respiratory amk Flashcards
A 6-day-old child is referred to a community paediatrician by a general physician for poor feeding, vomiting and increasing lethargy. The child was born at term via spontaneous vaginal delivery, and his antenatal scans report no complications.
On examination, the baby looks floppy and tired. His nappy is wet and has a characteristic maple syrup odour.
Given the most likely diagnosis, which of the following is a known complication if left untreated?
metabolic acidosis
ketoacidosis
what is the most common cause of occupational asthma
Isocyanates
leaning forward improves chest and shoulder pain caused by what nerve
phrenic nerve
pericardium
surface production begins when
Surfactant production begins around week 22 of development
when surfactant detachable
first detectable around 28 weeks
35 weeks so premature babies are prone to respiratory distress syndrome
Can differentiate into Type 1 pneumocytes during lung damage
silent chest
A silent chest is a life-threatening feature of an asthma attack
cANCA postive
cANCA positive? Think granulomatosis with polyangiitis
Churg-Strauss disease - this is not the correct answer. Also known as eosinophilic granulomatosis with polyangiitis, which condition is pANCA positive. The eosinophils within the differential would also be raised, however in this patient the differential is reported as normal.
PE can cause
respiratory alkalosis
what level does the portal vein begin
L1
cervical rib cause
Cervical ribs occur as a result of the elongation of the transverse process of the 7th cervical vertebra. It is usually a fibrous band that attaches to the first thoracic rib.
cervical rib cause
Cervical ribs occur as a result of the elongation of the transverse process of the 7th cervical vertebra. It is usually a fibrous band that attaches to the first thoracic rib.
Compression of the subclavian artery may produce absent radial pulse on clinical examination and in particular, may result in a positive Adsons test (lateral flexion of the neck towards the symptomatic side and traction of the symptomatic arm- leads to obliteration of radial pulse)
commonest cause of empyema and pneumonia- what organism
The commonest cause of empyema is Streptococcus pneumoniae, which is also the commonest cause of pneumonia
The management of patients with community-acquired pneumonia is usually determined according to a risk stratification process using a scoring system called
CURB-65
components of CURB-65
C Confusion (abbreviated mental test score <= 8/10)
U Urea >7 mmol/L
R Respiration rate >= 30/min
B Blood pressure: systolic <= 90 mmHg and/or diastolic <= 60 mmHg
65 Aged >= 65 years
Patients with a CURB-65 score of 0 should be managed in the community.
Patients with a CURB-65 score of 1 should have their Sa02 assessed which should be >92% to be safely managed in the community and a CXR performed. If the CXR shows bilateral/multilobar shadowing hospital admission is advised.
Patients with a CURB-65 score of 2 or more should be managed in hospital as this represents a severe community acquired pneumonia.
The CURB-65 score also correlates with an increased risk of mortality at 30 days with patients with a CURB-65 score of 4 approaching a 30% mortality rate at 30 days.
normal icp
The normal intracranial pressure is between 7 and 15 mm Hg. The brain can accommodate increases up to 24 mm Hg, thereafter clinical features will become evident.
