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UKMLA Prep > Respiratory 🫁 > Flashcards

Respiratory 🫁 Flashcards

1
Q

What is the skin prick test?

A

Most commonly used test for allergies, involving drops of diluted allergen placed on the skin and pierced with a needle. Results interpreted after 15 minutes.

Includes histamine (positive) and sterile water (negative) controls.

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2
Q

What does the radioallergosorbent test (RAST) measure?

A

Determines the amount of IgE that reacts specifically with suspected allergens, graded from 0 (negative) to 6 (strongly positive).

Useful for food allergies and inhaled allergens.

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3
Q

What is skin patch testing used for?

A

Useful for diagnosing contact dermatitis by placing allergens on the back and reading results after 48 hours.

May include testing for irritants.

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4
Q

Define oral allergy syndrome (OAS).

A

An IgE-mediated hypersensitivity reaction to specific raw plant-based foods, often linked to pollen allergies.

Presents with tingling or pruritus in the mouth.

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5
Q

How does OAS differ from traditional food allergies?

A

OAS is caused by cross-sensitization to similar proteins in pollen, while food allergies are due to direct sensitivity to food proteins.

Non-plant foods do not cause OAS.

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6
Q

What is the epidemiology of OAS in the UK?

A

About 2% of the UK population has OAS, often under-diagnosed.

1/2 of general pollen allergy patients and 3/4 of birch pollen allergy patients report OAS symptoms.

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7
Q

What are common associations with OAS?

A
  • Birch pollen allergy
  • Rye grass pollen allergy
  • Rubber latex allergy
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8
Q

What are the common symptoms of OAS?

A
  • Itching and tingling of lips, tongue, mouth
  • Mild swelling and redness
  • Nausea and vomiting in severe cases
  • Symptoms resolve within one hour
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9
Q

Is anaphylaxis a common complication of OAS?

A

False

Anaphylaxis is very rare in OAS.

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10
Q

What investigations can be used for diagnosing OAS?

A

Clinical diagnosis; standard IgE RAST and skin prick testing for common allergens may be performed.

Positive skin prick test indicates allergy.

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11
Q

What is the primary management for OAS?

A

Avoidance of culprit foods.

Oral antihistamines can be used if symptoms develop.

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12
Q

What defines local and systemic reactions to venom allergies?

A

Local reactions are confined to the site of exposure, while systemic reactions occur away from the site and may involve widespread symptoms.

Anaphylaxis may occur with or without systemic reactions.

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13
Q

What is the first-line management for anaphylaxis?

A

Intramuscular adrenaline, intravenous steroids, and intravenous antihistamines as needed.

Oxygen and nebulised bronchodilators may also be required.

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14
Q

What is venom immunotherapy (VIT)?

A

An effective immunotherapy for patients with a history of systemic reactions and raised levels of venom-specific IgE.

Recommended for those with airway compromise or hemodynamic instability.

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15
Q

What are the ‘Hs’ and ‘Ts’ in reversible causes of cardiac arrest?

A
  • Hs: Hypoxia, Hypovolaemia, Hyperkalemia, Hypokalaemia, Hypoglycaemia, Hypocalcaemia, Acidaemia, Hypothermia
  • Ts: Thrombosis, Tension pneumothorax, Tamponade, Toxins
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16
Q

What is the recommended chest compression to ventilation ratio for adults during CPR?

A

30:2

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17
Q

What are the major points in the 2015 Resuscitation Council guidelines for cardiac arrest?

A
  • Chest compressions
  • Defibrillation
  • Drug delivery via IV or IO
  • Administration of adrenaline and amiodarone
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18
Q

What is the typical presentation of myocardial infarction?

A

Sudden onset of central, crushing chest pain, possibly radiating to the neck and left arm.

May include nausea and sweating.

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19
Q

What is the characteristic feature of a dissecting aortic aneurysm?

A

‘Tearing’ chest pain radiating through to the back and unequal upper limb blood pressure.

Most common in Afro-Caribbean males aged 50-70.

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20
Q

Which condition is associated with sharp chest pain relieved by sitting forwards?

A

Pericarditis

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21
Q

What is the common treatment for a perforated peptic ulcer?

