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Year 5 Conditions > respiratory > Flashcards

respiratory Flashcards

1
Q

clinical features of acute moderate asthma exacerbation

A

PERK < 75% predicted

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2
Q

clinical features of acute moderate asthma exacerbation

A

PERK 33-50% predicted

can not finish full sentence

RR >25

HR > 110

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3
Q

clinical features of acute life-threatening asthma exacerbation

A

33 92 chest

PERK < 33
O2 < 92

Cyanosis 
Hypotension 
Exhaustion - normal or low PCO2
Silent chest 
Tachycardia
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4
Q

management of acute asthmatic attack?

A

O SHIT ME

o2 
salbutamol - 2.5-5mg neb 
Hydrocortisone  - 100mg IV 
Ipratropium - 500mcg neb 
Theophylline - aminophylline infusion 1g in 1L saline 0.5ml/kg/h

Magnesium sulfate
escalate care

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5
Q

clinical features of acute COPD exaecbeation?

A
  • Cough
  • SOB
  • Tachypnoea
  • ↑ Sputum production/appearance change/viscosity change
  • Wheeze/coarse crackles
  • Accessory muscle use and lip-pursing (increases end expiratory pressure – prevents collapse of airways at low pressure)
  • Assess hyperinflation (barrel chest)
  • Evidence of hypercapnia:
  • Tremor
  • CO2 retention flap
  • Bounding pulse
  • Peripheral vasodilation
  • Drowsiness
  • Confusion
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6
Q

management of acute COPD in hospital

A

O SHIT -if in hospital

Oxygen - aim for 88-92 via venturi mask

Salbutamol - 5mg neb
Hydrocortisone - 100mg IV
Ipratropium bromide 500mcg neb
Theophylline -0.5mg/kg/h

ABx
BiPAP - respiratory acidosis persists despite max standard medical treatment for > 1 h

escalate

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7
Q

management of acute COPD at home

A
  • Prednisolone 30mg for 7 days
  • Regular inhalers/home nebs – salbutamol and corticosteroid
  • Abx - if evidence of infection
  • Airway clearance technique
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8
Q

aetiology of hyperventilation (panic attack)

A 
panic disorder 
anxiety 
astham 
metabolic acidosis - compensatory hyperventilation 
PE 
pulmopnary oedema 
hypoxia 
fever 
aspirin overdose
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9
Q

clinical features of hyperventilation in panic disorder

A

usually paroxysmal - rapid onset on anxiety, lasting 20-30 mins

SOB 
chest pain 
paraesthesia - usually both arms (Ca2+ ) 
perioral tingling (Ca2+ ) 
dizziness 
depresonalisation 
derealisation 
tinnitus 
weakness 
palpitatioons 
use of accessory muscles 
inspiratory > expiratory phase
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10
Q

investigation for hyperventilation

A

ABG - inc O2, respiratory alkalosis

ECG

pulmonary function test

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11
Q

management of hyperventilation

A

explaination of the nature of the condition with anxiety

rebreathing into a paper bag -only use when diagnosis is certain

relaxation techniques

O2

benzo if severe

propranolol

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12
Q

complications of hyperventilations

A

secondary hypocalcaemia - due to Ca dissociation is shifted towards the unionised, bound form

  • Trousseaus’s sign - muscle spasm in the hand, tips of fingers and thumb apposed and the fingers straight
  • chvostek’s sign
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13
Q

what is acute bronchitis

A

refers specifically to the infections causing inflammation in the bronchial airways

a self-limiting LRTI

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14
Q

aetiology of acute bronchitis

A
  • Smoking

* Infection – viral esp (Influenza A/B, parainfluenza, RSV, adenovirus, rhinovirus)

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15
Q

clinical features of acute bronchitis

A
  • Cough >5 days – normally productive (clear, white or discoloured sputum)
  • Runny nose/sore throat precedes
  • Wheeze/rhonchi/course crackles
  • Fever
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16
Q

what is the criteria used to diagnose acute bronchitis

A

MacFarlane

a) an acute illness of < 21 days
b) cough as predominant symptom
c) at least 1 other LRTI eg sputum production, wheezing, chest pain
d) no alternative explanation for the symptoms

17
Q

management of acute bronchitis

A
  • If without significant wheezing, cough associated with increased activity or nocturnal cough – observe and symptomatic relief
  • Significant wheezing, cough associated with increased activity or nocturnal cough – SABA

abx if systemically unwell

18
Q

when will you consider using VQ scan

A

used in pt with CKD, contrast allergy or at risk from radiation eg young and pregnant

19
Q

what is idiopathic pulmonary fibrosis

A

no know cause pulmonary fibrosis

RF - FHx, smoking, older age, male

SOB, on exertion, non productive cough, clubbing, end expiratory fine crackles, weight loss, fatigue, malaise

20
Q

what is bronchiectasis

A

permanent dilatation of the bronchi due to destruction of the elastic and muscular components of hte bronchial wall

  • chronic productive cough, large volumes produced worse when lying down
  • haemoptysis
  • high pitch inspiratory squeaks
  • SOB
  • fever

signet ring sign on CT - bronchi appears bigger than vessel on CT

Year 5 Conditions (19 decks)

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