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F1 and Stage 5 > Respiratory conditions: diseases > Flashcards

Respiratory conditions: diseases Flashcards

1
Q

Definition of primary vs secondary pneumothorax

A 
Primary = no hx of lung disease
Secondary = hx of lung disease
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2
Q

Managing primary pneumothorax

Air rim <2 cm
Aim rim >2 cm

A

Air rim <2cm, no symptoms = discharge

Air rim <2cm, SOB = aspirate

Air rim >2cm = chest drain

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3
Q

Managing secondary pneumothorax

Air rim <1 cm
Aim rim 1-2 cm
Air rim >2cm

A

Air rim <1 cm = Give oxygen, admit for 24h

Air rim 1-2cm = aspirate

Air rim >2cm = chest drain

Breathless at any point = chest drain

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4
Q

Who should get a chest drain if they have a pneumothorax

A
  1. Primary/ secondary pneumothorax, air rim >2cm
  2. Secondary pneumothorax, patient >50yo
  3. Secondary pneumothorax, patient breathless
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5
Q

Contraindication to usage of bupropion for smoking cessation

A

Epilepsy (risk of reduced seizure control)
Pregnancy
Breastfeeding

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6
Q

Where is the safe triangle for chest drain insertion

A
  1. Latissimus dorsi
  2. Pec major
  3. 4th/5th intercostal space in the mid axillary line

Direct tube high and anteriorly

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7
Q

How much oxygen to give in venturi in a COPD CO2 retainer

A

24percent oxygen

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8
Q

Which 2 groups of COPD patients should be put on LTOT

A
  1. PaO2 <7.3 despite maximum treatment

2. Peripheral oedema/ polycythaemia

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9
Q

Drugs for long term management of COPD

A
  1. SABA or SAMA
    • LABA + ICS
    • LAMA
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10
Q

Drugs for long term management of asthma

A
  1. SABA
  2. SABA + ICS
  3. SABA + ICS + LTRA
  4. SABA + ICS + LABA (continue LTRA depending on response)
  5. SABA + LTRA + higher dose ICS
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11
Q

Management of suspected pulmonary embolism

A

LMWH (if normotensive)

Thrombolysis (if hypotensive)

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12
Q

Management of recurrent pulmonary embolism

A

Consider IVC filter

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13
Q

What investigation to do in a suspected PE with a LIKELY Wells score

A

Likely Wells score (>4)

Immediately CTPA

(if can’t do immediately then give anticoagulants first then CTPA)

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14
Q

What investigation to do in a suspected PE with an UNLIKELY Wells score

A

Unlikely Wells score (4 or less)

do D dimer, then if positive do CTPA

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15
Q

Most common site of aspiration pneumonia. Why this site?

A

Apical and posterior segments of the lower lobe of the right lung

Due to larger caliber and more vertical orientation of the right mainstem bronchus

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16
Q

What pneumonias can cause dry cough

A

Legionella (if travel, air con)
Chlamydia psittaci (bird lovers)
PCP (immunocompromised)
Mycoplasma

(Lungs Cant Produce Mucus)

17
Q

What pneumonia causes redcurrant jelly sputum

A

Klebsiella

18
Q

Risk factors for Klebsiella pneumonia

A

Elderly
Diabetes mellitus
Alcohol

19
Q

Risk factors for Legionella pneumonia

A

Travel

Aircon

20
Q

Most common bacterial causes of IECOPD

A
  • Haemophilus influenza (most common)
  • Strep pneumoniae
  • Moraxella catarhallis
21
Q

Treatment for IECOPD

A

Prednisolone 30mg for 7-14 days

Abx only if clinical signs of pneumonia

22
Q

Cavitating pneumonia in upper lobes -most likely organism

A

Klebsiella

23
Q

Most common cause of HAP in patients on ventilator in ITU

A

Pseudomonas aeruginosa

24
Q

CXR pattern in klebsiella pneumonia

A

Cavitating pneumonia in upper lobes

25
Q

CXR pattern in mycoplasma

A

Patchy consolidation of 1 lower lobe

+ flu like symptoms

26
Q

CXR pattern in legionella pneumophilia

A

Bibasal consolidation

27
Q

What pneumonia causes redcurrant jelly sputum

A

Klebsiella

28
Q

What PEFR levels indicate moderate, severe and life threatening asthma

A

PEFR:
50-75percent of best/predicted: moderate
33-50 of best/predicted: severe
<33 of best/predicted: life threatening

29
Q

Causes of lower zone pulmonary fibrosis

A
  • idiopathic pulmonary fibrosis
  • most connective tissue disorders (except ankylosing spondylitis) e.g. SLE
  • drug-induced: amiodarone, bleomycin, methotrexate
  • asbestosis
30
Q

Causes of upper zone pulmonary fibrosis

A

Upper zone fibrosis: CHARTS

C - Coal worker's pneumoconiosis
H - Histiocytosis/ hypersensitivity pneumonitis
A - Ankylosing spondylitis
R - Radiation
T - Tuberculosis
S - Silicosis/sarcoidosis
31
Q

Drug induced causes of pulmonary fibrosis

A

Amiodarone
Methotrexate
Neomycin

32
Q

Most common cause of spontaneous secondary pneumothorax

A

COPD

33
Q

Most common chemical cause of occupational asthma

A

Isocyanates eg spray painting, foam moulding with adhesives

34
Q

What drugs cause pulmonary eosinophilia

A

Nitrofurantoin

Sulphonamides

35
Q

Which of these causes fibrosis in the upper or lower zones

  • Silicosis
  • Coal worker’s pneumoconiosis
  • Asbestosis
A

UPPER ZONE

  • Silicosis
  • Coal worker’s pneumoconiosis

LOWER ZONE
-Asbestosis

F1 and Stage 5 (29 decks)

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