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Nephrology > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Fev1/Fvc <75%

A

Obstructive

Asthma, COPD, bronchiectasis, bronchiolitis obliterans

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2
Q

Fev 1 /Fvc normal/raised

A

restrictive
PF, asbestosis, sarcoidosis
ARDS, kyphoscoliosis, neuromuscular disorders

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3
Q

HAP -most common bacteria type

A

Gram negative anaerobes

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4
Q

Most common organism CAP

A

Strep pneumonia
HI
Mycoplasma

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5
Q

Aspiration microbes

A

Anaerobes

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6
Q

Pneumococcal

A

Most common
Fever, pleurisy, herpes labialis
Lobar consolidation
rust coloured sputum

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7
Q

Staphylococcal

A

Complicates flu
Young, old, IVDU
Bilateral cavitating pneumonia

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8
Q

Klebsiella

A 
Rare
Old, DM
Upper lobe cavitating
Drug resistance often
red current jelly sputum
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9
Q

Pseudonomas - who gets it?

A

Bronchiectasis

CF

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10
Q

Mycoplasma

A 
Epidemics 4 yrs
Flu symptoms > dry cough
cold agglutinins
CXR reticular nodular shadowing patches
>autoimmune hemolytic anaemia
>erythema multiform, Stephen Johnsons, GBS
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11
Q

Legionella

A 
Flu like > dry cough
D&V, renal failure
CXR Bilateral consolidation
Lymphopenia
Hyponatraemia
Deranged LFTs
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12
Q

RSV

A

Bronchiolitis

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13
Q

Parainfluenza virus

A

Croup

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14
Q

Rhinovirus

A

Common cold

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15
Q

Haemophilus Influenzae

A

CAP
Most common for bronchiectasis exacerbations
Acute epiglottitis

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16
Q

Pneumocystis Jiroveci

A

HIV
Few chest signs
Exertional dyspnoea

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17
Q

Tonsitilits

A

group B haemolytic strep

18
Q

Pseudomembranous croup

19
Q

q fever

A

corxiella burnetti
cattle sheep goats
flu like + GI symp
>ARDS, endocarditis

20
Q

chlamydia psittaci

A

bird fanciers lung
systemic prodrome
rising titre complement fixing antibody

21
Q

Exudate

A

protein > 30

Inflammatory, cancer

22
Q

Transudate

A

<30

HF, cirrhosis etc

23
Q

Positive BDR testing

A

Improvement of FEV1 of 12% or more and increase in volume of 200 ml or more
In children just 12%

24
Q

Diagnosis Asthma

A

Spirometry and BDR test

Should have FeNO test

25
Q

FeNO results

A

Children > 35 parts/ billion

Adults > 40

26
Q

g

27
Q

LAMA examples

A

glycopyronium

tiotropium

28
Q

Theophylline

A

Phosphodiesterase inhibitor

Increases cAMP ….. > decrease leukotrienes

29
Q

How to step down asthma therapy.

A

If stable reduce ICS by 25-30% every 3 months

30
Q

Spirometry grade severity COPD

A 
FEV1: FVC ration < 70 
AND
FEV1:
>80 - - mild (stage 1)
50 - mod
30 - severe
<30 v severe (stage 4)
31
Q

Most common viral cause of COPD

A

Human rhinovirus

32
Q

First line abx for exacerbation of COPD

A

Amox, clari, doxy

33
Q

Asthma Adult management

A 
SABA
\+ low ICS
\+LTRA
\+LABA
\+MART - low, medium
> high seperate ICS + LABA
\+ LAMA/ theophylline/ expert
34
Q

Asthma management 5-16

A

As per adults - changes:
Stop LTRA if not working
High dose MART available

SABA
\+ low ICS
\+ LTRA - stop if not working
\+ LABA
> MART - low, med, high.

Trial theophylline

35
Q

Asthma management in children <5

A

SABA
Trial 8 moderate ICS
> back in 4/52 - low ICS
> >4/52 - retrial 8 weeks

+ LTRA
Stop, refer paeds

36
Q

COPD management

A

SABA/ SAMA

Then.. is there asthma features?

Yes - LABA + ICS (then + LAMA)
No - LABA + LAMA

Theophylline
Oral abx  - macrolide - azith
(should not smoke), needs CT thorax, sputum cultures
LFTs/ QT
hearing loss tinnitus
37
Q

Prophylactic antibiotics in COPD

A

Macrolide - azith
(should not smoke), needs CT thorax, sputum cultures
LFTs/ QT
hearing loss tinnitus

38
Q

Example LABA

A

Salmeterol

39
Q

Example LAMA

A

Tiotropium

40
Q

What is theophylline

A

Phosphodiesterase inhibitor..

relaxes smooth muscle

Nephrology (26 decks)

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