A

Laparotomy, with small defects excised and larger defects managed with partial gastrectomy.

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22
Q

What type of pain is typically worse immediately after eating in gastric ulcers?

A

Gastric pain

This is a characteristic symptom associated with gastric ulcers.

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23
Q

What diagnostic tool may show free intra-abdominal air in cases of perforated gastric ulcers?

A

Erect chest x-ray

A small amount of free air may indicate perforation.

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24
Q

What is the typical treatment for a perforated gastric ulcer?

A

Laparotomy

Smaller defects may be managed with an omental patch, while larger defects may require partial gastrectomy.

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25
Q

What syndrome is characterized by spontaneous rupture of the oesophagus due to repeated vomiting?

A

Boerhaave’s syndrome

This condition typically involves severe chest pain and mediastinitis.

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26
Q

What imaging technique is used to diagnose Boerhaave’s syndrome?

A

CT contrast swallow

This method helps visualize the rupture in the esophagus.

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27
Q

What ECG changes are associated with Anteroseptal myocardial infarction?

A

V1-V4

This indicates involvement of the left anterior descending artery.

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28
Q

What does a new left bundle branch block (LBBB) indicate?

A

Acute coronary syndrome

LBBB can be a sign of underlying cardiac issues.

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29
Q

What are common symptoms of Pancoast tumors?

A

Persistent cough, haemoptysis, dyspnoea, chest pain, weight loss, anorexia, hoarseness

These symptoms can occur due to tumor pressure on surrounding structures.

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30
Q

What paraneoplastic syndrome is associated with small cell lung carcinoma?

A

ADH secretion

This can lead to hyponatremia and other electrolyte imbalances.

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31
Q

What is a characteristic feature of acute severe asthma?

A

Worsening dyspnoea, wheeze, and cough not responding to salbutamol

These symptoms indicate a significant asthma exacerbation.

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32
Q

What classification is used for the severity of acute asthma?

A

Moderate, Severe, Life-threatening

This classification helps guide treatment decisions.

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33
Q

What is the first-line antibiotic recommended for acute bronchitis in certain patients?

A

Doxycycline

Alternatives include amoxicillin, but doxycycline cannot be used in children or pregnant women.

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34
Q

What is the primary causative agent of acute epiglottitis?

A

Haemophilus influenzae type B

This infection can lead to severe airway obstruction.

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35
Q

What is the ‘thumb sign’ on lateral x-ray indicative of?

A

Swelling of the epiglottis in acute epiglottitis

This sign can help in diagnosing epiglottitis.

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36
Q

What are the features of bronchiectasis?

A

Persistent productive cough, dyspnoea, haemoptysis

These symptoms arise due to chronic infection or inflammation.

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37
Q

What is the main cause of Chronic Obstructive Pulmonary Disease (COPD)?

A

Smoking

COPD encompasses chronic bronchitis and emphysema.

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38
Q

What is the post-bronchodilator FEV1/FVC ratio that indicates mild COPD?

A

> 80%

This is classified as Stage 1 - Mild according to the severity grading.

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39
Q

What is the most common cause of community-acquired pneumonia (CAP)?

A

Streptococcus pneumoniae

This bacterial pathogen is frequently responsible for pneumonia cases.

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40
Q

What is the CRB65 score used for?

A

Assessing pneumonia severity in primary care

It helps to stratify patients based on mortality risk.

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41
Q

What does a CURB65 score of 3 or more indicate?

A

High risk (more than 15% mortality risk)

This necessitates intensive care assessment.

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42
Q

What are common signs of pneumonia upon examination?

A

High temperature, tachycardia, hypotension, confusion, dullness on percussion

These signs indicate systemic infection and fluid accumulation.

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43
Q

What are potential features of pulmonary embolism?

A

Chest pain, dyspnoea, haemoptysis, tachycardia, tachypnoea

These symptoms can vary widely among patients.

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44
Q

What are the recommended antibodies for patients at intermediate or high risk of pulmonary embolism?

A

Ella antibodies

Ella antibodies are used to help in the diagnosis of pulmonary embolism.

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45
Q

What are potential features of pulmonary embolism?

