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Emergency Medicine > Respiratory Emergencies > Flashcards

Respiratory Emergencies Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

Common conditions in respiratory ED

A

Acute severe asthma, COPD exacerbation, pneumonia, acute PE, acute pulmonary oedema

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2
Q

What is hypoxia

A

Oxygen is not available in sufficient amounts at tissue level

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3
Q

What is hypoxaemic hypoxia

A

Reduced alveolar ventilation, V/Q mismatch, shunt, decreased diffusion

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4
Q

Types of hypoxia

A

Hypoxaemic, circulatory/ischaemic/stagnant hypoxia, anaemic, histotoxic (CN poisoning)

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5
Q

What does oxygen delivery depend on

A

Amount of free oxygen in the blood, arterial O2 saturation, haemoglobin and cardiac output.

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6
Q

Acute pathologies of the pleura

A

Pneumothorax, haemothorax, pleural effusion

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7
Q

Acute pathologies of the alveoli

A

Pneumonia, pulmonary oedema

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8
Q

Acute pathologies of the airways

A

Asthma, COPD exacerbation, bronchiectasis

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9
Q

Why are legs raised to increase oxygen flow

A

Increases preload to the heart to increase cardiac output

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10
Q

How is PE severity graded

A

Using severity index score - PESI index

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11
Q

Diagnosis of PE

A

CTPA

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12
Q

Options for treatment of PE

A

Oxygen therapy, anticoagulation, systemic thrombolysis, percutaneous catheter directed embolectomy, surgical embolectomy, vena cava filters, management of RV function and ECMO

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13
Q

What is CPAP used for

A

Improving haemodynamics in HF patients, increased functional residual capacity

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14
Q

What is BiPAP used for

A

Patients with type 2 resp failure such as COPD - it gives inspiratory positive airway pressure with expiratory positive airway pressure

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15
Q

Causes of central cyanosis

A

Decreased arterial oxygen saturation, polycythaemia, haemoglobin abnormalities

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16
Q

Causes of decreased arterial oxygen saturation

A

Altitude, lung disease (COPD), V/Q mismatch (PE), right to left shunt (cyanotic ongenital heart disease)

17
Q

Causes of peripheral cyanosis

A

Reduced cardiac output (cardiogenic shock, LVF), cold exposure, arterial or venous obstruction

18
Q

Causes of congenital cyanotic heart disease

A

Tetralogy of fallot, transposition of great arteries, truncus arteriosus, tricuspid atresia, total anomalous pulmonary venous connection, pulmonary atresia, eisenmenger syndrome

19
Q

Factors which shift oxyhaemoglobin dissociation curve to the left

A

Decreased temperature, imcreased pH, decreased 2,3 DPG, increased methemoglobin, presence of sulfhemoglobin

20
Q

Factors which shift oxyhaemoglobin dissociation curve to the right

A

Increased temperature, decreased pH, increased 2,3 DPG

21
Q

What is the hyperoxia test ad how does it help with cyanosis workup

A

Supplemental source onto a patient with cyanosis - if patient responds well they are likely to havea diffusion deficit. If do not respond they are likely to have a shunt.

22
Q

What are Cheyne Stokes

A

Abnormal breathing pattern characterised by progressively deeper and/or faster breathing, followed by a gradual decrease in depth/rate that results in temporary apnoea

23
Q

What is the definition of dysopnoea

A

Unpleasant awareness of increased respiratory effort (breathlessness)

24
Q

Most common causes of dysopnoea in ED

A

Asthma, COPD, cardiac failure, pneumonia, ILD, psychogenic disorder

25
Q

Life threatening causes of dysopnoea

A

Obstruction, anaphylaxis, epiglottitis, severe pulmonary oedema, severe asthma, tension pneumothorax, cardiac tamponade, massive PE

26
Q

Causes of acute stridor

A

FB inhalation, epiglottitis, croup, laryngitis, anaphylaxis, neck space abscess

27
Q

Causes of chronic stridor

A

Layngomalacia, subglottic stenosis, vocal cord paralysis, subglottic haemangioma, respiratory papillomatosis, macroglossia, micrognathia, malignancy

28
Q

What is the pathophysiology of stridor

A

Noise made by air forced through narrowed upper airways - supraglottic, glottic, subglottic, trachea

29
Q

What is the pathophysiology of stertor

A

Low pitched snoring sound from stenosis between nasopharynx to supraglottic regions

Emergency Medicine (17 decks)

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