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CMS > Respiratory Medicine > Flashcards

Respiratory Medicine Flashcards

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Introductory Sommelier Exam (CMS) flashcards
1
Q

How can the mast cells be stimulated if not directly from allergen?

A

Allergen stimulates cd4 lymphocyte ( th2 cells)
Interleukin 4 produced
Be cells stimulated to produce igE
Mast cells stimulated

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2
Q

What are symptoms of asthma?

A

Wheeze
Breathlessness
Cough

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3
Q

How is asthma assessed?

A

Peak flow readings- plotted by sex, age and heigh

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4
Q

What can be precipitants of asthma?

A 
Allergens
Irritants
Exertion
NSAIDs
Emotion
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5
Q

What medications are used to treat asthma?

A

Inhaled b2 agonists
Inhaled steroids
Combination inhalers
Anti leukotrienes

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6
Q

What b2 antagonist is short acting?

A

Salbutamol

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7
Q

What b2 agonist is long acting ?

A

Salmeterol

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8
Q

What is an inhaled steroid?

A

Beclamethasone

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9
Q

What is a combination inhaler?

A

Seri tide

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10
Q

What is an anti leukotrienes?

A

Montelukast

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11
Q

How is moderate asthma defined?

A

Peak flow 50-75%
No features of acute
Resp and pulse rate normal

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12
Q

What defines acute severe asthma?

A

Peak flow 33-50%
Resp rate >25
Heart rate > 110
Inability to complete sentences in one breath

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13
Q

What defines unstable asthma?

A

Recent infections
Poor compliance
Symptoms- requiring more frequent inhaler or reduce exercise limit
Change of meds by gp

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14
Q

Dental aspects re. Asthma

A

Avoid NSAIDs
Oral candidiasis
Altered taste
Dry mouth

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15
Q

What IS COPD?

A

Airflow obstruction that is not fully reversible
Progressive
Often caused by smoking

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16
Q

What is FEV.?

A

Forced expired volume in 1 second

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17
Q

What is FVC

A

Vital capacity

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18
Q

What defines obstruction?

A

FEV/FVC = less than 0.7

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19
Q

What is the pathophysiology of COPD?

A

Emphysema- alveolar destruction

Bronchitis- airway inflammation, increased mucous

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20
Q

What are symptoms of COPD?

A

Breathlessness pop exertion
Wheeze- consistent
Chronic cough and sputum
Frequent infections due to stagnant mucous

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21
Q

What are pulmonary lung function test

A

Lung function
Spirometry
FEV1
FVC

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22
Q

What is the management of COPD?

A

Oral and inhaled therapies- tiotropion
Cease smoking
Exercise training
Home o2 if severe

23
Q

Management of acute COPD

A

Stop tx
Give oxygen- not high flow unless desperate
Bronchodilator
Hospitalisation

24
Q

What is relevant re. Dental tx and COPD?

A

Avoid NSAIDs
Avoid sedation
Assess ability to lie flat

25
Q

What is pneumonia?

A

Infection of lung tissue

26
Q

What are symptoms of pneumonia?

A 
Cough with green sputum
Breathlessness 
Fever
Pleuritic chest pain 
Shadow on chest X-ray
27
Q

Management of pneumonia?

A

Antibiotics

Hospitalisation re. IV fluid, o2

28
Q

What does curb stand for ?

A

Confusion
Urea > 19
Resp rate >30
Bp 65

29
Q

What does a higher curb score mean?

A

Higher the score the higher the mortality rate

30
Q

What is pneumothorax

A

Leak of air into pleural space

Sudden onset of breathlessness and chest pain

31
Q

Who is susceptible re. Pneumothorax?

A

Tall young people
Especially smokers
Chronic lung disease

32
Q

What shows on chest X-rays?

A

Loss of lung markings

33
Q

What is management of pneumothorax?

A

Aspirate
Chest drain
Surgery

34
Q

What is sleep apnoea?

A

Collapse of upper airway during sleep

35
Q

What is sleep apnoea associated with ?

A

Obesity
Large neck
Sedative meds
Smoking or alcohol before sleep

36
Q

What are symptoms of sleep apnoea?

A 
Snoring
Daytime sleepiness
Micro sleeps 
Irritability
Headaches
37
Q

Management of sleep apnoea?

A

Lifestyle
Cpap- continuous positive airways device
Mad- mandibular advancement device

38
Q

What are causes of interstitial lung disease?

A

Allergens
Direct damage- asbestos
Auto immune

39
Q

Symptoms of interstitial lung disease

A

Breathlessness

Cough

40
Q

Management of interstitial lung disease?

A

Avoid sedation
Steroids
Remove underlying cause

41
Q

What is cystic fibrosis?

A

Gene defect causing abnormal chloride ion channels

42
Q

What can occur as a result of cystic fibrosis?

A

High viscosity mucous
Affects lung and pancreas
Affects male gonadal function

43
Q

Childhood symptoms of cystic fibrosis?

A

Recurrent respiratory infections
Malabsorption
Pancreatic duct obstruction
Bowel obstruction

44
Q

What are symptoms of cystic fibrosis in adults?

A

Diabetes
Male infertility
Osteoporosis

45
Q

How is cystic fibrosis diagnosed?

A

Blood test at birth

Sweat test

46
Q

What is management of cystic fibrosis?

A 
Prophylactic ab cover
Nutrition
Physio
Heart/ lung transplant 
Avoid sedation
47
Q

What is DVT?

A

Deep vein thrombosis.

Clot formation in peripheral veins ( usually legs)

48
Q

What is PE?

A

Pulmonary embolus

Clot migrates to lungs

49
Q

What are predisposing factors to DVT and PE?

A

Obstruction to blood flow
Surgery
Increased coagulation of blood

50
Q

Symptoms of DVT?

A

Painful lower leg

Dilated veins, hot red and swollen

51
Q

Symptoms of PE?

A

Pleuritic chest pain
Breathlessness
Haemolysis
Collapse sudden death

52
Q

Management of DVT and PE

A

Anticoagulation
Immediate- heparin
Long term- warfarin

53
Q

What do mast cells produce to stimulate bronchoconstriction?

A

Leukotrienes and histamine

CMS (14 decks)

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