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2A - Stuff i just cannot remember > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Pt presents with fever, night sweats, pleuritic chest pain, dyspnea. They’re coughing and bringing up some blood.
The pt is tired and has noticed weight loss + bone pain.

What investigations should be carried out?

A

TB SUSPECTED

Elevated ESR/CRP. Anaemia.

CXR - Nodules

Tuberculin skin test (Mantoux) - cannot differentiate active vs latent

Sputum smear microscopy + ZN STAIN = acid-fast bacilli

Mycobacterial Culture - Mycobacterium Tuberculosis

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2
Q

TB Management

A

RIPE RI

2 months of:

  1. Rifampicin
  2. Isoniazid
  3. Pyrazinamide
  4. Ethambutol

THEN 4 months:

  1. Rifampicin
  2. Isoniazid
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3
Q

What are the 4 classifications of pneumonia?

A

Community-acquired (CAP)

Hospital-acquired (HAP)

Pneumonia in immunocompromised

Aspiration pneumonia

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4
Q

Causes of CAP

A

Mycoplasma pneumonia
H. influenza
Strep Pneumonia

Pneumocystitis jiroveci - HIV/AIDS

Respiratory syncytial virus - young kids

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5
Q

Pneumonia investigations

A

CXR - lobar/patchy/diffuse shadowing

Silhouette sign - loss of structural borders

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6
Q

Pneumonia treatment

A

Supportive +

Empirical:

Non-severe - amoxicillin + erythromycin

Severe - Clarithromycin + Co-amoxiclav

Then specific Abx

Then Repeat CXR after 6 days

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7
Q

Antibiotic for S. pneumoniae

A

Amoxicillin/ benzylpenicillin

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8
Q

Antibiotic for M. pneumoniae

A

Erythromycin/ clarithromycin

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9
Q

Antibiotic for C. pneumoniae

A

Erythromycin/ clarithromycin

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10
Q

Antibiotic for C. psittaci and C. burnetti pneumoniae

A

Doxycycline

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11
Q

Antibiotic for Legionella spp. pneumonia

A

Clarithromycin +/- Rifampicin

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12
Q

Most common lung cancer. 2nd most common.

A

Most common = SSC

2nd = Adenocarcinoma

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13
Q

Pt presents with cough, haemoptysis and chest pain. They have lost weight and are short of breath.

You observe finger clubbing and tests reveal anaemia.

Likely diagnosis?

A

Lung cancer

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14
Q

Pt presents with progressive SOB + Finger clubbing. You note bilateral basal end-inspiratory crackles.

Likely diagnosis? RF?

A

Asbestosis

RF: Occupation - builder

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15
Q

Hypoxia + Hypercapnia

A

Type 2 Respiratory Failure

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16
Q

Management of acute pulmonary oedema

A 
High flow O2
IV Furosemide 
IV Morphine 
GTN 
Urgent CXR
17
Q

Asbestos exposure is a RF for which cancer?

A

Mesothelioma

Cancer of pleura

18
Q

Pt recently underwent a parathyroidectomy. She is becoming increasing SOB. RR 24, O2 drops to 83%, HR 118, BP 108/64, temp 37.9

She’s struggling to swallow food. She has no arrhythmias; her pupils are reactive. There are no rashes or abnormal bruising.

Likely diagnosis? Management

A

Neck haematoma, 2o to parathyroidectomy

Open surgical wound, to release pressure

19
Q

Initial management of a tension pneumothorax

A

Cannula into 2nd ICS MCL

20
Q

Anaphylaxis tx

A

IM Adrenaline

21
Q

Pt has had a 2 wk history of productive cough, worsening SOB and left back pain.

His obs reveal RR 22, O2 92%, temp 37.7

Auscultation reveals coarse crackles in the left lung base.

Likely diagnosis?

A

Pneumonia

  • fever
  • productive cough
  • hypoxia
  • unilateral coarse crackle
22
Q

Pt has had a 2 wk history of productive cough, worsening SOB and left back pain.

His obs reveal RR 22, O2 92%, temp 37.7

Auscultation reveals coarse crackles in the left lung base.

Likely diagnosis?
Risk assessment?

A

Pneumonia

  • fever
  • productive cough
  • hypoxia
  • unilateral coarse crackle

CURB-65

23
Q

18-month old pt presents with barking cough and inspiratory stridor, witch accessory muscle use. He responds well to dexamethasone.

Likely aetiology? Pathophysiology? Mx?

A

CROUP - PARAINFLUENZA VIRUS 1

Pathophysiology:
Inflammation of larynx + trachea

Mx: Steroids + nebulised adrenaline

24
Q

Causes of RESPIRATORY finger clubbing

A 
Asbestosis 
Bronchiectasis
Cancer (lung)
Do NOT say COPD 
Empyema

Interstitial Lung Disease

25
Q

Extrinsic allergic alveolitis

Triggers
Presentations

Acute vs chronic

A

Hypersensitivity reaction to ORGANIC dusts/ moulds

Trigger:

  • organic dust - fungus
  • keeps birds

Acute: asthmatic px
Chronic ILD px
- progressive SOB
- dry cough

26
Q

Pneumoconiosis

Triggers
Presentations

A

Interstitial lung diesase due to inhalation of INORGANIC dusts

  • miners
  • silicosis
  • asbestosis
27
Q

How to tell difference between extrinsic allergic alveolitis and pneumoconiosis

A

EAA: ORGANIC

Pneumoconiosis: INORGANIC

28
Q

Signs of a SEVERE asthma attack

A
  • inability to speak complete sentences
  • RR >25
  • Peak flow 33-50% predicted
29
Q

Signs of a LIFE-THREATENING asthma attack

A

BECCS

Bradycardia
Exhaustion 
Confusion 
Cyanosis
SILENT chest

2A - Stuff i just cannot remember (19 decks)

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