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Core Conditions > Respiratory Conditions > Flashcards

Respiratory Conditions Flashcards

1
Q

Who is most likely to be affected by acute asthma?

A

CHILDREN-

boys and WOMEN

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2
Q

What is the cause of acute asthma?

A

It is the PAROXYSMAL and REVERSIBLE obstruction of the airways.
INFLAMMATORY condition combined with bronchial hyper-responsiveness
BRONCHOSPASM: smooth muscle spasm -narrowing of airways
EXCESSIVE SECRETIONS - pluggin airways

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3
Q

What are the risk factors associated with asthma?

A

NON-MODIFIABLE: family history of asthma/atopy, maternal smoking, prematurity and low birth weight
MODIFIABLE: smoking, obesity
PMH: personal history of atopy

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4
Q

What are the most noticeable symptoms related to asthma?

A 
Wheeze
Breathlessness
Chest tightness
Cough
Worse at night and early in the morning
Worse in response to exercise/allergen exposure/cold air
Worse after aspirin/beta blocker use
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5
Q

What are the clinical signs of acute asthma?

A

Wheeze
Low FEV1
Low peak flow

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6
Q

What are some differential diagnoses for acute asthma?

A 
Bronchiolitis
Cystic fibrosis
GORD
Croup
Bronchiectasis/tuberculosis
COPD
Heart failure/CHD
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7
Q

Which investigations are appropriate in acute asthma?

A

Peak flow
Spirometry
CXR

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8
Q

What is the management for acute asthma?

A

Beta agonist for relief (salbutamol)

Regular inhaled steroid (beclometasone diproprionate)

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9
Q

Who is most typically affected by bronchial carcinoma?

A

WOMEN

increasing age

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10
Q

What is the most likely cause of bronchial carcinoma?

A

Non-small cell lung cancers
SMOKING
ASBESTOS

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11
Q

What are the risk factors for developing bronchial carcinoma?

A

NON-MODIFIABLE: increased age
MODIFIABLE: smoking, asbestos, chromium, arsenic, iron oxide, radiation
PMH: COPD, previous cancer

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12
Q

What are the symptoms of bronchial cancer?

A 
WEIGHT LOSS
HAEMOPTYSIS
BONE PAIN
COUGH
DYSPNOEA
clubbing, fever, weakness, SVC obstruction, dysphagia, headache, nausea/vomiting, hoarseness, wheezing/stridor
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13
Q

What are the clinical signs of bronchial carcinoma?

A

Opacity in CXR

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14
Q

What are some differentials for bronchial carcinoma?

A 
Secondary malignancy
Arteriovenous malformation
Pulmonary haematoma
Bronchial adenoma
Abscesses
Granuloma
Encysted effusion
Cyst
Foreign body
Skin tumour
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15
Q

What investigations should be done in suspected bronchial carcinoma?

A

IMAGING: CXR, CT, PET, bronchoscopy
SAMPLING: biopsy

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16
Q

What is the treatment for bronchial carcinoma?

A

Surgery
Radiotherapy
Chemotherapy

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17
Q

Who is affected by COPD?

A

It is found in 3 million people in the UK and is more common in MEN

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18
Q

What is the primary cause of COPD?

A

SMOKING

other causes include: long term exposure to lung irritants, inherited alpha 1 antitrypsin deficiency

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19
Q

What are the risk factors for COPD?

A

NON-MODIFIABLE: genetic

MODIFIABLE: smoking, occupational exposure- asbestos, chromium, arsenic, iron oxide, radiation, air pollution

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20
Q

What are the main symptoms for COPD?

A

Exertional breathlessness, chronic cough, wheezing, regular sputum production, recurrent chest infections, weight loss, exercise intolerance, ankle swelling, fatigue

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21
Q

What are the clinical signs of COPD?

A 
Use of accessory muscles in breathing?
Pursed lip breathing
Drowsiness/ flapping tremour, mental confusion
Cyanosis
Hyperinflation of the chest
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22
Q

What are the differential diagnoses for COPD?

A 
Asthma
Congestive heart failure
Bronchiectasis
Allergic fibrosing alveolitis
Pneumoconiosis
Asbestosis
Tuberculosis
Lung cancer
Obliterative bronchiolitis
Bronchopulmonary dysplasia
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23
Q

What investigations should be done in suspected COPD?

A

Spirometry
CXR
BLOODS: FBC

24
Q

What is the best management for COPD?

A

Smoking cessation
INHALED THERAPY: short acting beta agonist (salbutamol), Short acting muscarinic antagonist (ipratropium)/ long acting beta agonist and muscarinic antagonist (salmeterol, tiotropium)
ORAL THERAPY: corticosteroids, theophylline, mucolytics (carbocisteine)
OXYGEN THERAPY
PHYSIOTHERAPY
PULMONARY REHAB

25
Q

Who is most likely to be affected by lobar pneumonia?

A

the VERY YOUNG

ELDERLY

26
Q

What are the causes of pneumonia?

A

BACTERIAL: s. pneumoniae, h.influenzae, chlamydophila pneumonia, mycoplasma pneumonia.
VIRAL: rhinovirus, influenza virus, RSV, adenovirus, parainfluenza
FUNGAL
PARASITIC
NON-INFECTIOUS

27
Q

What are the risk factors for lobar pneumonia?

A

MODIFIABLE: smoking
PMH: preceding viral infections, immunosuppression (AIDS, cytotoxic therapy), respiratory problems, IVDU, hospitalisation, aspiration pneumonia, underlying disease

28
Q

What are the symptoms of lobar pneumonia?

