Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Primary Care > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Indications for urgent CXR

A

-Haemoptysis
-Unexplained or present >3weeks;
Cough
Chest/ Shoulder Pain
Dyspnoea
Cervical/SC Lymphadenopathy
Signs of Mets
Weight Loss
Chest signs
Hoarseness
Clubbing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Peak Flow is best used for?

A

Monitoring progress and effects of treatment on asthma

overestimates lung function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When measuring FEV1 and FVC what should you ensure?

A

2 readings within 100mL or 5% of each other

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Fractional exhaled nitric oxide concentration if normal does not exclude?

A

A dx of asthma

Should be increased in patients with asthma/inflammatory respiratory conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the RCP three questions used to monitor asthma control?

A
  • Sleep Symptoms
  • Daytime Symptoms
  • Interfered with activity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

FEV1/FVC <70% indicates

A

Obstructive Lung Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Cough/ Acute Corzya & Bronchitis:

Reasons to prescribe antibiotics immediately?

A

-Systemically very unwell, signs/symptoms suggestive of serious illness/complications
-Risk factors for developing complications (CF, CCF, Lung, renal, liver, neuromuscular, immunosuppression, premature babies)
->65 (2) or >85 (1);
Hospitalization in last year
T1DM or T2DM
Oral Glucorcorticoids
CCF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Cough:

What Antibiotics would you prescribe?

A

Amoxicillin
or Clarithromycin
or Doxycycline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Causes of haemoptysis/ blood-stained sputum?

A
  • Infection: TB, Pneumonia, Bronchitis, Lung Abscess
  • Bronchiectasis
  • Malignancy
  • PE (blood not mixed with sputum)
  • Iatrogenic
  • Inhaled Foreign Body
  • Trauma
  • Cardiac (Acute LVF)
  • Blood Dyscrasia
  • Mycosis (aspergilloma)
  • Goodpasture’s Syndrome
  • Wegener’s Granulomatosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Urgent chest physician referral?

haemoptysis

A
  • Abnormal CXR
  • Normal CXR w/t persistent haemoptysis
  • > 40yrs and smoker/exsmoker
  • high suspicion of malignancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Patients with COPD, Asthma, Bronchiectasis, CF, should be advised to get which 2 vaccinations?

A

Influenza

Pneumococcal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Pectus Carinatum is associated with?

A

Chronic childhood asthma

Rickets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Structural Kyphosis may be caused by?

A

Osteoporosis
Paget’s Disease
Ankylosing spondylitis
Scheuermann’s Disease (juvenille osteochondrosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Types of pleural effussions?

A

Simple:
Transudates (protein <30g/L)
Exudates (protein >30g/L)

Complex:
Blood
Lymph
Pus (empyema)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Causes of Pleural Effussion?

A 
Malignancy
Infection
Infarction (PE)
Heart Failure
Constrictive Pericarditis
Inflammation (SLE, RA, Pancreatitis, Asbestos exp)
Hypoproteinemia
Hypothyroidism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Referal for CXR (resp disease)

A

SC or Cervical Lymphadenopathy >3wk
Unexplained neck lump- recent onset, changed over 3-6wks
Unexplained clubbing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Dysphonia Referal?

A

Hoarseness >3wk (esp. smokers >50yrs and heavy drinkers)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Before suggesting long-term use of nebulizer therapy for COPD/asthma, you should?

A
  • Review diagnosis, technique, compliance
  • Try increasing BD dose for 2wks
  • Perform 2wk trial and monitor results (PEFR)
  • Prove instructions on use
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Stop steroids abruptly if;

A

Disease unlikely to relapse

and Tx recieved for <3wk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Withdraw steroids gradually if

A 
Disease unlikely to relapse and;
-Taken for >3wk
Taken short coarse < 1yr after stopping long term therapy
-Recieved >40mg dose prednisolone
-given repeat doses in eveving 
-recently had repeated steroid courses
21
Q

What is brittle asthma?

A

rapid development of acute asthma attacks

22
Q

Asthma:

Reasons for referral?

A 
Severe asthma exacerbation
monophonic wheeze/stridor
cxr shadowing
unclear dx
unexpected clinical findings (clubbing, crackles, cyanosis)
constant breathlessness
poor response to tx
unexplained restrictive spirometry
suspected occupational asthma 
chronic sputum production
eosinophilia (>1x10-9/L)
23
Q

MRC Dyspnoea Scale

A

1: strenuous exercise
2: hurrying/walking uphill
3: level ground
4: stops after 100m
5: dressing

24
Q

COPD

Referal for specialist care?

