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SA2 - Gen Med > Respiratory > Flashcards

Respiratory Flashcards

1
Q

What must you ALWAYS remember with chest pain.

Because Ryan, you always forget this differential.

A

PULMONARY EMBOLISM

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2
Q

What type of pneumonia is assocaited with erythema multiforme?

A

Mycoplasma pneumonae

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3
Q

What does base excess indicate?

A

The metabolic component. -2 to +2. Over two is metabolic alkalosis, below -2 is acidosis

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4
Q

What is the difference between Type 1 and Type 2 respiratory failure

A

Type 1 - Low o2 and low C02

Normal PH and bicarbonate is normal

Type 2 - Low O2 and high C02

Ph is Low (acidosis) and Bicarbonate is normal or high if it is acute.

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5
Q

What is a normal PH?

A

7.35-7.45

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6
Q

What do ABGs tell you?

A
  1. Oxygenation via gas exchange
  2. Ventilation control via C02
  3. Kidney function via bicarb
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7
Q

What should p02 be?

A

11-13 or 10 below inspired air. Normal ‘on air’ is 21kPa

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8
Q

What is acidosis?

A

PH

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9
Q

What is alkalosis?

A

PH > 7.45

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10
Q

What five things need to be considered when interpreting ABGS

A

1) How is the patient? Eg did they have a head injury or MI? if head injury low resp drive so high Co2. IF MI now O2 but high lactic acid

2)Oxygenation levels

3)Alkalotic or acidotic?

4) Resp component - Look at C02 levels. is this high or low?

5) Metabolic component - Look at bicarb. Is this high or low?

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11
Q

Study this table

A
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13
Q

How can you tell if the problem is respiratory or metabolic?

A

Look at the oxygen consumption and the base excess.

If oxygen is normal but base excess isn’t then it is metabolic.

If oxygen isnt it is respiratory

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14
Q

What compensation is quick and what is slow?

A

Quick - Respiration rate

Longer - bicarb

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15
Q

What does it mean when there is a mixed picture? I.E raised bicarb and low Co2 or raised Co2 and low bicarb?

A

Mixed acidosis or alkalosis

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16
Q

What is normal bicarb?

A

25

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17
Q

What is a normal value for base excess?

A

-2 to +2

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18
Q

What does a base excess >+2 mean?

A

Metabolic alkalosis

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19
Q

What does a base excess of below -2 mean?

A

Metabolic acidosis

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20
Q
  • Patient on room air
  • High Co2
  • Low O2
  • Low PH
  • Normal bicarb
A

Respiratory acidosis with no compensation

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21
Q
  • Low o2
  • High co2
  • Normal PH
  • High bicarb
A

Respiratory acidosis with full compensation

22
Q
  • Low o2
  • Normal Co2
  • High PH
  • High bicarb
A

Metabolic alkalosis with no compensation

23
Q

P02 of 18.8 on 40% O2

Low O2

High Co2

Normal bicarb

Low PH

A

Respiratory acidosis with no compensation and impaired oxygenation

24
Q

Cardiac arrest on 50% O2

Low O2 (7.5)

Low PH

High Co2

Low bicarb

A

Mixed acidosis and impaired oxygenation

25
Q

COPD on 85%

Low O2 (19.5)

High co2

Low Ph

High bicarb

A

Respiratory acidosis with incomplete compensation and impaired oxygenation

26
Q

What is type 1 respiratory failure, what would an ABG show and what could cause it?

A

Low 02, normal or low C02.

Pneumonia

PE

Lung fibrosis

27
Q

What is type 2 respiratory failure, what would an ABG show and what could cause it?

A

Low O2, high Co2

Opiate overdose

COPD

Respiratory muscle paralysys

28
Q

What are some examples of resipratory acidosis?

A

Drug overdose

Airway obstruction

Hypoventilation

29
Q

What are some examples of resipratory alkalosis?

A

Hyperventilation (eg panic attack)

Pain

Aspirin overdose

30
Q

What are some examples of metabolic acidosis?

A

DKA

CKD

Diarrhoea of bicarb

31
Q

What are some examples of metabolic alkalosis?

A

Vomiting HCL

CF

Antacid abuse

32
Q

What four things do you comment on when interpreting ABGs?

A

Alkalotic/Acidotic

Cause - Resp or metabolic

Compensation - none/partial/full

Oxygenation - impaired/hypoxic/normal

33
Q

How do you enter with an ABG and what do you do first?

What are some contraindications?

A

30-45 degrees

Allens test

Local sepsis

Mastectomy

Anticoag

34
Q

How long has an ABG got to be processed what do you need?

A

10 mins

Patients 02 sats

Patients temperature

35
Q

What do you think with acidosis and increased lactate?

36
Q

What are the findings for acute lung presentations?

37
Q

What causes clear and watery of pink froffy sputum?

A

Acute pulmonary oedema

38
Q

What causes clear and grey mucous sputum?

A

COPD or chronic bronchitis

39
Q

What causes white mucous sputum?

40
Q

What causes yellow purulent sputum?

A

Acute infection

41
Q

What causes green sputum?

A

Chronic infection

42
Q

What causes rusty red sputum?

A

Pneumoccocal infection

43
Q

What are CURB65 criteria what does this mean for management?

A

Score one for each of the following in relation to pneumonia:

Confusion

Urea > 7

RR > 30

BP <90 systolic of 60 diastolic

65 - over 65

0 - 1 - In the community

2 - Consider short stay

3 - 5 Inpatient

44
Q

What is pleurodesis and when is it used?

A

Fusion of the visceral and parietal pleura

Used for recurrent pleural effusions of pneumothoraces eg cancer

45
Q

what are the signs of COPD on CXR/

A

Hyperinflation

flattened diaphragm

Reduced lung markings

46
Q

What is the FEV1, FVC and the ratio for obstructive and restricted?

47
Q

What are some differences between asthma and COPD?

48
Q

What are the lung causes of clubbing?

A

Bronchiectasis

Bronchial carcinoma

CF

Fibrolising alveolitis

Lung abscess

Empyema

Mesothilioma

49
Q

What are the non respiratory causes of clubbing?

A

CV - Atrial myxoma, Bacterial endocarditis

GI - IBD, cirrhosis

Other - Graves, idiopathic

50
Q

What are the common causes of atelectasis?

A
  • Bronchial carcinoma
  • foreign body
  • Mucous plug

They all reduce air entry

  • Post surgical - pain and opiods reduce breathing
  • Tumour
  • Pneumothorax

They stop expansion

SA2 - Gen Med (5 decks)

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