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Phase 2a > Respiratory > Flashcards

Respiratory Flashcards

1
Q

How is COPD investigated?

A

CXR:
- Hyperinflation, flat hemidiaphragm (also important to exclude lung cancer in this cohort of patients)

Lung function tests (spirometry):

  • FEV1/FVC ratio < 0.7
  • FEV1 may be normal or reduced
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2
Q

Describe the conservative management of COPD.

A

Smoking cessation

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3
Q

Describe the pharmacological management of COPD.

A
  • 1st line = SABA, e.g. salbutamol AND LAMA (long acting muscarinic antagonist) e.g. tiotropium bromide
  • 2nd line = Add LABA, e.g. salmeterol
  • 3rd line = Add ICS (inhaled corticosteroid), e.g. beclomethasone
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4
Q

Which micro-organism causes tuberculosis?

A

Mycobacterium tuberculosis

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5
Q

What are the symptoms of tuberculosis?

A
  • Cough
  • Haemoptysis
  • Pleuritic chest pain
  • Fever/night sweats
  • Fatigue
  • Weight loss
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6
Q

How is TB investigated?

A
  • Sputum test (3x)

- Mantoux skin test

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7
Q

Describe the pharmacological management of TB and give a side effect for each of the drugs used.

A 
RIPE!
R - rifampicin
I - isoniazid
P - pyrazinamide
E - ethambutol
Side effects:
Rifampicin = red urine
Isoniazid = peripheral neuropathy
Pyrazinamide = hepatitis
Ethambutol = visual problems
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8
Q

What is bronchiectasis?

A

Permanent abnormal dilatation of the bronchi and bronchioles - this leads to a build-up of mucus that makes the lungs more susceptible to infection

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9
Q

What are the causes of bronchiectasis?

A
  • Congenital, e.g. cystic fibrosis
  • Infections, e.g. TB, pneumonia
  • Bronchial obstruction, e.g. tumour
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10
Q

What are the clinical features of bronchiectasis?

A
  • Cough
  • Copious amounts of purulent sputum
  • Intermittent haemoptysis
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11
Q

How is bronchiectasis investigated?

A
  • Sputum culture
  • Spirometry - obstructive pattern
  • CXR shows cystic shadows and thickened bronchial walls
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12
Q

Describe the management of bronchiectasis.

A
  • Sputum expectoration/mucus drainage
  • Abx if necessary
  • Bronchodilators
  • Inhaled corticosteroids
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13
Q

What is a pneumothorax?

A

Build up of air in the pleural space

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14
Q

What are the symptoms and signs of pneumothorax?

A

Symptoms:

  • Dyspnoea
  • Acute, ONE SIDED pleuritic chest pain

Signs:

  • Hypotension
  • Hypoxaemia
  • Diminshed breath sounds on affected side
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15
Q

What is the most common cause of pneumothorax?

A

Trauma

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16
Q

Describe the investigation of pneumothorax

A

CXR

17
Q

Describe the management of pneumothorax

A

Small hole = may heal spontaneously
Chest drain
Surgery

18
Q

What is the difference between a pneumothorax and a tension pneumothorax?

A

Pneumothorax = pleura allows air in and out

Tension pneumothorax = hole acts as one-way valve, allowing air in but not out

19
Q

How could you tell if it is a pneumothorax/tension pneumothorax?

A

CXR - in tension peumothorax, trachea will deviate away form affected side

20
Q

Describe the management of tension pneumothorax

A

MEDICAL EMERGENCY

Immediate chest drain and surgery

21
Q

What is pleural effusion?

A

Build up of fluid in the pleural space

22
Q

What are the symptoms and signs of pleural effusion?

A

Symptoms:

  • Cough
  • Dyspnoea
  • Pleuritic chest pain

Signs: ALL ON AFFECTED SIDE

  • Reduced chest expansion
  • Diminished breath sounds
  • Dull to percussion
23
Q

What are the causes of pleural effusion?

A

Transudate vs. exudate

Transudate:

  • Excessive production of pleural fluid/resorption reduced
  • Increased hydrostatic pressure, e.g. heart failure
  • Reduced oncotic pressure, e.g. cirrhosis, nephrotic syndrome
  • Clear fluid, low protein/WCC

Exudate:

  • Results from damaged pleura
  • E.g. PE, pneumonia, TB, cancer
  • Cloudy fluid, high protein/WCC
24
Q

Describe the investigation of pleural effusion

A
  • CXR

- Thoracocentensis to determine cause

25
Q

Describe the management of pleural effusion

A
  • Chest drain

- Treat underlying cause

26
Q

Pulmonary hypertension is defined as a pressure over how many mmHg?

A

25 mmHg

27
Q

Describe the signs of pulmonary hypertension on a CXR

A

ELEE

E - enlargement of pulmonary arteries
L - lucent lung fields
E - enlargement of right atrium
E - elevated cardiac apex due to RV hypertrophy

28
Q

What is hypersensitivity pneumonitis/extrinsic allergic alveolitis?

A

Inflammation of the alveoli due to prolonged exposure to a particular allergen, e.g dust, animal proteins

29
Q

Describe the management of hypersensitivity pneumonitis/extrinsic allergic alveolitis

A
  • Avoid exposure to allergen

- Corticosteroids, e.g. prednisolone

30
Q

Give 2 signs of TB on chest X ray

A

Ghon complex

Bihilar lymphadenopathy

31
Q

Small cell lung cancers may present as a (…?) syndrome

A

Paraneoplastic syndrome

Phase 2a (16 decks)

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