Respiratory COPY Flashcards
What is Goodpasture’s Syndrome?
- autoimmune anti glomerular basement membrane disease
- antibodies attack basement membrane in lungs and kidneys
- bleeding lungs, glomerulonephritis, kidney failure
Presentation of Goodpasture’s
- haemoptysis
- haematuria
- dyspnoea
- glomerulonephritis
- chest pain
- fever
- fatigue
Investigations for Goodpasture’s
lung and kidney biopsy → anti-GBM antibodies
Treatment for Goodpasture’s
- supportive
- corticosteroids
- immunosuppresants
- removal/replacement of plasma → plasmapheresis
What is hypersensitivity penumonitis?
- type 3 hypersensitivity reaction
- alveolar and bronchial inflammation after exposure to inhaled allergen
Presentation of hypersensitivity
- dyspnoea
- cough
- fever
- malaise
- weight loss
Investigations for hypersensitivity pneumonitis
bronchoalveolar lavage
- raised lymphocytes
- raised mast cells
Treatment of hypersensitivity pneumonitis
- remove allergens
- steroids
What are examples of occupational lung disorders
- silicosis
- asbestosis
- bird fanciers lung
What is pharyngitis?
rapid onset of sore throat and pharyngeal inflammation +/- exudate
Common causes of pharyngitis
- EBV
- adenoviruses
- enteroviruses
- group A streptococcus
Symptoms of pharyngitis
- sore throat
- fever
- headache, nausea, abdominal pain → kids
- rhinorrhoea, nasal congestion, cough → viral
What factors suggest a group A strep pharyngitis?
- pharyngeal exudates
- cervical adenopathy
- fever
- absence of cough/rhinorrhoea
Diagnosis of pharyngitis
- clinical symptoms consistent with group A strep infection
- rapid antigen detection test for group A strep
- -ve → conventional throat culture
Treatment of pharyngitis
- supportive → analgesia
- if group A strep, add Abs
What is sinusitis?
- inflammation of mucous membrane of nasal cavity and paranasal sinuses
- AKA acute rhinosinusitis
Causes of sinusitis
- streptococcus pneumoniae
- haemophilus influenzae
- rhinoviruses
- can progress to secondary bacterial infection
Risk factors for sinusitis
- nasal pathology → septal deviation, nasal polyps
- recent local infection → rhinitis, dental extraction
- swimming
- smoking
Viral presentation of sinusitis
- symptoms <10 days
- clear nasal discharge
- fever
- sore throat
Bacterial presentation of sinusitis
- symptoms >10 days
- purulent nasal discharge
- dental/facial pain
- headache
Investigations of sinusitis
- clinical diagnosis
- distinguish viral vs bacterial
Management of sinusitis
viral
- self limiting disease
- treatment is symptomatic
bacterial
- symptom-based therapy
- Ab generally avoided but can shorten infection
What is acute otitis media?
- inflammation of the middle ear
- associated with effusion, signs of infection
Causes of acute otitis media
viral
- RSV
- rhinovirus
- adenovirus
- influenza
most common bacterial
- H.influenzae
- S.pneumoniae
- moraxella catarrhalis
Risk factors for acute otitis media
- young
- male
- smoking
- frequent contact with other children
- family history
Presentation of acute otitis media
- otalgia
- preceding URTI symptoms
- fever
- sleep disturbance
- irritability in children
Diagnosis of acute otitis media
otoscopy → bulging and erythema of tympanic membrane
Management of acute otitis media
- regular analgesia
- amoxicillin
- consider admitting kids <3 months/ 3-6 months with temp 39+
What is acute epiglottitis
- inflammation of epiglottis
- airway emergency
- typically 2-6, can be younger
causes of acute epiglottitis
- inflammation of supraglottis
- classically with H.influenzae
- can be S.pneumoniae
Presentation of acute epiglottitis
- acute onset high fever
- toxic appearance
- tripoding
- sore throat
- dysphagia and painful
- difficulty breathing
- decreased oral intake
- stridor
Diagnosis of acute epiglottitis
- laryngoscopy during intubation in an OT
- lateral neck radiography → thumb print sign
Management of acute epiglottitis
- secure airway
- IV Abs
- supplemental O2
- maybe heliox and corticosteroids