A 
Uncertain dx
age <40yrs
severe COPD
Rapid decline in FEV1
Cor Pulmonale
Frequent Infections
Haemoptysis
A1AT def
Assessment for:
Long Term O2 Therapy
Long Term Oral Steroids
withdrawl of steroids
long term nebulizer therapy
pulmonary rehabilitation
surgery
25
Q

Long Term O2 Therapy, refer if;

A 
FEV1<30%
O2 sats <92%
Cyanosis
Polycythaemia
peripheral oedema
raised JVP
26
Q

The BODE Index takes what parameters into account?

A

FEV1
Dyspnoea (MRC)
BMI
Exercise Capacity

27
Q

Home treatment of acute exacerbations of COPD?

A

Increase Bronchodilators
Antiobiotics- clarithromycin (sputum becomes purulent, signs of pneumonia, consolidation on CXR)
Oral Corticosteroids-Prednisolone

28
Q

immediate Referral for suspected lung cancer?

A 
Stridor
SVC obstruction (swelling of face/neck, increased JVP)
29
Q

Urgent referal for suspected lung cancer?

A

Persistent haemoptysis (smokers >40yrs)
CXR suggestive of lung ca (pleural effussion and consolidation)
High suspicion of lung ca
Hx of asbestos exposure and recent onset - chest pain, dyspnoea, or other where a cxr indicates a pleural effussion, pleural mass, etc.

30
Q

Paraneoplastic Syndrome

A

clinical syndromes involving nonmetastatic systemic effects that accompany malignant disease

E.g: ectopic ACTH, SIADH, hypercalcaemia, hypercoagulability

31
Q

Most common cause of acute corzya/ rhinopharyngitis?

A

Rhinovirus (30-50%)

Picornavirus, echovirus, coxsackie virus

32
Q

Which type of influenza virus causes the complication of viral pneumonia?

A

Influenza A (Asian Flu)

33
Q

Chest infections secondary to influenza are usually caused by which 2 pathogens?

A

S.aureus

Strep. pneumoniae

34
Q

When should you consider the use of antivirals when treating influenza?

A

High Risk groups
Prevalent in the community
*Onset <72hrs

35
Q

What antivirals should you consider for the management of influenza in adults? and children?

A

Shortens symptoms
Reduces Complications
Adults: Zanamivir
+ Children: Oseltamivir

36
Q

At Risk groups for severe disease with influenza

A 
>/= 65yrs
COPD, asthma, MS, MND, CerebroVascularAccident
CVD exc. HTN
Immunosuppression
Chronic Renal Failure
DM
37
Q

Indications for Influenza vaccine?

A 
>/= 65yrs
Pregnant 
DM
Chronic Renal Disease
COPD, asthma
Chronic Liver Disease 
Nursing Home Residents
Health Professionals
CVD
Immunocompromised patients
38
Q

Common causative organisms of pneumonia?

A 
S.pneumoniae
H.influenxae- elderly
Influenza A, B- winter
*Mycoplasma pneumoniae
*C.psittaci - bird contact
S.aureus - secondary toinfluenza, acute coryza 
*Legionella spp. - sept/oct travel
39
Q

CURB-65 Score

A

Confusion
Urea > 7mmol/L
RR >30bpm
Blood Pressure < 90/60mmHg

1/2 - Consider Hospital Referral
3/4 - Urgent Hospital Referral

40
Q

Treatment of Pneumonia @ home?

A

Stop smoking, rest, fluids
Amoxicillin or Doxycycline or Clarythromycin
Analgesia - Pleuritic Pain
Review - 48hrs

41
Q

Complications of pneumonia?

A 
Para-pneumonic effussion
Empyema
Abscess- swinging fever and worsening 
Septicaemia
Metastatic infection
Respiratory Failure 
Jaundice
42
Q

What dermatological feature is associated with primary TB?

A

Erythema nodosum

43
Q

TB sputum sample culture?

A

Acid-fast bacilli

44
Q

Tuberculin skin tests can be false negatives under which circumstances?

A 
Corticosteroid therapy
immunosuppressed 
Viral infections inc. Glandular fever
Live Vaccines <3wks 
Sarcoidosis 
Hodgkins
45
Q

Positive Tuberculin Skin Test? Mantoux

A

Ring of induration with clear centre

5-14mm may be normal in school children

46
Q

Treatment of TB?

A

Asymptomatic: Isoniazid + Rifampicin 3mnths
Symptomatic: Isoniazid,(6mnths) Rifampicin, pyrazinamide, Ethambutol (2mnths)

47
Q

Invasive Aspergillosis?

A

Immunocompromised

Lungs - Kidneys, Brain, etc

48
Q

Aspergilloma?

A

Cavity from TB, Sarcoidosis
CXR: round lesion with air halo
Haemoptysis

49
Q

Pneumocystis Jiroveci

A

Pneumonia in Immunocompromised patients

Tx: Co-trimoxazole, Dapsone

Primary Care (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions