Respirology Flashcards
(25 cards)
Red-current jelly sputum is typical of which infective organism?
Klebsiella pneumoniae
What are the three A’s of Klebsiella?
Aspiration pneumonia
Alcoholics and diabetics
Abscesses in lungs
What are the common organisms in CAP?
Strep. pneumoniae Staph. aureus Strep. pyogenes Haemophylus influenzae Mycoplasma pneumoniae
Which pneumonia causing infective organism is associated with an elevated CK?
Legionella pneumophilia
How is COPD diagnosed and what value is diagnostic?
COPD is diagnosed using pulmonary function testing specifically looking at the FEV1/FVC ratio which has to be
What is alpha-1 antitrypsin deficiency?
It is an autosomal dominant inherited deficiency in alpha-1 antitrypsin which is made in the liver which is usually responsible for breaking down proteases in the lungs. With this deficiency you get a break down of the alveolar and this can cause COPD.
What is the treatment regime for TB?
RIPE
- Rifampacin
- Isoniazid
- Pyrazinamide
- Ethambutol
What are the names of SABAs used in Asthma?
Salbutamol
Turbutaline
What are the names of ICS?
Fluticasone
Budesonide
What are the names of LABAs?
Salmeterol
Formoterol
What does seretide contain?
Fluticasone and salmeterol
What does symbicort contain?
Budesonide and formoterol
What is the acute pathophysiology of asthma?
Mediator release from mast cells and eosinophils:
Histamine, prostaglandins, leukotrienes, cytokines in response to an allergen (usually).
This results in bronchoconstriction, oedema and mucous production.
What is the pathophysiology of chronic inflammation in asthma?
Early structural changes involving cell recruitment and epithelial damage which can lead to airway remodelling involving:
Smooth muscle and goblet cell hyperplasia and thickening of the basement membrane.
When is asthma typically worse?
In the early morning as the circadian rhythm of the sympathetic and parasympathetic nervous systems means that bronchodiameter is smallest at this time.
What are the three conditions associated with atopic disease?
Asthma, eczema, hayfever
What are the predisposing factors for asthma?
Genetics - Family history
Atopy - eczema and allergic rhinitis
Airway hyperresponsiveness
Sex - severe persistent asthma more common in women
What are some typical triggers of asthma?
Pollen Pollution Weather Exercise URTI's Allergens Smoking Anxiety/stress Medications (NSAIDS/aspirin or B-Blockers) GORD
How can asthma be diagnosed?
RFT’s
- Reduced FEV1/FVC below lower limit of normal
AND
- Increased FEV1 by 12% (min. 200ml) post bronchodilator
PEF
20% variation in PEF in consecutive days or >8% for twice daily readings
What are the causes of a respiratory wheeze?
Asthma Exaccerbation COPD Bronchitis Heart failure Vocal cord dysfunction Obstructing endobronchial lesion (tumour, foreign body)
What are the goals of asthma treatment?
- Control symptoms
- Prevent exacerbations
- Maintain normal levels of activity
- Maximise lung function and prevent lung function decline
- Lowest dose of medication to achieve adequate control and minimise symptoms
What are the common local side effects of ICS?
Oral Thrush
Hoarse Voice
What are the common side effects of a SABA?
Tremor
Aggitation
Palpitations/Tachycardia
What is COPD?
COPD is a group of disorders characterised by airway inflammation and airflow limitation that is not fully reversible.
