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MSRA > Respiratory Medicine > Flashcards

Respiratory Medicine Flashcards

1
Q

How is COPD diagnosed?

A

Post bronchodilator FEV1/FVC < 0.7

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2
Q

What is the first line treatment for COPD?

A

SABA/SAMA

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3
Q

What is the second line treatment for COPD if no features of asthma/steroid responsiveness are present?

A

Add LABA + LAMA

(If already taking SAMA, switch to SABA)

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4
Q

What is the second line treatment for COPD if features of asthma/steroid responsiveness are present?

A

LABA + ICS + LAMA

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5
Q

What is the third line treatment for COPD?

A

Triple therapy - ICS + LABA + LAMA

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6
Q

What are the treatment options for COPD?

A

Physical training
Postural drainage
Antibiotics for exacerbations
Bronchodilators
Immunisations
Surgery

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7
Q

Which parameters make up a CURB 65 score?

A

Confusion
Urea >7
RR > 30
BP SBP <= 90mmHg and/or diastolic <= 60mmHg
65 - Age >= 65

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8
Q

Which acute features are seen in sarcoidosis?

A

Erythema nodosum
Bilateral hilar lymphadenopathy
Swinging fever
Polyarthralgia

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9
Q

Which insidious features are seen in sarcoidosis?

A

Dyspnoea
Non productive cough
Malaise
Weight loss

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10
Q

Which skin rashes/lesions are associated with sarcoidosis?

A

Lupus pernio
Erythema nodosum

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11
Q

Which triad are features are characteristic in Granulomatosis with polyangiitis (GPA)?

A

Haemoptysis
Renal impairment
Saddle nose

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12
Q

Which features are seen in moderate acute asthma?

A

PEFR 50-75%
Speech normal
RR < 25
HR <110 bpm

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13
Q

Which features are seen in severe acute asthma?

A

PEFR 33-50%
Can’t complete sentences
RR > 25
HR >110 bpm

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14
Q

Which features are seen in life threatening acute asthma?

A

PEFR < 33%
SpO2 <92%

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15
Q

Which features suggest asthmatic features/steroid responsiveness in COPD?

A

Asthma/atopy
Eosinophilia
Substantial variation in FEV1
Diurnal variaration in PEF

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16
Q

Which antibiotic is given for COPD exacerbation prophylaxis?

A

Azithromycin

17
Q

Which ABG features are suggestive of chronic CO2 retention in COPD?

A

Normal pH
Increased PaCO2
Increased bicarb (chronic renal compensation)
Low PO2

18
Q

Which features of Light’s criteria suggest that a pleural effusion is exudative?

A

LDH >2/3rds upper limit of serum
Pleural fluid LDH/ serum LDH >0.6
Pleural protein / serum protein >0.5

19
Q

How should asthma treatment be stepped down?

A

Reduced ICS dose by 25-50%

20
Q

How is a primary pneumothorax <2cm with no SOB managed?

A

Discharge

21
Q

How is a primary pneumothorax <2cm with SOB managed?

A

Aspiration

22
Q

How is a primary pneumothorax <2cm with SOB managed if initial management fails?

A

Chest drain

23
Q

How is a secondary pneumothorax >2cm, with SOB, in a patient >50 years managed?

A

Chest drain

24
Q

How is a secondary pneumothorax with a rim of 1-2cm managed?

A

Aspiration

25
Q

What can cause anterior mediastinum masses?

A

Thymoma, thymic mass, thyroid mass, lymphadenopathy.

26
Q

What is the commonest cause of bronchiectasis in children/young people?

A

Cystic fibrosis

27
Q

What is the second line treatment for asthma?

A

SABA + ICS + LABA

28
Q

Which features are seen on examination in a haemothorax?

A

Dull percussion of affected side with absent breath sounds?

29
Q

What is lupus vulgaris?

A

Painful cutaneous TB lesions. Nodular in appearance

30
Q

Which ABG features are seen in T1RF?

A

Hypoxia
Normal/low PaO2

31
Q

Which ABG features can be seen in PE?

A

Low Co2, increased pH (respiratory alkalosis)

V/Q mismatch - increased respiratory drive

32
Q

What is the commonest lung injury following blunt trauma?

A

Pulmonary contusion

33
Q

Which condition can cause hyper-resonance on percussion?

A

Pneumothorax
Emphysema

34
Q

How does Strep. pneumoniae pneumonia typically present?

A

CAP
Rust coloured “blood tinged” sputum
Lobar pattern of infection

35
Q

What is the first line management for HAP?

A

Co-amoxiclav

36
Q

What is the second line management for HAP?

A

Doxycycline

37
Q

What are the top 3 causes of pleural effusion?

A

Malignancy
Heart failure
Pneumonia

38
Q

Define mild COPD

A

FEV1 >80%

39
Q

What is the rationale for prescribing ICS in COPD patients?

A

Reduces frequency of exacerbations

MSRA (13 decks)

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