Respiratory Flashcards
1
Q
Features of Bronchiectasis?
A
Clubbing Suspected COPD but smoking Hx less than 10yrs History of TB or recurrent pneumonia Disadvantaged childhood Unusual organisms on sputum
2
Q
Causes of bronchiectasis?
A
Cystic fibrosis Primary ciliary dyskinesia Congenital hypogammaglobulinaemia Infections on childhood Localised disease - bronchial adenoma, TB, FB ABPA RA and sjorgens syndrome COPD Recurrent aspiration ILD Idiopathic
3
Q
Investigations for bronchiectasis?
A
CXR - infection, cystic lesions, tram tracking Sputum MCS Immunoglobulin FBC ? eosinophilia CF testing Lung function tests ABG HRCT
4
Q
Treatment of bronchiectasis?
A
Physiotherapy Inhaled steroids Antibiotics during exacerbations Vaccinations Treatment of heart failure IVIG if hypogamma Haemoptysis - bronchial artery embolisation Smoking cessation Home oxygen Surgery Lung transplant
5
Q
Investigation of potential lung carcinoma?
A
CXR and CT chest
Bronchoscopy and biopsies or transthoracic biopsy
Pleural effusion = thoracocentesis and pleural biopsy
FBC, EUCs, Calcium and LFTs
CT CAP
Lung function tests ? resection
6
Q
Causes of COPD?
A
Smoking Wood, charcoal, coal smokes Grain dust Nitrogen dioxide Dusts - organic and mining Plastic, textile and rubber manufacturing Leather and food manufacturing Alpha-1 anti-trysin deficiency
7
Q
Investigations of COPD?
A
Lung function tests - FEV1 CXR - hyperinflation ABG - ? hypoxia or hypercapnia FBC ?polycythaemia Sputum MCS ECG Alpha-1 anti-trypsin level
8
Q
Treatment of COPD?
A
LABA and LAMA ICS if severe COPD or acute exacerbation Vaccinations Pulmonary rehab programs O2 therapy CPAP Treat HF Replace Alpha-1 antitrypsin Lung transplant
9
Q
Assessment of Sleep apnoea?
A
Obesity - BMI BP ? HTN Epsworth sleepiness scale Sleep study for AHI TFTs ECG ?arrhythmias CPAP assessment
10
Q
Why treat OSA?
A
Reduces daytime sleepiness
Reduces motor accidents
Improves HTN
Improves cognition
11
Q
Classifications of ILD?
A
- ILD with known association:
- Drugs
- Occupational exposure
- Connective tissue disease - SLE, RA, S. Sclerosis, PM and DM, Sjogrens - Granulomatous:
- Hypersensitivity pnuemonitis
- Sarcoidosis - Idiopathic:
- IPF
- NSIP
- Respiratory bronchiolitis ILD - Other ILD:
- Lyphoangioleiomyomatosis
- Pulmonary langerhans cell hystiocytosis
12
Q
Investigations for ILD?
A
CXR HRCT Lung function tests and DLCO ABG FBC ?Eosinophilia Bronchoscopy and biopsy
13
Q
Treatment for ILD?
A
Stop smoking Steroids Treat GORD Treat infections Treat OP Treat OSA Treat pulmonary HTN Home O2 Lung transplant
14
Q
Diagnosis of Pulm HTN?
A
PAP >25
Lung causes = PCWP <15
Heart causes = PCWP >15
15
Q
Classifications of pulmonary HTN?
A
- Idiopathic
- 2ndary to Left heart disease
- 2ndary to lung disease
- Chronic thromboembolic pulm HTN
- Miscellaneous