A
  • Chest pain
  • Dyspnoea
  • Haemoptysis
  • Tachycardia
  • Tachypnoea
  • Clear chest on examination

In real-world clinical practice, findings may vary.

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46
Q

What is the frequency of tachypnea in patients diagnosed with pulmonary embolism according to the PIOPED study?

A

96%

This indicates that tachypnea is a very common sign in pulmonary embolism cases.

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47
Q

What are the common clinical signs associated with pulmonary embolism?

A
  • Tachypnea (96%)
  • Crackles (58%)
  • Tachycardia (44%)
  • Fever (43%)

These findings are based on the PIOPED study results.

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48
Q

What is pulmonary tuberculosis primarily caused by?

A

Mycobacterium tuberculosis

Other rare causes include Mycobacterium bovis and Mycobacterium africanum.

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49
Q

What are the features of symptomatic primary infection of tuberculosis?

A
  • Fever
  • Pleuritic or retrosternal pain

Pleuritic pain may be due to pleural effusion, while retrosternal pain may be due to enlarged bronchial lymph nodes.

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50
Q

What are common symptoms of upper respiratory tract infections (URTIs)?

A
  • Nasal discharge
  • Nasal obstruction
  • Sore throat
  • Headache
  • Cough
  • Tiredness
  • General malaise

Other symptoms may include facial pain, earache, hoarseness, and nausea.

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51
Q

How often are adults affected by URTIs on average per year?

A

2-3 times

Children may average up to 5-6 infections per year.

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52
Q

What is the typical management for an uncomplicated cold in a healthy adult?

A
  • Reassurance
  • Paracetamol
  • Fluids
  • Rest
  • Over-the-counter remedies if appropriate

The condition is self-limiting and usually resolves within 7-10 days.

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53
Q

What are the features of acute asthma?

A
  • Worsening dyspnoea
  • Wheeze
  • Cough not responding to salbutamol

It may be triggered by a respiratory tract infection.

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54
Q

What defines moderate asthma according to PEFR measurements?

A

PEFR 50-75% best or predicted

Patients can speak normally, with a respiratory rate of < 25/min and pulse < 110 bpm.

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55
Q

What is the most common cause of acute bronchitis?

A

Viral infection

Around 80% of episodes occur in autumn or winter.

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56
Q

What are common features of bronchiectasis?

A
  • Persistent productive cough
  • Dyspnoea
  • Haemoptysis

Patients may expectorate large volumes of sputum.

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57
Q

What characterizes chronic obstructive pulmonary disease (COPD)?

A

An umbrella term for chronic bronchitis and emphysema

The majority of cases are caused by smoking.

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58
Q

What is the criteria for diagnosing COPD severity based on FEV1?

A
  • Stage 1 - Mild: FEV1 > 80%
  • Stage 2 - Moderate: FEV1 50-79%
  • Stage 3 - Severe: FEV1 30-49%
  • Stage 4 - Very severe: FEV1 < 30%

Symptoms must be present to diagnose COPD in Stage 1 patients.

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59
Q

What are the common causative pathogens for pneumonia?

A
  • Bacteria (e.g. Streptococcus pneumoniae)
  • Virus
  • Fungus (e.g. Pneumocystis jiroveci)

Streptococcus pneumoniae is the most common cause of community-acquired pneumonia.

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60
Q

What is anaphylaxis?

A

A severe, life-threatening, generalised or systemic hypersensitivity reaction

It can be triggered by food, drugs, or venom.

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61
Q

What are the symptoms of anaphylaxis according to the Resus Council UK?

A
  • Airway problems (swelling, hoarse voice)
  • Breathing problems (wheeze, dyspnoea)
  • Circulation problems (hypotension, tachycardia)

Symptoms progress rapidly.

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62
Q

What is the first-line treatment for anaphylaxis?

A

Intramuscular adrenaline

It should be administered as soon as possible.

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63
Q

What is the recommended dose of adrenaline for adults in anaphylaxis?

A

500 micrograms (0.5 ml 1 in 1,000)

Adrenaline can be repeated every 5 minutes if necessary.

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64
Q

What defines refractory anaphylaxis?

A

Respiratory and/or cardiovascular problems persist despite 2 doses of IM adrenaline

IV fluids should be administered for shock in such cases.

