Respiratory - Common diseases Flashcards
What test is diagnostic for COPD?
Spirometry
How is the response of COPD to therapy assessed?
Pre and post bronchodilator spirometry
List some symptoms of COPD:
Breathlessness Productive Cough Wheeze Minimal diurnal variation Chest pain Frequent chest infections
What spirometry reading would be suggestive of COPD?
FEV1 <80% of predicted
FEV1/FVC ratio <0.7
What finding on CT imaging is an independent risk factor for lung cancer in smokers?
Emphysema
What other investigations need to be done (other than spirometry) in an initial diagnosis of COPD and why?
FBC - polycythaemia or anaemia may be seen
CXR - look for sinister pathology
Sputum culture - to rule out infection
What illness should be ruled out in patients with symptoms of COPD who haven’t smoked?
Alpha-antitrypsin deficiency
What method of inheritance is alpha-antitrypsin deficiency?
Autosomal recessive
Define asthma:
Chronic reversible inflammation of the airways caused by increased sensitivity to various stimuli
What % of diurnal variation would you expect to see on a spirometry measurements in an asthmatic?
> 20% variation
What is samter’s traid?
Aspirin sensitivity
nasal polyps
Asthma
What spirometry findings would be seen in asthmatics?
FEV1 - Reduced
FVC - Normal
FEV1 / FVC .k.a. FEV1 % - <70%
What type of wheeze would be heard in someone with asthma?
Expiratory polyphonic wheeze
At what age can you objectively test a child for asthma?
5 years old
What assessment is used to predict the likelihood of someone actually having a PE / DVT when they are potentially symptomatic?
Wells Score
List some risk factors for developing a PE:
Immobility for long periods of time Hormone replacement therapy Malignancy FHx Recent surgery Pregnancy Thrombophilia Polycythaemia SLE
What are some symptoms of a PE?
Shortness of breath Chest pain pleuritic Hypoxia Tachycardia Low grade fever Hypotension / instability Cough
What is the most appropriate investigation for a PE?
CT Pulmonary angiogram
If you are unsure whether to do a CTPA for a PE, what test could be done first?
D dimer
In a pulmonary embolism, what is the likely ABG finding?
Respiratory alkalosis
