Respiratory Flashcards
Spirometry:
FEV1/FVC of asthma?
Obstructive pattern…<70%
Low FEV1 and PEFR
Spirometry:
Evidence of reversibility of asthma?
Post-bronchodilator FEV1 increased by at least 12%
Asthma hypersensitivity type and description…Ig?
Type I
IgE mediated
Clinical atopy
Asthma step 1 treatment
SABA as required
CONSIDER low dose ICS
Asthma step 2 treatment
Reliever: SABA
Low dose ICS
Asthma step 3 treatment
Reliever: SABA (or low dose ICS)
Low dose ICS/LABA
Asthma step 4 treatment
Reliever: SABA (or low dose ICS)
Med/high dose ICS/LABA
Asthma step 5 treatment
Reliever: SABA (or low dose ICS) (refer for add on treatment:) Tiotropium Mepolizumab Omalizumab
What drug is common anti-emetic?
Metoclopramide
Daytime symptoms of OSA?
Sleepiness!! Headaches (morning) Dry throat Poor concentration Anxiety/depression
Nightime symptoms of OSA?
Snoring Apnoeas Choking Sweating Restlessness
Investigations for confirming OSA?
Sleep studies (polysomnography) Nocturnal oximetry tracing
Treatment for OSA?
LIFESTYLE! - Lose weight - Cut alcohol - Smoking cessation CPAP!! - Continuous positive airways pressure
Dorsal and ventral respiratory groups in medulla responsible for?
Dorsal respiratory group = inspiratory
(and inhibits ventral RG)
Ventral respiratory group = expiratory
(Pre-botzinger complex in VRG)`
At normal PO2 + PCO2, what is main stimulus for respiration?
CO2
Reasons for night-sweats in OSAHS?
Holding breathing causes catecholamine excess…leading to night sweats
Cause of nocturia in OSAHS?
Increase in atrial natriuretic peptide (due to atrial distention)
This dilates arteries+veins…increased GFR…increased diuresis and natriuresis (Na excretion)
Acute asthma attack treatment?
- Give oxygen, steroids, and SABA.
- a) Give MgSO4 if acute severe
b) Give Ipratropium bromide if life threatening
ECG signs of PE?
S1Q3T3
Large S wave in lead I
Q wave in lead III
T wave inversion in lead III
COPD first line inhalers?
SABA or SAMA
COPD 2nd line inhalers
Depends on FEV1:
>50% - LABA or LAMA
<50% - LABA + ICS or LAMA
