD w/ asthmatic fts/steroid responsiveness
triple therapy
LAMA + LABA + ICS
(if SAMA prior, discontinue and switch to SABA)
+ phosphodiesterase-4 inhibitor (roflumilast) if 2+ exacerbation in 12mo despite established triple therapy
Criteria for asthmatic fts/ steroid responsiveness in COPD pt
- previous, secure diagnosis of asthma or atopy
- higher blood eosinophic count
- substantial variation in FEV1 over time (400mL)
- substantial diurnal variation in PEFR (>20%)
not spirometric reversibility
