Respiratory Flashcards
What is a common organism which causes pneumonia in bird owners?
chlamydia psittaci
cavitating pneumonia in the upper lobes, mainly in diabetics and alcoholics suggest what?
Klebsiella pneumoniae
Long term use of what can precipitate restrictive lung disease?
Nitrofurantoin
Which condition is immune deficiencies such as hypogammaglobulinemia associated with?
Bronchiectasis
What type of picture do you get on pulmonary function testing in asbestosis?
Restrictive - FEV1 goes down, FVC goes down A LOT therefore overall FEV1/FVC increases
What is the investigation of choice for occupational asthma?
Peak flows at work and home
What is the pathogen involved in Farmer’s lung?
Saccharopolyspora rectivirgula
Chlamydophila psittaci is associated with what?
Contact with birds
How should any critically ill patient be managed with oxygen?
15L high flow oxygen via non-rebreather as hypoxia kills before hypercapnia
What should you aim for in step down treatment of asthma?
reduction of 25-50% in the dose of inhaled corticosteroids
pulmonary fibrosis predominantly affecting the lower zones
Asbestosis
How would opiate overdose present on blood gas?
Respiratory acidosis
Redcurrant jelly sputum is found in what?
Klebsiella pneumonia
What is the COPD exacerbation treatment?
- Give O2 if <90%; Venturi 24% mask at 2-3l or nasal cannula flow rate 1-2l/min; Target oxygen sats 88-92%
- Nebulised bronochodilators: salbutamol (beta adrenergic agonist) or ipratropium (muscarinic antagonis)
- Steroid therapy: 30mg oral pred od for 5d or IV hydrocortisone
- Consider need for Abx: amoxicillin 500mg 3x d for 5d (or clarithromycin or doxy) or if at high risk of treatment failure then co-amoxiclav 500/125mg 3xd for 5d
- IV Theophylline if not responding to bronchodilators
- Non invasive ventilation e.g. BIPAP (if develop T2resp failure)
Why does hypotension occur in tension pneumothorax?
Cardiac outflow obstruction
Most common organism causing infective exacerbation of COPD?
H influenzae
30-40 year old with basal emphysema and abnormal LFTs
Alpha-1-antitrypsin deficiency
Fine end-inspiratory crepitations
pulmonary fibrosis
Investigation of choice for sleep apnoea?
Polysomnography
Coal workers’ pneumoconiosis causes what?
Upper zone fibrosis
What should be sent with diagnostic pleural taps?
- Biochemistry to determine protein
- Cytology
- Microbiology for gram staining and culture
What is important to remember about lung cancers?
Lesion can sometimes be too small to see on CXR
Paratracheal lymph nodes should raise alarm bells for?
Lung cancer
Sarcoidosis can cause what?
Hypercalcaemia