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Final Year > Respiratory > Flashcards

Respiratory Flashcards

1
Q

LRTI

A

pneumonia
acute bronchitis - bronchi or bronchioles

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2
Q

Pneumonia defn

A

inflammation of lung tissue in the alveolar space

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3
Q

Aspiration Pneumonia is?

A

due to the aspiration of food or fluids
impaired swallow

anerobic bacteria

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4
Q

signs of pneumonia?
auscultation?
percussion note?

A

bronchial breath sounds: HARSH inspiratory and expiratory due to consolidation around the airways

focal coarse crackles
dull to percussion : lung tissue filled wih sputum or collapsed

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5
Q

Percussion findings respiratory exam why dull?

A

increased tissue density

more solid tissues : consolidation
mass (cancer)
fluid
sputum

pleural effusion is sometimes said to be stony dull

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6
Q

Percussion findings respiratory exam why hyper resonant?

A

too much air
pneumothorax

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7
Q

what is the sepsis indication sin LRTI?

A

tachypnoea
tachycardia
hypoxic
hypotense
fever
confusion

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8
Q

CURB-65 /CRb-65

A

confused?

urea >7mmol/l
RR >30
BP : <90 systolic or 60 diastolic
65 > age

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9
Q

atypical pneumonia

A

cannot be cultured in the normal way / detected by gram stain

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10
Q

Mx of atypical pneumonia?

A

macrolide
fluoroquinolones
tetracyclines

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11
Q

Infected water systems > atypical pneumonia > which investigations?

A

legionella pneumophilia

SIADH = hyponatraemic
urine antigen test

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12
Q

SOB, cough, unwell but with target lesions?

A

rash is erythema multiforme : pink ring with pale center

Mycoplasma pneumoniae

neuro symptoms in some patients

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13
Q

atypical pneumonia with the mnemonic: “Legions of psittaci MCQs

A

Legions – Legionella pneumophila
Psittaci – Chlamydia psittaci
M – Mycoplasma pneumoniae
C – Chlamydophila pneumoniae
Qs – Q fever (coxiella burnetii)

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14
Q

PCP mx?

A

co trimoxazole

fungal pneumonia

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15
Q

Ix pneumonia

A

CXR
FBC
renal profile : urea / aki
CRP

sputu
blood cultures
urinary antigen tests

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16
Q

when does CRP start to rise?

A

6 hours from onset and peaks 24-48 hours

17
Q

mild pneumonia tx ?

A

5 days oral
amoxicillin
doxy
clarithromycin

18
Q

Complications of pneumonia?

A

sepsis
ARDS
pleural effusion
Empyema
Abscess
Death

19
Q

Acute Bronchitis - defn

A

Oedematous large airways
production of Sputum
3 weeks
self resolve
viral

20
Q

Mx of Acute bronchitis is dependent on what lab measure?

A

CRP >100mg/l
offer abx - DOXY

analgesia
good fluid intake

21
Q

what is the name of the respiratory stimulant used when NIV or intubation is not appropriate?

In COPD acute exarcebation

A

Doxapram

22
Q

NIV - inclusion criteria COPD

A

Persistent respiratory acidosis
(pH < 7.35 and PaCO2 > 6)
despite maximal medical treatment

Potential to recover
Acceptable to the patient

23
Q

IPAP

A

inspiratory pressure - air is forced into the lungs

positive airway pressure

24
Q

EPAP

A

pressure during expiration – stopping the airways from collapsing

25
Q

most common cause of COPD exarcebations?

A

bacterial:
haemophilus influenzae
streptococcus pneumoniae
moraxella catarrhalis

26
Q

what Abx in COPD exacerbation?

A

Amoxicillin
Clarithromycin
Doxycycline

27
Q

admission criteria for COPD?

A

severe breathlessness
acutely confused

cyanosis
oxygen sat <90% on pulse oximetry

28
Q

Oxygen therapy secondary care
COPD before blood gases?

A

28% - WHITE venturi mask
4L/min

29
Q

Severe exacerbations requiring secondary care: COPD

A

O2 therapy
nebulised bronchodilators

> Salbutamol : Beta2 adrenergic agonist
muscarinic antagonist : Ipratropium bromide

IV hydrocortisone
IV theophylline

30
Q

BiPaP pressures COPD

A

EPAP: 4-5cm H2O
IPAP: 12-15cm H2O

31
Q

CXR findings of COPD

A

hyperinflation
bullae:
flat hemidiaphragm
exclude lung cancer

32
Q

Severity of COPD - FEV1

A

> 80% : Stage 1 mild
50-79% : Stage 2
30-49% : Stage 3
<30% : Stage 4

33
Q

LTOT : COPD

A

pO2 <7.3 kPa,

pO2 of 7.3-8 kPa
1) secondary polycythaemia
2) peripheral oedema
3) pulmonary HTN

34
Q

oral PDE-4 inhibitors such as roflumilast reduce risk of?

A

?

35
Q

Idiopathic pulmonary fibrosis

A

acute SOBOE
dry cough > 3 months

finger clubbing

36
Q

Interstitial fibrosis : drug which reduces fibrosis and inflammation by inhibiting tyrosine kinase?

A

nintedanib

37
Q

Pirfenidone

A

reduces fibrosis and inflammation through various mechanisms

pulmonary fibrosis

38
Q
A

Final Year (11 decks)

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