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65
Q

What are the features of secondary infection (postprimary/reactivation) of tuberculosis?

A
  • Cough, gradually becoming productive
  • Haemoptysis (minority)
  • Weight loss
  • Fatigue
  • Night sweats
  • Low-grade fever

These symptoms typically develop as the disease reactivates.

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66
Q

What are the signs of pneumonia?

A
  • Erythema or injection of the back of the throat
  • Nasal discharge
  • Tender cervical lymphadenopathy
  • Mild fever

These signs may vary based on the underlying cause of pneumonia.

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67
Q

What may be required in less straightforward cases of URTIs?

A

Investigations

This is particularly true for vulnerable populations such as infants or immunocompromised adults.

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68
Q

What are the common complications of upper respiratory tract infections?

A
  • Sinusitis
  • Otitis media
  • Secondary bacterial infection (e.g. pneumonia)
  • Exacerbations of pre-existing respiratory conditions
  • Viral wheeze, bronchiolitis, and croup in infants

These complications can arise from untreated or severe URTIs.

69
Q

What is the feature that differentiates acute bronchitis from pneumonia regarding symptoms?

A

Sputum, wheeze, breathlessness may be absent in acute bronchitis

At least one of these symptoms tends to be present in pneumonia.

70
Q

What is pneumonia?

A

A common inflammatory condition affecting the alveoli in the lungs due to pathogens entering the lower respiratory tract.

71
Q

What are common causative pathogens of pneumonia?

A
  • Bacteria (e.g., Streptococcus pneumoniae)
  • Virus
  • Fungus (e.g., Pneumocystis jiroveci)
72
Q

What is the pathophysiology of pneumonia?

A

An inflammatory cascade begins with neutrophils migrating to infected alveoli, releasing cytokines, inducing fever, and causing fluid accumulation that impairs gaseous exchange.

73
Q

What are the risk factors for pneumonia?

A
  • Aged under 5 or over 65 years old
  • Smoking
  • Recent viral respiratory tract infection
  • Chronic respiratory diseases (e.g., cystic fibrosis, COPD)
  • Immunosuppression (e.g., cytotoxic drug therapy, HIV)
  • Patients at risk of aspiration
  • IV drug users
  • Other non-respiratory co-morbidities (e.g., diabetes, cardiovascular disease)
74
Q

What are the common symptoms of pneumonia?

A
  • Cough with purulent sputum (rust colored/bloodstained)
  • Dyspnoea
  • Chest pain (may be pleuritic)
  • Fever
  • Malaise
75
Q

What signs indicate systemic infection in pneumonia?

A
  • High temperature
  • Tachycardia
  • Hypotension
  • Confusion
76
Q

What is the CRB65 criteria used for?

A

To assess patients in primary care for pneumonia risk stratification.

77
Q

List the CRB65 criteria markers.

A
  • C: Confusion (abbreviated mental test score <= 8/10)
  • R: Respiration rate >= 30/min
  • B: Blood pressure (systolic <= 90 mmHg and/or diastolic <= 60 mmHg)
  • 65: Aged >= 65 years
78
Q

What does a CRB65 score of 0 indicate?

A

Low risk (less than 1% mortality risk)

79
Q

What does a CRB65 score of 3 or 4 indicate?

A

High risk (more than 10% mortality risk)

80
Q

What is the recommendation for CRP < 20 mg/L in pneumonia treatment?

A

Do not routinely offer antibiotic therapy.

81
Q

What is a tension pneumothorax?

A

A severe pneumothorax that results in the displacement of mediastinal structures, leading to respiratory distress and haemodynamic collapse.

82
Q

What are the classifications of pneumothorax?

A
  • Spontaneous pneumothorax
  • Traumatic pneumothorax
  • Iatrogenic pneumothorax
83
Q

What are common symptoms of pneumothorax?

A
  • Dyspnoea
  • Chest pain (often pleuritic)
84
Q

What are the signs of a tension pneumothorax?

A
  • Respiratory distress
  • Tracheal deviation away from the side of the pneumothorax
  • Hypotension
85
Q

What are common features of pulmonary embolism?

