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0 FINALS NOTES > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Management of acute asthma exacerbation

A

O - Oxygen
S - Salbutamol 5m Nebs
H - Hydrocortisone 100mg IV (or pred 40mg PO)
I - Ipratropium 500mcg Neb
T - Theophylline = aminophylline infusion 1g in 1L 0.5ml/kg/hr

M - Mag Sulph 2g IV over 20 mins
E - Escalate care (anaesthetist)

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2
Q

Normal FEV1/FVC raion

A

> 70%

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3
Q

Management of exacerbation of COPD

A

Antibiotics only if increased sputum purulence

  1. Amoxicillin 500mg tds
  2. Doxy 200mg on day 1 ten 100mg OD for 5 days

Pred 30mg for 7-14 days

Oxygen

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4
Q

Management of CAP

A

0-2 (mild/mod) = Amoxicillin 1g tds (5 days)
3-5 (sev) = co-amoxiclav IV + doxycycline PO (7 days)

ICU or NBM = co-amoxiclav IV + clarithromycin IV (7 days) Step down = doxycyline

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5
Q

Management of HAP

A 
Non-severe = PO Amoxicillin (5 days) 
Severe = IV Amox + Gent (if allregic - IV co-trim + Gent) - 7 days           step down = PO co-trim
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6
Q

Management of aspiration pneumonia

A 
Non-severe = PO amox + met (5 days) 
Severe = IV amox + met + gent (7 days)
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7
Q

Cause + management of pneumonia after influenza A infection

A

Staphylococcal

Mx = cefotaxime or impenum

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8
Q

Cause + management of pneumonia with ‘red jelly sptum’

A

Klebsiella

Mx = meropenem

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9
Q

Cause of pneumonia n CF patients + management

A

Pseudomonas

Mx= Ciprofloxacin

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10
Q

Management of chlamydia pstiacci pneumonia

A

Doxycycline

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11
Q

Presentation, diagnosis + management of mycoplasma pneumonia

A

P x = insidious onset, flu-like symptoms, dry cough

Dx = serology

Mx = macrolide (clarithromycin, erythromycin)

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12
Q

Diagnosis + management of Legionella Pneumonia

A

Dx = urine antigen

Mx = Fluroquinolone (2-3wks) or clarithromycin

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13
Q

Management of PCP

A

Co-trimoxazole

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14
Q

3 paraneoplastic syndrome assoc with SCLC

A

ADH (SIADH)
ACTH (Cushing’s)
Lambert-Eaton = antibodies to voltage-gated Ca channels

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15
Q

Paraneoplastic syndrome for squamous cell lung cancer

A

PTH-related protein (Hypercalcaemia)
Clubbing
Hypertrophic pulmonary osteoarthropathy

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16
Q

Paraneoplastic for adenocarcinoma

A

Gynaecomastia

Hypertrophic pulmonary

17
Q

Management of primary spontaneous pneumothorax

A

if <2cm + assymptomatic = discharge

if >2cm + symptomatic = admit for aspiration (if this fails = chest drain)

18
Q

Management of secondary spontaneous pneumothorax

A

if 0-1cm = oxygen + admit for 24hr
if 1-2cm + asymptomatic = aspiration (if fails - chest drain)
if >2cm = chest drain

19
Q

Mx of tension pneumothorax

A

Large bore cannula 2nd IC, MC line
then CXR
then chest drain

20
Q

Site of chest drain

A

5th IC space

MID-AXILLARY line

21
Q

Management of PE

A

Warfarin within 24hrs of diagnosis + LMWH (until INR 2 or more)

Provoked PE = anticoag for 3 months
Unprovoked PE = anticoag 6 months
Active cancer = LMWH for 6 months

22
Q

Most common causative organism infective exacerbations of COPD

A

Haem influenzae

23
Q

Causes of transudate pleural effusion (<30 gl/l)

A

Increased venous pressure (HF, constrictive pericarditis, fluid overload)

Hypoalbuminaemia (cirrhoses, malabsorption, nephrotic syndrome)

Hypothyroidism

Meigs syndrome

24
Q

Causes of exudative pleural effusion (> 30g/l)

A

Pneumonia
SLE
TB
Malignant mets

25
Q

TB drug that inavtivates COCP

A

Rifampicin

26
Q

Side effects of isoniazid

A

Deranged LFTs
Raised WCC
Neuropathy (stop + give pyrodoxine)

27
Q

‘egg shell calicfication of hilar lymph nodes’

A

Silicosis

28
Q

Progression of coal workers pneumonitis

A

CXR - small round opacities in upper zones

Progresses to

  • large round opacities
  • emphysema +++
  • black sputum

Progresses to

  • pulmonary HTN
  • cor pulmonale
29
Q

Drug causes of lung fibrosis

A

Nitrofuratoin
Amiodarone
Sulfasalazine

30
Q

What is Caplan’s syndrome?

A

RA + Pneumoconiosis + Pulmonary rheumatoid nodules

31
Q

Blood results for sacroidosis

A

ACE (sensitive 60%, specific 70%)
Hypercalcaemia
Raised ESR

32
Q

Investigations for CF

A

Sweat test
- positive = >60mmol/L
- normal = <30 mmol/L
(if intermittent range - genetic testing)

33
Q

What is atelectasis + how should it be managed?

A

Common post-op complication
Basal alveolar damage leads to breathing difficulties
Caused when airways become blocked by bronchial secretions

Suspect in pts with breathlesness 72hrs post-op

Mx = chest physio

34
Q

Features of Kartageners syndrome

A

Defect resulting in immotile cillia

Dextrocardia or complete sinus inversus
Bronchiectasis
Recurrent sinusitis
Subfertility

0 FINALS NOTES (10 decks)

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