A 
Cough 
Purulent Sputum
Breathlessness
Fever
Malaise
29
Q

What are the clinical signs associated with lobar pneumonia?

A 
Tachypnoea
Bronchial breathing
crepitations
pleural rub
dullness with percussion
30
Q

What are some differential diagnoses for lobar pneumonia?

A 
Acute bronchitis
Congestive heart failure
COPD exacerbation
Asthma exacerbation
Bronchiectasis exacerbation
TB
Lung cancer/METs
Empyema
31
Q

What are the investigations for lobar pneumonia?

A 
CURB-65 
Confusion
Urea
Respiratory rate
BP
65
CXR
32
Q

What is the treatment for lobar pneumonia?

A

Oxygen for treating hypoxia
Fluids for dehydration
Analgesics for mild pleuritic pain
Nebulised saline
Antibiotics- 5 DAY AMOXICILLIN (macrolide/tetracycline for pen. allergies and FLUCLOXACILLIN if staph infection is suspected)
7-10 days AMOXICILLIN and macrolide for moderate to severe
Beta-lactamase and a macrolide for most severe (carbapenem)

33
Q

Who is more likely to have pneumothoraces?

A

Men under 20 and peak at 60

Women 30-34 and peak at 60

34
Q

What are the causes of pneumothorax?

A 
Primary- SPONTANEOUS
Secondary- underlying lung disease
TRAUMA
IATROGENIC
CATAMENIAL PNEUMOTHORAX
35
Q

What are the risk factors of pneumothorax?

A

NON-MODIFIABLE: Marfan’s
MODIFIABLE: smoking
PMH: endometriosis, subpleural blebs and bullae

36
Q

What are the symptoms of pneumothorax?

A

Sudden onset of pain
SOB
Breathlessness

37
Q

What are the clinical signs of pneumothorax?

A 
Tachycardia
Pulse paradoxicus
asymmetry of chest wall during inspiration
hyper resonance in percussion
deviated trachea
reduced/absent breath sounds
38
Q

What are the differentials for pneumothorax?

A

Pleural effusion
Chest pain
Pulmonary embolism

39
Q

What investigations are available for pneumothorax?

A

IMAGING: CXR, USS, CT SCAN
BLOODS: ABG

40
Q

What is the treatment for pneumothorax?

A

Needle aspiration- large bore needle
Chest drain
Oxygen
Surgery

41
Q

How common is pulmonary embolus?

A

It is the most common cause of post-operative death affecting 60-70 per 100,000

42
Q

What are the causes of pulmonary embolus?

A 
Thrombosis from DVT
Tumours (breast and prostate)
Fat
Amniotic fluid
Sepsis
Foreign bodies
Air
43
Q

What are the risk factors for PE?

A 
Surgery
Obstetrics
Malignancy
Lower limb problems
Reduced mobility
Previous VTE
Minor risk factors- cardiovascular, oestrogens, misc.
44
Q

What are the symptoms of PE?

A

Dyspnoea
Pleuritic chest pain
Cough and haemoptysis

45
Q

What are the clinical signs for PE?

A 
Tachycardia, tachypnoea
Hypoxia
Pyrexia
Elevated JVP
Gallop heart rhythm
Pleural rub
Systemic hypotension and cardiogenic shock
46
Q

What are the differentials for PE?

A 
ACS
Aortic dissection
Cardiac tamponade
Pneumonia
Pneumothorax
Sepsis
47
Q

What investigations are required for PE?

A

BLOODS: d-dimers, ABG, FBC, troponin, BNP
o2 sats
IMAGINGL CXR, ECG, ECHO

48
Q

What is the management for PE?

A

100% O2
Fluid restoration
Anticoagulation- low weight molecular heparin, rivaroxaban
Vitamin K antagonist

49
Q

What is the cause of unilateral pleural effusion?

A 
Results from accumulation of abnormal volumes of fluid in the pleural space. It can split into transudate and exudative
Associated with-
Cardiac failure
Pneumonia
Malignancy
PE
50
Q

What are the risk factors for unilateral pleural effusion?

A

MODIFIABLE: smoking, asbestos exposure
PMH: Pre-existing lung damage/disease, lung cancer, liver cirrhosis, heart failure

51
Q

What are the symptoms associated with unilateral pleural effusion?

A 
Dyspnoea
Breathlessness
Pleuritic chest pain
cough and haemoptysis
weight loss
52
Q

What are the clinical signs of unilateral pleural effusion?

A

finger clubbing
rheumatoid changes in the hands
accessory muscle use
reduced movement on the side of the effusion
tracheal deviation away from the lesioned side
stony dullness on percussion
diminished breath sounds over effusion

53
Q

What are the differentials for unilateral pleural effusion?

A 
Pulmonary oedema
diaphragmatic injuries
hypothyroidism
pancreatitis
rheumatoid arthritis
54
Q

What investigations are appropriate in suspected unilateral pleural effusion?

A

IMAGING: CXR-PA
SAMPLING: pleural aspiration (thoracentesis), centrifuge, haematocrit, cholesterol and triglycerides
BLOODS: ESR, CRP, albumin, amylase, TFTs, blood culture

55
Q

What is the treatment for unilateral pleural effusion?

A

Pleural drainage
Tapping the fluid
Pleurodesis- injection of sclerosant to cause adhesion of visceral and parietal pleura and prevents re-accumulation. (tetracycline, sterile talc, bleomycin)

Core Conditions (11 decks)

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