Respiratory

Question 1

How does respiratory system change in pregnancy?

Answer 1

Oxygen demand increases
Tidal volume increases
Arteria pO2 increases and pCO2 falls along with bicarbonate giving compensated respiratory alkalosis

Question 2

Symptoms of asthma?

Answer 2

Cough
Breathlessness
Wheeze
Chest tightness
Diurnal variation

Question 3

Diagnosis of asthma?

Answer 3

> 20% diurnal vibration in PEFR for 3+ days/week during 2 week period
15% improvement in FEV1 after inhaled bronchodilators

Question 4

Management of asthma?

Answer 4

Prevent acute attacks
Most medication is safe in prengancy but do not start LTRA
Check inhaler technique
Smoking cessation advice

Question 5

Features of pneumonia?

Answer 5

Dry cough progressing to productive
Fever
Rigors
Breathlessness
Pleuritic chest pain

Cord crackles on auscultation
Signs of consllidation

Question 6

MAnamgnet fo pneumonia?

Answer 6

FBC, U&E
CRP
Sputum culture, ABG and CXR (very small dose of radiation)

Maintain SaO2 at >96%
Ensure hydrated
Arrange chest physiological
Give abx (amoxicillin or clarithromycin)

IV cefuroxime + clarithromycin if severe

Question 7

Features of TB?

Answer 7

Insidious onset
Cough
Haemoptysis
Weight loss
Night sweats
Coarse crackles in upper lobes
Lymphadenopathy

Question 8

Diagnosis of TB?

Answer 8

Sputum culture for acid fast bacilli (takes 6 weeks)

Question 9

Management of TB?

Answer 9

Rifampicin + Isoniazid + pyrazinamide + ethambutol
For 2 months
R + I for 4 further months

R: Orange secretions
I: Peripheral neuropathy give with pyroxidine B6
P: Hepatotoxic
E: Optic neuritis and colour blidnenss