A
  • Chest pain (typically pleuritic)
  • Dyspnoea
  • Haemoptysis
  • Tachycardia
  • Tachypnoea
86
Q

What is the PIOPED study?

A

A study that looked at the frequency of different symptoms and signs in patients diagnosed with pulmonary embolism.

87
Q

What pulmonary function test results indicate obstructive lung disease?

A
  • FEV1: significantly reduced
  • FVC: reduced or normal
  • FEV1% (FEV1/FVC): reduced
88
Q

What pulmonary function test results indicate restrictive lung disease?

A
  • FEV1: reduced
  • FVC: significantly reduced
  • FEV1% (FEV1/FVC): normal or increased
89
Q

What is acute bronchitis?

A

A type of chest infection resulting from inflammation of the trachea and major bronchi, often self-limiting.

90
Q

What are the common symptoms of acute bronchitis?

A
  • Cough
  • Sore throat
  • Rhinorrhoea
  • Wheeze
91
Q

How can acute bronchitis be differentiated from pneumonia?

A
  • History: Sputum, wheeze, breathlessness may be absent in acute bronchitis
  • Examination: No focal chest signs in acute bronchitis other than wheeze.
92
Q

What is the first-line antibiotic recommended for acute bronchitis?

A

Doxycycline

93
Q

What features characterize childhood infections?

A
  • Chickenpox: Itchy rash starting on head/trunk
  • Measles: Koplik spots and maculopapular rash
  • Mumps: Parotitis and fever
  • Rubella: Pink maculopapular rash
  • Scarlet fever: Strawberry tongue and rash
  • Hand, foot and mouth disease: Vesicles in mouth and on palms/soles
94
Q

What CURB65 score indicates low risk for mortality?

A

CURB65 score of 0 or 1

Less than 3% mortality risk

95
Q

What CURB65 score indicates intermediate risk for mortality?

A

CURB65 score of 2

3-15% mortality risk

96
Q

What CURB65 score indicates high risk for mortality?

A

CURB65 score of 3 or more

More than 15% mortality risk

97
Q

What does a chest X-ray typically show in cases of infection?

A

Consolidation

Opacity on the X-ray film

98
Q

What does raised white cell count in blood tests indicate?

A

Infection

99
Q

What is the definition of sepsis?

A

Life-threatening organ dysfunction caused by a dysregulated host response to infection

100
Q

What is the definition of septic shock?

A

A more severe form of sepsis with greater risk of mortality than sepsis alone

101
Q

What criteria must be met for quickSOFA (qSOFA) score?

A

At least 2 of the following:
* Respiratory rate of 22/min or greater
* Altered mentation
* Systolic blood pressure of 100 mmHg or less

102
Q

What are the red flag criteria for risk stratification in sepsis?

A

Criteria include:
* Responds only to voice or pain/unresponsive
* Systolic B.P <= 90 mmHg
* Heart rate > 130 per minute
* Respiratory rate >= 25 per minute
* Needs oxygen to maintain SpO2 >= 92%
* Non-blanching rash, mottled/ashen/cyanotic
* Not passed urine in last 18 hours
* Lactate >= 2 mmol/l

103
Q

What are the components of the ‘sepsis six’ management protocol?

A
  1. Administer oxygen
  2. Take blood cultures
  3. Give broad-spectrum antibiotics
  4. Give intravenous fluid challenges
  5. Measure serum lactate
  6. Measure accurate hourly urine output
104
Q

What is the SOFA score used for?

A

To identify and categorize patients based on organ dysfunction

105
Q

What is the most common cause of community-acquired pneumonia?

A

Streptococcus pneumoniae

106
Q

What are the typical symptoms of pulmonary tuberculosis?

A

Cough, weight loss, fatigue, night sweats, low-grade fever

107
Q

What are the features of a secondary (postprimary/reactivation) tuberculosis infection?

A

Cough, gradually becoming productive, weight loss, fatigue, night sweats, low-grade fever

108
Q

What are some common causes of haemoptysis?

A
  1. Lung cancer
  2. Tuberculosis
  3. Pulmonary embolism
  4. Bronchiectasis
  5. Mitral stenosis
109
Q

What distinguishes a transudate from an exudate in pleural effusions?

