Respiratory - Acute and Infections

Question 1

what is a pneumothorax?

Answer 1

accumulation of air in the pleural space

Question 2

types of pneumothorax?

Answer 2

primary - spontaneous

secondary - underlying disease

Question 3

features of a pneumothorax?

Answer 3

pain 
hyperexpansion
hyper resonant
absent breath sounds 
SOB

Question 4

treatment for a pneumothorax?

Answer 4

oxygen
aspiration
thoracostomy

Question 5

treatment of a tension pneumothorax?

Answer 5

large bore cannula in 2nd ICS midclavicular line

Question 6

cause of croup?

Answer 6

parainfluenza virus

Question 7

features of croup?

Answer 7

barking cough 
stridor
worse at night
lethargy
prodrome of coryza and fever

Question 8

investigations for croup?

Answer 8

clinical diagnosis

Question 9

admission criteria for croup?

Answer 9

RR>60
looks unwell
high fever

Question 10

treatment for croup?

Answer 10

oxygen
steroid (dexamethasone)
paracetamol
ibuprofen
fluids

Question 11

what is epiglotitis?

Answer 11

surgical emergency

cellulitis of the supraglottis

Question 12

features of epiglotitis?

Answer 12

fever
sore throat
drooling 
difficulty eating/breathing
tripod position

Question 13

cause of epiglottitis?

Answer 13

Haem influenza
step pneumoniae
staph aureus
MRSA

Question 14

why is epiglotitis less common now?

Answer 14

Hib vaccine prevents

Question 15

XRAY signs for epiglottitis?

Answer 15

thumbprint on lateral neck XRAY

Question 16

treatment for epiglotitis?

Answer 16

secure airway
oxygen
ceftriaxone

Question 17

what causes pertussis?

Answer 17

bordatella pertussis infection

droplet spread

Question 18

features of pertussis?

Answer 18

whooping cough
sick after coughing paroxysms
inspiratory whoop
fever

Question 19

investigation for pertussis?

Answer 19

nasal swab and culture

Question 20

treatment for pertussis?

Answer 20

<1 month = clarithromycin
> = azithromycin
pregnant = erythromycin
stay off work until 48hrs of Abx given

Question 21

how long can whooping cough stay for?

Answer 21

2-3 weeks

can return with other infections

Question 22

is pertussis a notifiable disease?

Answer 22

yes

Question 23

cause of flu?

Answer 23

inflenza A/B

Question 24

prevention of pertussis?

Answer 24

vaccine (given as a child or during pregnancy)

Question 25

who gets the flu vaccination?

Answer 25

those with health conditions
>65yrs
pregnant
healthcare workers

Question 26

what is ARDS?

Answer 26

acute lung injury consisting of pulmonary oedema and lung inflammation

Question 27

features of ARDS?

Answer 27

cyanosis
tachypnoea
increased RR
fever
cough
sputum

Question 28

investigations in ARDS?

Answer 28

CXR (bilateral infiltrates <1wk)
FBC
ABGs
U+Es, LFTs, amylase
clotting 
CRP
blood cultures

find a cause

Question 29

what causes diptheria?

Answer 29

corynebacterium diptheriae infection

produces exotoxin causing tissue necrosis

Question 30

features of diptheria?

Answer 30

sore throat
croup cough
neck swelling
pseudomembrane formation

Question 31

investigation and treatment of diptheria?

Answer 31

culture

erythro/penicillin

Question 32

why is diptheria less common?

Answer 32

vaccination (3 in 1 - DTaP)

Question 33

types of pleural effusion?

Answer 33

transudate <25g/l protein

exudate >35g/l

Question 34

features of a pleural effusion?

Answer 34

stony dull percussion
pleuritic pain
diminished breath sounds

Question 35

causes of transudate?

Answer 35

heart failure
fluid overload
nephrotic syndrome
cirrhosis

Question 36

causes of exudate?

Answer 36

infection
inflam
malignancy

Question 37

investigation of a pleural effusion?

Answer 37

PA CXR (blunted costophrenic angles)
US aspirate
bloods

find cause

Question 38

what is the difference between a transudate and exudate pleural tap?

Answer 38

transudate <30g/l protein

exudate >30g/l

Question 39

causes of transudate pleural fluid?

Answer 39

HF
low albumin (liver)
hypothyroid
meig’s

Question 40

causes of exudate pleural fluid?

Answer 40

infection
CTD
cancer