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Core Conditions > Respiratory > Flashcards

Respiratory Flashcards

1
Q

2 characteristics of asthma?

A

Airway inflammation and hyper-responsiveness

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2
Q

Atopic Trias

A

Asthma, Allergic Rhinitis and Ecezma

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3
Q

Risk factors for acute asthma

A

Atopy, young male/old female, respiratory infections in childhood, smoking, obesity and social deprivation

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4
Q

Presentation of acute asthma

A

Wheeze, cough, breathlessness, chest tightness - diurnal variation

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5
Q

Trigger of asthma

A

Cold, allergens, NSAIDs, B-blockers, infection, exercise

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6
Q

Asthma Investigations

A

PEFR, FEV1/FVC - bronchodilatory reversibility

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7
Q

2 underlying causes of COPD

A

Chronic Bronchiectasis and Emphysema

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8
Q

Chronic Bronchitis Pathology

A

Hypertrophy of mucus glands and inflamed bronchioles + squamous metaplasia - Blue Bloater

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9
Q

Emphysema Pathology

A

Destruction of tissues distal to the terminal bronchioles. - Pink Puffer

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10
Q

COPD Risk factors

A

Smoking, Occupation, Alpha-1-antitrypsin, air pollution

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11
Q

COPD Presentation

A

Cough, Wheeze, SoB, frequent exacerbations, poor chest expansion, hyperinflation, accessory muscle use

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12
Q

COPD Investigations + findings

A

Spirometry - Irreversible obstructional airflow.
CXR - Hyperinflated lungs, diaphragm flat and long narrow heart
ABG - PP = normal, BB = Hypoxia +/- hypercapnia

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13
Q

COPD Treatment

A

Stop smoking, anticholinergics, SABA, LABA and corticosteroids.

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14
Q

Two types of Bronchial Carcinoma

A

Small cell - 15%

Non-small Cell - 85%

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15
Q

Small Cell Lung Cancer characteristics

A

Highly malignant and usually inoperable at presentations

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16
Q

Non-Small Cell Lung Cancer types

A

42 % Squamous cell carcinoma, 39% Adenocarcinoma

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17
Q

Risk factors for bronchial carcinoma

A

Smoking, Age, COPD, Asbestos exposure

18
Q

Bronchial carcinoma presentation

A

Cough, dysopnoea, haemoptysis, clubbing, SVC obstruction, lymphadenopathy (Virchow’s node),

19
Q

Bronchial carcinoma investigations + findings

A

CXR - Circular opacity, hilar enlargement, consolidation, pleural effusion
Contrast CT, bronchoscopy + biopsy

20
Q

Small and Non small cell treatment

A

SCLC - Chemo/radiotherapy - 25 % 5yr survival

NSCLC - Neoadjuvant and adjuvant chemo/radiotherapy and surgical resection.

21
Q

Risk factors for Pneumothorax

A

Smoking (22x), tall, Marfans, COPD, TB

22
Q

Pneumothorax presentation

A

Sudden pain, SoB, tachycardia, pulsus paradoxus, tracheal deviation, hyperresonance + reduced breath sounds

23
Q

Pneumothorax Treatment - simple, tension and recurrent

A

O2 for hypoxia + to increase N2 excretion
Tension = Drainage - 2/3 ICS mid clav or 4/5 ICS mid axillary
If recurrent then Pleurodesis

24
Q

Proportion of benign and malignant pleural effusions

A 
Malignant = 40,000/yr
Benign = 80,000/yr
25
Q

Two different types and different causes

A

Transudative - hydrostatic/osmotic disruption

Exudative - Increased permeability

26
Q

Transudative effusion contents and causes

A

Protein < 30g/l

Heart failure, cirrhosis, hypoalbuminemia, dialysis

27
Q

Exudative effusion contents and causes

A

50% protein, 50% LDH

Pneumonia or Malignancy

28
Q

What is a chylothorax and a pseudochylothorax

A 
Chylothorax = Chlye present due to disruption to thoracic duct - neoplasms, TB, trauma, sarcoidosis
Pseudochylothorax = Cholesterol crystals in long standing effusion
29
Q

Pleural Effusion Presentations

A

SoB, Cough, Pleuritic chest pain, reduced chest expansion, stony dullness, reduced breath sounds

30
Q

Pleural Effusion investigations

A

CXR +/- aspiration for cytology

31
Q

Pleural Effusion Treatment

A

Treat underlying cause, chest drain/ pleurodesis if recurrent

32
Q

Define pneumonia

A

Acute inflammation with intense infiltration of neutrophils in and around the alveoli

33
Q

Pneumonia risk factors

A

Smoking, alcohol, asthma, COPD, malignancy

34
Q

Pneumonia causative organisms

A

S.pneumoniae, S.aureus, H.influenza

35
Q

Pneumonia presentation

A

Cough, purulent sputum, SoB, fever, malaise

Tachypnea, bronchial breathing, crepitations, pleural rub, dull percussion

36
Q

Pneumonia scoring system

A 
CURB56
Confusion
Urea >7mmol/l
Resp rate >30/min
Blood pressure <90 systolic
Age > 65
37
Q

Pneumonia treatment - inc specific Abx

A 
O2, Fluids, Analgesia and Abx:
Mild = Amoxicillin/Tetracylcine
Moderate = Amoxicillin + Macrolide
Severe = Stable B-lactam + Macrolide
HAP = Co-amoxiclav
38
Q

Risk factors of PE

A

Hypercoagulability, reduce motility, blood vessel abnormalities, surgery, late pregnancy, fracture, malignancy, IVDU

39
Q

PE presentation

A

Non-specific symptoms - SoB, pleuritic chest pain, cough/haemoptysis, DVT

40
Q

Scoring system for PE

A

Wells

41
Q

PE Investigations

A

CT angiogram and D-dimer

42
Q

PE Treatment

A

O2 high flow, venous access, analgesia
LMWH/Fondaparinux + Vit K antagonist for 3 months
Rivaroxaban prophylaxis
Surgical embolectomy if thrombolysis ineffective

Core Conditions (10 decks)

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