A

Transudate: < 30g/L protein
Exudate: > 30g/L protein

110
Q

What imaging studies are recommended for evaluating pleural effusion?

A
  1. Posterior-anterior chest X-rays
  2. Ultrasound
  3. Contrast CT
111
Q

What is Light’s criteria used for?

A

To distinguish between transudate and exudate in pleural fluid analysis

112
Q

What are the classic examination findings in pleural effusion?

A

Dullness to percussion, reduced breath sounds, reduced chest expansion

113
Q

What are the risk factors for pneumonia?

A
  1. Aged under 5 or over 65 years
  2. Smoking
  3. Chronic respiratory diseases
  4. Immunosuppression
  5. Recent viral respiratory tract infection
114
Q

What is the typical presentation of pneumonia symptoms?

A

Cough with purulent sputum, dyspnoea, chest pain, fever, malaise

115
Q

What is the CRB65 criteria used for?

A

To assess the risk of death in pneumonia patients in primary care

116
Q

What does the ‘C’ in the CRB65 criteria stand for?

A

Confusion (abbreviated mental test score <= 8/10)

117
Q

What is the mortality risk associated with a CRB65 score of 0?

A

Low risk (less than 1% mortality risk)

118
Q

What CRP level indicates that antibiotic therapy should not be routinely offered?

A

CRP < 20 mg/L

119
Q

What additional criterion is included in the CURB65 compared to the CRB65?

A

Urea > 7 mmol/L

120
Q

What is the recommended action for patients with a CURB65 score of 3 or more?

A

Consider intensive care assessment (high risk, more than 15% mortality risk)

121
Q

What imaging is typically performed to investigate pneumonia?

A

Chest X-ray

122
Q

What does a raised white cell count in blood tests indicate?

A

Infection

123
Q

What is the purpose of a sputum sample in pneumonia diagnosis?

A

To diagnose causative organism after culture

124
Q

What are Light’s criteria used for?

A

To distinguish between a transudate and an exudate

125
Q

What are the signs of systemic infection in pneumonia?

A
  • High temperature * Tachycardia * Hypotension * Confusion
126
Q

What are common symptoms of pneumonia?

A
  • Cough with purulent sputum * Dyspnoea * Chest pain * Fever * Malaise
127
Q

True or False: The incidence of epiglottitis has increased in adults due to the immunisation programme.

A

False

128
Q

What is a key feature of acute epiglottitis?

A

Stridor

129
Q

What is the management step for suspected acute epiglottitis?

A

Immediate senior involvement, including those able to provide emergency airway support

130
Q

What is the common viral cause of croup?

A

Parainfluenza viruses

131
Q

What is the recommended treatment for all children with croup, regardless of severity?

A

Single dose of oral dexamethasone (0.15mg/kg)

132
Q

What does the PIOPED study relate to?

A

Features making pulmonary embolism more likely

133
Q

What are the signs of pulmonary embolism according to the PIOPED study?

A
  • Tachypnea (96%) * Crackles (58%) * Tachycardia (44%) * Fever (43%)
134
Q

What is the first-line management for moderate or severe OSAHS?

A

Continuous positive airway pressure (CPAP)

135
Q

Fill in the blank: The _______ scale is used to assess sleepiness.

A

Epworth Sleepiness Scale

136
Q

What is a characteristic finding in chest X-ray for pneumonia?

A

Consolidation (opacity on the X-ray film)

137
Q

What should be done if pleural fluid is purulent or turbid/cloudy?

A

A chest tube should be placed to allow drainage

138
Q

What risk factors are associated with pneumonia?

A
  • Aged under 5 or over 65 years * Smoking * Recent viral respiratory tract infection * Chronic respiratory diseases * Immunosuppression * Patients at risk of aspiration * IV drug users * Other non-respiratory co-morbidities
139
Q

What is the consequence of untreated OSAHS?

A

Daytime somnolence

140
Q

What is the typical presentation of cough in croup?

A

Barking, seal-like cough

141
Q

What is the recommended action for patients with a CURB65 score of 2 or more?

A

Consider hospital-based care (intermediate risk, 3-15% mortality risk)

142
Q

What is the ‘thumb sign’ associated with?

