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Year Four - Finals > Respiratory System - Finals Paper One > Flashcards

Respiratory System - Finals Paper One Flashcards

1
Q

What is a feature of life-threatening asthma attacks?

A

Normal pCO2 Levels

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2
Q

What is a feature of a near-fatal asthma attack?

A

Raised pCO2 Levels

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3
Q

When are ABGs used to investigate acute asthma attacks?

A

Saturations < 92%

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4
Q

What are the four admission criteria for acute asthma?

A

Life Threatening

Severe With Management Failure

Previous Near-Fatal Attack

Pregnancy

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5
Q

When is nebulised SABA used to manage acute asthma attacks?

A

Life Threatening

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6
Q

What corticosteroid is used to manage acute asthma attacks?

A

Oral Prednisolone

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7
Q

When is nebulised ipratropium bromide used to manage acute asthma attacks?

A

Severe/Life-Threatening Astma

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8
Q

What ventilation method is recommended in acute asthma?

A

Intubation & Ventilation

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9
Q

What are the two management options of mild to moderate asthma attacks in children?

A

Beta-2 Agonist Bronchodilator

Oral Prednisolone

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10
Q

What are the two management options of mild to moderate asthma attacks in children?

A

Beta-2 Agonist Bronchodilator

Oral Prednisolone

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11
Q

What spirometry reversibility testing result indicates asthma?

A

FEV1 > 12% improvement

FEV1 > 200ml

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12
Q

When bronchodilator reversibility is negative, what is the most appropriate next step?

A

Fractioned Exhaled Nitric Oxide Testing

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13
Q

What is step one of asthma management in adults?

A

Short-Acting Beta Agonist

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14
Q

What is step two of asthma management in adults?

A

Short-Acting Beta Agonist

Low Dose Inhaled Corticosteroid

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15
Q

What is step three of asthma management in adults?

A

Short-Acting Beta Agonist

Low Dose Inhaled Corticosteroid

Leukotriene Receptor Antagonist

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16
Q

What is step four of asthma management in adults?

A

Short-Acting Beta Agonist

Low Dose Inhaled Corticosteroid

Long-Acting Beta Agonist

*The Leukotriene Receptor Antagonist should be continued dependent on the patient’s response *

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17
Q

What is the most appropriate step down treatment of asthma?

A

Reduce inhaled corticosteroid dose by 25% - 50%

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18
Q

What is the most appropriate management step when occupational asthma is suspected?

A

Specialist Referral

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19
Q

What is step one of asthma management in children < 5 years old?

A

Short-Acting Beta Agonist

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20
Q

What is step two of asthma management in children < 5 years old?

A

Short-Acting Beta Agonist

8 Week Trial Moderate Dose Inhaled Corticosteroid

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21
Q

What is step three of asthma management in children < 5 years old?

A

Short-Acting Beta Agonist

Low Dose Inhaled Corticosteroid

Leukotriene Receptor Antagonis

22
Q

What is the most common organism associated with bronchiectasis?

A

Haemophilus Influenzae

23
Q

What is an indicator of surgical management of bronchiectasis?

A

Localised Disease

24
Q

What is the most common cause of infective exacerbations of chronic obstructive pulmonary disease?

A

Haemophilus Influenzae

25
Q

What are the two management options of acute chronic obstructive pulmonary disease exacerbations?

A

Nebulised Bronchodilator

Oral Prednisolone for 5 Days

26
Q

When are antibiotics used to manage acute exacerbations of chronic obstructive pulmonary disease?

A

When sputum is purulent or there are clincial features of pneumonia

27
Q

What are the three first line antibiotics used to manage acute exacerbations of chronic obstructive pulmonary disease?

A

Amoxicillin

Clarithromycin

Doxycycline

28
Q

What ventilation method is used to manage acute chronic obstructive pulmonary disease exacerbations with type two respiratory failure?

A

Non-invasive ventilation

29
Q

What should be offerred to those with frequent chronic obstructive pulmonary disease exacerbations?

A

A home supply of prednisolone and an antibiotic

30
Q

What is used to determine the severity of chronic obstructive pulmonary disease?

A

FEV1

31
Q

What FEV1 result indicates mild/stage one chronic obstructive pulmonary disease?

A

> 80%

32
Q

What FEV1 result indicates moderate/stage two chronic obstructive pulmonary disease?

A

50% - 79%

33
Q

What FEV1 result indicates severe/stage three chronic obstructive pulmonary disease?

A

30% - 49%

34
Q

What FEV1 result indicates very severe/stage four chronic obstructive pulmonary disease?

A

< 30%

35
Q

What are the two first line management options of chronic obstructive pulmonary disease?

A

Short-Acting Beta2-Agonist

OR

Short-Acting Muscarinic Antagonist

36
Q

Name a short-acting muscarinic antagonist inhaler used to manage chronic obstructive pulmonary disease

A

Ipratropium

37
Q

What is the second line management options of chronic obstructive pulmonary disease - in those with no asthmatic features?

A

Add Long-Acting Beta2 Agonist

AND

Add Long-Acting Muscarinic Antagonist

When taking a short-acting muscarinic agonist, discontinue and switch to short-acting beta2 agonist

38
Q

Name a long -acting beta2 agonist inhaler used to manage chronic obstructive pulmonary disease

A

Formoterol

39
Q

Name a long-acting muscarinic antagonist inhaler used to manage chronic obstructive pulmonary disease

A

Tiotropium

40
Q

What are the four asthmatic features of chronic obstructive pulmonary disease?

A

A previous diagnosis of asthma/atopy

A higher blood eosinophil count

A substantial variation in FEV1 over time > 400 ml

A substantial diurnal variation in peak expiratory flow > 20%

41
Q

What is the second line management options of chronic obstructive pulmonary disease - in those with asthmatic features?

A

Long Acting Beta2 Agonist

AND

Inhaled Corticosteroid

42
Q

What is the third line management options of chronic obstructive pulmonary disease - in those with asthmatic features?

A

Long Acting Beta2 Agonist

AND

Inhaled Corticosteroid

AND

Long Acting Muscarinic Antagonist

43
Q

What prophylactic antibiotic is used to manage chronic obstructive pulmonary disease?

A

Azithromycin

44
Q

What investigation should be conducted prior to azithromycin administration? Why?

A

ECG Scan

Side Effect = Prolonged QT

45
Q

Which six feautres should indicate assessment for long term oxygen therapy in chronic obstructive pulmonary disease?

A

FEV1 < 30%

O2 < 92%

Cyanosis

Polycythaemia

Raised JVP

Ankle Oedema

46
Q

When is long term oxygen therapy used to manage chronic obstructive pulmonary disease?

A

pO2 < 7.3 (x2 positive results)

OR

pO2 7.3 - 8 with one of the following…

  • Secondary Polycythaemia
  • Peripheral Oedema
  • Pulmonary Hypertension
47
Q

What heel prick test result indicates cystic fibrosis?

A

Increased Immunoreactive Trypsinogen (IRT) Levels

48
Q

What is the dietary management option of cystic firbosis?

A

High calorie and high fat diet, with pancreatic enzyme supplemetation for every meal

49
Q

What is the management option used to reduce chest infections in cystic fibrosis?

A

Advise individuals to minimise contract with each other due to the risk of cross infection

50
Q

What antibotic is used to manage Pseudomonas Aeruginosa infection in cystic fibrosis?

A

Oral Ciprofloxacin

51
Q

Which two organisms are associated with the greatest mortality risk in cystic fibrosis?

A

Pseudomonas

Bulkholderia

Year Four - Finals (2 decks)

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