Respiratory Medicine in Primary Care

Question 1

How do you treat URTIs in primary care?

Answer 1

Reassure the patient.
Give advice about the natural history of illness.

Question 2

How do you treat LRTIs in primary care?

Answer 2

Use CRB-65.
Follow up recovery and give general support.
Give sick lines if required.

Question 3

How can you treat asthma in primary care?

Answer 3

Optimise treatment.
Manage exacerbations.
Admit to the hospital if required.

The vast majority of asthmatics are managed exclusively in primary care.

Question 4

What is supportive management of asthma?

Answer 4

Have honest conversations with patients.
Focus on their personal values.
Set achievable goals.
Check inhaler technique.
Consider medication - efficacy, side effects, tolerability, adherence.
Create an asthma action plan.
Promote smoking cessation.

Question 5

How can you treat acute asthma in primary care?

Answer 5

Optimise treatment.
Further investigations and medications may be required.

Question 6

How can you treat COPD in primary care?

Answer 6

Optimise inhaled treatment.
Review as needed, and after admission.

Question 7

How can you treat acute exacerbation of COPD in primary care?

Answer 7

Assess severity and compare to baseline.
Review to assess response and recovery.
Most patients stay at home.
Many are admitted to hospital (if severe).

Question 8

How can you treat lung cancer in primary care?

Answer 8

Break bad news.
Support patients and family, through discussions and journey of treatment.
End of life care and palliative care.

Question 9

How can you treat bronchiectasis in primary care?

Answer 9

Sputum sample, CXR, bloods.
Refer to secondary care for HRCT and ongoing management.
Flare ups are treated with 2 weeks of antibiotics (after the sputum sample is sent).

Question 10

How can you treat interstitial lung disease in primary care?

Answer 10

History is vital.
Assess with bloods and CXR.
Refer to secondary care for HRCT and ongoing management.
Long-term care and end of life care.