A

Swelling of the epiglottis

The ‘thumb sign’ is a radiological sign indicating epiglottitis.

143
Q

What is the recommended dose of oral dexamethasone for children?

A

0.15mg/kg

This is recommended regardless of severity.

144
Q

What are some emergency treatments for acute asthma?

A
  • High-flow oxygen
  • Nebulised adrenaline
145
Q

What are the features of acute severe asthma?

A
  • Worsening dyspnoea
  • Wheeze
  • Cough not responding to salbutamol
146
Q

How are patients with acute severe asthma stratified?

A
  • Moderate
  • Severe
  • Life-threatening
147
Q

What PEFR indicates a life-threatening asthma condition?

A

< 33% best or predicted

148
Q

What does a normal pCO2 indicate in an acute asthma attack?

A

Exhaustion

This should classify the situation as life-threatening.

149
Q

What is the leading cause of acute bronchitis?

A

Viral infection

Accepted that around 80% of episodes occur in autumn or winter.

150
Q

What are common presenting symptoms of acute bronchitis?

A
  • Cough (may or may not be productive)
  • Sore throat
  • Rhinorrhoea
  • Wheeze
151
Q

What differentiates acute bronchitis from pneumonia in history?

A

Sputum, wheeze, breathlessness may be absent in acute bronchitis

152
Q

What is the first-line antibiotic recommended for acute bronchitis?

A

Doxycycline

Cannot be used in children or pregnant women.

153
Q

What is anaphylaxis defined as?

A

A severe, life-threatening, generalised or systemic hypersensitivity reaction.

154
Q

What are common identified causes of anaphylaxis?

A
  • Food (e.g. nuts)
  • Drugs
  • Venom (e.g. wasp sting)
155
Q

What are airway problems in anaphylaxis?

A
  • Swelling of the throat and tongue
  • Hoarse voice
  • Stridor
156
Q

What are breathing problems in anaphylaxis?

A
  • Respiratory wheeze
  • Dyspnoea
157
Q

What is the recommended dose of adrenaline for adults and children over 12 years in anaphylaxis?

A

500 micrograms (0.5ml 1 in 1,000)

158
Q

What is refractory anaphylaxis?

A

Respiratory and/or cardiovascular problems persist despite 2 doses of IM adrenaline.

159
Q

What is the pathogen responsible for most cases of bronchiolitis?

A

Respiratory syncytial virus (RSV)

Responsible for 75-80% of cases.

160
Q

What are the common presenting symptoms of bronchiolitis?

A
  • Coryzal symptoms
  • Dry cough
  • Increasing breathlessness
  • Wheezing
161
Q

What is the main management strategy for bronchiolitis?

A

Supportive management

162
Q

What is a common cause of chronic obstructive pulmonary disease (COPD)?

A

Smoking

163
Q

What are the features of COPD?

A
  • Cough (often productive)
  • Dyspnoea
  • Wheeze
164
Q

What is the FEV1/FVC ratio indicating airflow obstruction in COPD?

A

Less than 70%

165
Q

What is the classification of COPD severity based on post-bronchodilator FEV1?

A
  • Stage 1 - Mild: FEV1 > 80%
  • Stage 2 - Moderate: FEV1 50-79%
  • Stage 3 - Severe: FEV1 30-49%
  • Stage 4 - Very severe: FEV1 < 30%
166
Q

What is the significance of measuring peak expiratory flow in COPD?

A

Limited value as it may underestimate the degree of airflow obstruction.

167
Q

Moderate asthma signs

A
  • PEFR 50-75% best or predicted
  • speech normal
  • RR <25 per min
  • pulse <110 bpm
168
Q

Severe asthma diagnosis

A
  • PEFR 33-50% of best or predicted
  • can’t complete full sentences
  • RR > 25/ min
  • pulse > 110 bpm
169
Q

Life threatening

A

PEFR < 33% best or predicted
Oxygen sats < 92%
‘Normal’ pC02 (4.6-6.0 kPa)
Silent chest, cyanosis or feeble respiratory effort
Bradycardia, dysrhythmia or hypotension
Exhaustion, confusion or coma

UKMLA Prep (46 decks)

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