Respiratory Flashcards
Which organism most commonly causes infective exacerbations in COPD?
Haemophilus influenzae
Which COPD patients should be referred for assessment for home oxygen?
If peripheral oxygen saturation < 92% on air
Raised JVP or peripheral oedema
Polycythaemia
Cyanosis
Very severe outflow obstruction (FEV1 - <30%) or CONSIDER in severe airflow obstruction (FEV1 30-49%)
How is assessment for home oxygen carried out?
Must be done when stable (not during an acute exacerbation) and on optimised COPD treatment
Take 2x arterial blood gases at least 3 weeks apart.
Eligible if pa02 <7.3 kPa
OR
if pa02 <8 kPa with polycythaemia, peripheral oedema or pulmonary hypertension
Contraindications
If SMOKES
They all need a risk assessment before starting home 02.
Need to use it at least 15 hrs per day and ideally 20 hrs per day for maximal benefit
What are the Royal College of Physicians 3 questions as it pertains to asthma reviews and what suggests good v poor control?
- Do your asthma symptoms disrupt your sleep (including cough)?
- Have you had your usual asthma symptoms during the day?
- Does your asthma interfere with your usual activities (housework, school, work etc)
No to all 3 = can assume good control
Yes to 2 or 3 = poor control
NOT LICENSED FOR USE IN CHILDREN
for whom either the Childhood Asthma Control Test or the Asthma Control Questionnaire should be used instead
What is the first line treatment for patients diagnosed with pulmonary sarcoidosis?
Oral steroids (pred) initially a higher dose (0.5mg/kg/day) for 1 month then tapered down to a maintenance dose that controls symptoms for 1-2 years.
2nd line is immunosupressive, e.g methotrexate
What is the most common presenting symptom in lung cancer?
Cough (56%)
followed by chest pain (37%)
For which patients should a low-range peak flow meter be prescribed?
Only those with predicted / best PFs < 200l/min
