Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

1. Jim > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Key aspects of COPD management

A

Active Rx
- Pharmacotherapy
- Pulmonary rehab
- Action plan
- Self-management
Prevention
- Vaccination
- Smoking cessation
- Nutrition
- Co-morbidities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Diagnosis of COPD

A

Hx, then needs to be confirmed on SPIROMETRY
Persistent airflow limitation (without complete reversibility)
= Post bronchodilator FEV1/FVC <0.7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How to assess COPD severity
3/2/1

A

Testing
- oximetry <92% when stable
- ABG with peristent hypercapnia
- lung function
Through History
- effect of Sx of daily living
- level of breathlesssness
presence of complications/commorbidities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Complications and comorbidities with COPD (5)

A

Infections +- hospitalisations
Hypoxaemia
Pulmonary HTN
Heart failure
Polycythaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

5-As smoking cessation

A

Ask, Assess, Advise, Assist, Arrange

Ask and identify
Asses nictotine dependence + motivation to quite
Advise about risks of smoking + benefits of quitting
Assist cessation - counselling + pharamcotherapy
Arrange follow-up within 1 wk and 1 month

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

LAMAs (4)

A
  • ium
    Umeclidnium (Incruse Elipta)
    Tiotropium (Spiriva)
    Glycopyrronium (Seebri Breezhaler)
    Aclidinium (Bretaris Genuair)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

LABAs (3)

A
  • erol
    indacaterol (Onbrez)
    Formeterol
    Salmeterol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

ICS

A
  • asone + -onide
    Fluticasone
    Beclometasone
    Ciclesonide
    Budesonide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

LAMA/LABA (4)

A

Indacaterol/glycopyrronium (Ultibro)
Tiotroprium/olodaterol (Spiolto)
Umeclidinium/vilanterol (Anoro)
Aclidinium/formeterol (Brimica Genuair)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Testing and treatment for dry cough in bouts

A

Nasopharyngeal swab for pertussis PCR within 3wks, otherwise serology
Treatment - if within 3wks needs treatment with oral azithromycin for 5/7
Treat contacts if will expose at risk pt (<6mo, pregnant)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Features on XR + Diagnosis
60 smoker, presents with acute history of worsening SOB

A

Large RUZ opacity with collapse, assoc with hilar mass. Note hyperlucency of the hyper expanded RM and RL lobes
-> Small Cell Lung Cancer (SCLC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Key differences between 3 stages of asthma
- mild/mod
- severe
- life threatening

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

6+ child with asthma. Other than interval Sx, what are indications for preventer (3)

A
  1. Asthma symptoms limiting normal activity (school, sports)
  2. Asthma requiring hospitalization (mod flare) OR req ICU (severe flare)
  3. 2x exacerbations requiring oral steroids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Non pharma Mx of Paed asthma (5)

A
  1. Prepare up to date AAP
  2. Educate on avoidance of triggers
  3. Avoid passive smoke exposure
  4. Advise carrying salbutamol at all times
  5. Advise annual flu vacc
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Management steps for pertussis (4)

A
  1. Notify Deparment of Health
  2. Commence patient on oral azithromyxin for 5/7
  3. Reccomend treatment of other risk contacts
    - pregnancy
    - <6mo
    - whole house if <6mo or pregnant individual
    - any contacts who have exposure to high risk pts
  4. Advise patient to isolate when they have completed 5/7 of antibiotics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

4yo boy with symptoms of rhinosinusitis, Mx options (3)

A
  1. Oral loratidine OD
  2. Intranasal nasonex both nostrils BD
  3. Oral montelukast (singulair) OD
17
Q

Definition of severe acute asthma (3)

A

Speaking short sentences
Sats 90-94%
Mod-severe WOB

18
Q

11 yo with severe asthma, Mx in ED (5)

A
  1. 12puffs inhaled salbutamol with spacer
  2. 8 puffs inhaled ipratropium with spacer
  3. Prednislone 1mg/kg (??immediate)
  4. Supplemental oxygen to maintain sats >95%
  5. Gain peripheral IV access
19
Q

Adult asthma - when is PRN SABA appropiate?

A

Only if symptoms < twice a month + no risk factors for flare ups

20
Q

Patient with history consistent with asthma, has symptoms 1x per week. No previous management. Pharmacological management?

A

Regular low dose ICS OD + PRN SABA
or/
Budesonide/formeterol (low dose) PRN

21
Q

Adult asthma patient on PRN symbicort, having frequent exacerbations. Next step in management

A

Change symbicort (ICS/formeterol) to regular dose + use PRN
or/
Change to regular + PRN SABA

22
Q

Adult asthma patient on low dose ICS/formeterol daily. In last 3 months, has been using 2-4 extra puffs most days
?Rx

A

Poor control despite low dose regular ICS/formeterol
Increase to medium-high dose

NB: if doesnt work, refer to specialist

23
Q

WHen to consider step down of adult asthma management + features of good asthma control (4)

A

If stable for 2-3 months
Good control
- Day time symptoms <2days/wk
- Need for SABA <2days/wk
- No limitation on activities
- No symptoms during night or on waking

24
Q

Adult asthma, poorly controlled, before stepping up treatment - what should you double check (3)

A
  1. Symptoms are due to asthma
  2. Inhaler technique is correct
  3. Adherence is adequate
25
Q

Medium dose of budesonide?

A

500-800 microg PER DAY
ie, lower is low dose, higher is high dose

26
Q

When to step down children asthma treatment?

A

If stable for 6 months, different to adults who are only 2-3mo

27
Q

Spirometry - what defines positive bronchodilator response (2)

A

Increase FEV1 or FVC atleast 12% and 200ml

28
Q

Spirometry but it doesnt give LLN, only gives % predicted, how to intepret.

A

Older style
LLN for FVC + FEV1/FVC is <70% predicted
(FEV1 <80% predicted)

29
Q

35yo recent dx chest infection, hasnt responded to 3/7 augmentin. ?keep going or change treatment

A

Bilateral ill defined opacities
-> suggestive of mycoplasma pneumonia
-> Change to oral doxycycline BD

30
Q

40yo presents with 10/7 muscle aches, intermittent fever, dry cough. Tried amox with GP 5/7 ago, no improvement. Works in a pet store with birds.
DDx (6)

A
  1. Psittacosis
  2. Hypersensitivity pneumonitis
  3. Pertussis
  4. Post nasal drip from allergic rhinosinusitis
  5. Viral URTI
  6. Atypical pnuemonia (mycoplasma)
31
Q

KFP: Pt with COPD, exam findings that would warrant admission (6)

A
  1. Hypotension SBP <90
  2. Tachycardia HR >100
  3. Tachypnoea RR>30
  4. Hypoxia Sp02 <92% on RA
  5. Increased WOB
  6. New onset confusion
32
Q

KFP: Features on hx the support provisional dx of OSA - note need diversity (5)

A
  1. Waking with gasping/witnessed apnoeas
  2. Excessive daytime sleepiness
    (grouped with unrefreshing sleep etc)
  3. Poor concentration
  4. Low mood
  5. Nocturia

1. Jim (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions