Respiratory Block Flashcards
(364 cards)
What is PCP?
Pneumocystis pneumonia (PCP) is a serious infection caused by the fungus Pneumocystis jirovecii.
Affects people with weakened immune systems (I.e. HIV/AIDS, organ/stem cell transplant, autoimmune diseases, blood cancer)
Symptoms: Fever, cough, difficulty breathing, chest pain, chills, fatigue
- Develop over several weeks or a few days (in those who have a weakened immune system)
What drug is used to prevent/treat pneumocystis jirovecii pneumonia?
Trimethoprim/sulfamethoxazole (co-trimoxazole)
Give for 3 weeks by mouth/IV
Side Effects: Rash, fever
How is PCP diagnosed?
Sputum sample
Bronchoalveolar lovage
Lung biopsy
PCR to detect pneumocystis DNA
Blood test: b-D-glucan (part of the cell wall of many different types of fungi)
What is wernicke-korsakoff syndrome?
The combined presence of Wernicke encephalopathy and alcoholic Korsakoff syndrome
Caused by thiamine (Vitamin B1) deficiency
What disorders stem from thiamine deficiency?
- Beriberi
- Wernicke encephalopathy
- Alcoholic Korsakoff syndrome
What is the difference between Wernicke encephalopathy and Korsakoff syndrome?
Wernicke encephalopathy (WE) is most commonly seen in people who are alcoholic. The failure to diagnose WE may lead to death or permanent brain damage associated with WKS
What are the symptoms of wernicke encephalopathy?
- Ocular disturbances (nystagmus)
- Changes in mental state (confusion)
- Unsteady stance and gait (ataxia)
What are the symptoms of Korsakoff syndrome?
- Anterograde amnesia
- Variable retrograde amnesia
- Aphasia
- Apraxia
- Agnostic
- Defect in executive functions
- Confabulation
What is the treatment of Wernicke Syndrome?
IV thiamine to reverse it before it becomes irreversible Korsakoff syndrome
What are the signs and symptoms of hypovolemia?
- Increased HR
- Low BP
- Pale/cold skin
- Altered mental status
- Oliguria
- Low JVP
- Headache
- Fatigue
- Weakness
- Thirst
- Dizziness
What are causes of hyperkalemia?
- AKI
- CKI
- Addison’s Disease (adrenal insufficiency)
- Angiotensin II receptor blockers
- ACE inhibitors
- Beta blockers
- Dehydration
- Destruction of RBCs due to severe injury/burns
- Type 1 diabetes
What is the treatment for active pulmonary TB?
- Isoniazid + rifampicin (6mo)
2. Pyrazinamide + ethambutol (first 2mo of 6mo treatment)
How long after TB treatment is the patient no longer infectious?
After taking antibiotics for 2 weeks
When can patients make their own decisions about their treatment (when do patients have capacity)?
Age 16
How does the MCA set out a 2-stage test of capacity?
- Does the person have an impairment of their mind or brain, whether as a result of an illness, or external factors such as alcohol or drug use?
- Does the impairment mean the person is unable to make a specific decision when they need to?
The MCA says a person is unable to make a decision if they can’t:
- Understand the information relevant to the decision
- Retain that information
- Use or weigh up that info as part of the process of making the decision
Explain the WHO’s cancer pain ladder and name 1 drug for each step of the ladder
If pain occurs there should be a prompt oral administration of drugs in the following order:
- Nonopioids (aspirin, paracetamol)
- Mild opioids (codeine, co-codamol)
- Strong opioids (morphine, diamorphine, oxycodone)
Describe what emphysema look like on a (1) x-ray (2) CT
(1) Lungs appear much larger than they should be
2) CT will show destruction of alveoli (air sacs
How is one diagnosed with schizophrenia?
A person must have 2+ of the following symptoms occurring persistently in the context of reduced functioning:
- Delusions
- Hallucinations
- Disorganised speech
- Disorganised/catatonic behaviour
- Negative symptoms
Identify the stages of AKI
I - Cr > 150-200% from baseline OR acute increase of Cr > 25uM/L/48hr OR urine output < 0.5ml/kg/hr for >6hrs
II - Cr > 200-300% from baseline OR urine output < 0.5ml/kg/hr >12hrs
III - Cr > 300% from baseline OR Cr > 350uM/L OR urine output <0.3ml/kg/hr for 24hrs or auric for 12hrs OR requires renal replacement therapy irrespective of Cr
What are risk factors for AKI?
- Kidney disease
- Malignancy
- Heart failure
- Ischemic heart disease
- Liver disease
- Urological intervention
What are the nephrotoxic drugs?
- Angiotensin-converting enzyme inhibitors/angiotensin-II receptor antagonists
- NSAIDs
- Antivirals/antifungals
- Vancomycin/gentamicin
- Chemotherapy/contrast
How can an azygous lung lobe form?
When the R posterior cardinal vein, which is one of the precursors of the azygos vein penetrates the R lung apex, rather than migrating over it. The cardinal vein carries both pleural layers with it, resulting in entrapment of a portion of the R upper lobe.
Which drugs can cause hyponatremia?
- Diuretics (thiazides, loop diuretics, indapamide, amiloride)
- Antidepressants (amitryptilline)
- Anti-epileptic drugs (carbamazepine)
- Anticancer agents
- NSAIDS