Respiratory Flashcards
Massive haemoptysis + 2 similar episodes last months Often feel SOB + finished course of Tx for TB CXR: Cavitating lesions with opaque mass in it
Aspergillosis
(Caused by aspergillus fumigatus), when spores lodge in pulmonary tissue, usually lungs that have been damaged previously
PE
Wells score
D dimer
PE - Well score >four?
What Ix?
CTPA
Admit to hospital
Mx of PE if stable?
LMWH sub cut/Fondaparinux
Then warfarin for three months
Mx of PE if haemodynamically unstable?
Thrombolysis
Lung cancer in non smoker?
Adenocarcinoma
Features of adenocarcinoma?
Peripheral lung
Pleural involvement
Features of squamous cell
Central airways
Clubbing
PTHrp
What criteria is used to classify pleural effusion?
Light’s criteria
L=lung
30g
Pathology of upper zones of lung?
A PENT
Aspegillosis Pneumoconiosis- silica, coal Extrinsic allergic alveolitis Negative- apical lung fibrosis- from seronegative spondyloarthropathy TB
Pathology of lower zones of lung?
STAIR
Sarcoid/SLE Toxins/Drugs- IPF- bleomycin, methotrexate Asbestosis Idiopathic pulmonary fibrosis Rheumatoid arthritis
Low glucose in pleural fluid?
rheumatoid arthritis
TB
Raised amylase in pleural fluid?
Pancreatitis
Oesophageal perforation
Blood in pleural fluid?
Mesothelioma
TB
PE
Causes of Type One Resp failure I’d forgotten?
Asthma
Emphysema
ARDS
Causes of Type Two Resp failure I’d forgotten?
Sleep apnea
Sedatives
Neuromuscular lesion
Flail chest/kyphosis
What are some of the extrapulmonary causes of ARDS?
Septic shock
Pancreatitis
DIC
Multiple blood transfusion
Indications for non invasive ventilation- CPAP/BiPAP?
COPD- resp acidosis
Type Two resp failure- due to chest wall injury, sleep apnea or neuromuscular
Cardiopulmonary oedema
Stopping tracheal intubation
Differentials for cavitating lesion?
SKT SW
Staph aureus
Klebsiella
TB
Squamous cell
Wegener’s
When to give LTOT for COPD?
PaO2= < 7.3
Noctural hypoxaemia- waking up in night
Peripheral oedema
Pulmonary hypertension
NEW ASTHMA MANAGEMENT GUIDELINES- simplified
[not from Jack Teh]
1 SABA 2 SABA + ICS 3 SABA + ICS + LTRA 4 SABA + ICS + LTRA + LABA 5 SABA + ICS + LTRA + LABA [plus MART rescue inhalers- ICS+SABA] 6 Add theophylline/aminophylline 7 Add oral steroids?
