science knowledge for respiratory Flashcards
pneumonia is a
lower resp infection
pneumonia can lead to
type 1 resp failure
pneumonia causing organisms
hap - s aureus, gram -ve (most severe, causes abcess)
cap - strep pneumonia
can also get pneumonia from aspiration
can you get pneumonia from aspiration?
yes
pneumonia symptoms
fever rigor fatigue heamoptysis chest pain
pneumonia tests to diagnose
cxr o2 sats bloods sputum pleural effusion
pneumonia treatment
02 at 94 or above hydration nutrition AB thromoprophylaxis
pneumonia severity scale and values
CURB 65 c - confusion, <8 u - urea >7 r - RR >30 b - BP <90/60
curb scoring treatment
0-1 home, amox
1-2 hospital, amox
3 co amoxiclav
pneumonia treatment for atypical organisms
clarithromycin and amox/co-amox
complications from pneumonia
- parapneumonic pleural effusion
- lung absecess
- cancer
- resp failure
- hypotension
- AF
bronchial breathing sounds from
cavitation
consolidation
local fibrosis
what is bronchiectasis
chronic infection of bronchi
dilation of airways
causes of bronchiectasis
H influenza step penumonia staph aureus cf measels youngs syndrome post infection chlidhood infection immune deficiency
test for diagnosing bronchiectasis
sputum
cxr
bronchoscopy
bronchiectasis treatment
chest drain
AB - at least 2 weeks
bronchodilation
bronchiectasis assoiciations
RA and IBD
pack year calculations
20 x number of years smoked
heart failure and breathlessness
breathless when lying down, when they sit up it gets better
to ask when they have orthopnea
ask how many pillows they use at night
scale to measure dysponea
mrc scale
- no problem
- sob on incline or hurrying
- walks slow, stops
- <100 yards
- too breathless, house bound
productive cough could mean
bronchiectasis
copd general
- common, preventable, treatable
- alveolar abnormalities cause by gases
- persistent symptoms
- airflow limitations
- chronic dysponea
- chronic sputum
copd rf
- air pollution
- smoke
- low birth weight
- 2nd hand smoke
copd vs asthma main symptoms difference
COPD = breathless asthma = wheeze
copd diagnosing criteria
FEV <80
FEV/FVC <70
two types of copd
- chronic bronchitis
2. emphysema
pink puffers
increased ventilation
breathless
not cynosed
blue bloater
decreased ventillation
not breathless
cyanosed
copd test findings
fbc
cxr - hyperinflation 6 ribs above diaphragm
ecg - RV + A hypertrophy
spirometry
copd severity scale FEV1
<30 very severe
<30-50 severe
<50-80 moderate
<80 mild
copd and 02 management
88-92
above can lead to resp 2 failure, below would leave to pressure decrease
copd other managment
ventilator support
fluid balance
thromophylaxis
copd treatment
bronchodilators corticosteriods - 5-8 days, decrease inflam. AB if 2/3: mucolytics - breathless -sputum -change in colour
3 contributing factors to asthma
- bronchus contraction
- inflammation
- mucus production
asthma symptoms
dysponea
wheeze
nocturnal cough
sputum
tests to diagnose asthma
PERF - worse in AM spiro sputum FBC, U&E, CRP ABG - normal or low 02, low co2
asthma management
- short acting b agonist - symptoms relife
- inhaled steroid
- long acting b agonist
- b agonist tablet
- oral steriod
corticosteroid MOA
decrease mucus and inflammation
what does aminophyline do?
bronchodilation
increase cAMP levels
what is acute respiratory distress syndrome?
lung injury - inflammation and capillary permeability
causes of acute respiratory distress syndrome
- pulmonary and other
pulmonary: pneumonia
other: septicemia, pancreatitis
symptoms of acute respiratory distress syndrome
cynosis, tachypnoea, tachycardia
investigation for acute respiratory distress syndrome
FBC, U&E, LFT, CRP, ABG, CXR, D-dimer
Type I resp failure
o2 <8
co2 <6
Type II resp failure
02 <8 co2>6
hypercapnia
Type I resp causes
pneumonia odema PE asthma emphysema
Type II resp causes
asthma
copd
pneumonia
drugs
hypoxia symptoms
dysponea
restlessness
agitation
confusion
hypercapnia symptoms
headache
vasodilation
tachycardia
pulmonary embolism from
venous thrombosis in pelvis or leg
pulmonary embolism RF
recent travel thrombophilia leg fracture malignancy pregnancy
pulmonary embolism symptoms
breathless pleuritic chest pain leg swelling tachycardia tachypnea syncope cough
pulmonary embolism investigation findings
ABG - type 1 failure
CXR - normal
ECG - RBBB, or tachycardia
D dimer will ____ in thrombosis, malignancy and sepsis
increase
scoring system for pulmonary embolism
wells score
what is pleural effusion
fluid in pleural space
2 categories of pleural effusion
- transudate
2. exudate - proteins and high LDL
causes of pleural effusion
penumonia
TB
pulmonary infarcation
RA
pleural effusion symptoms
stony dull percussions
trachial deviation
dysponea
chest pain
pleural effusion investigation findings
CXR: blunted costaphrenic angels
ultrasound: shows fluid
aspiration
spontaneous pneumothroax causes
asthma copd penumonia lung abcess CF cancer
spontaneous pneumothroax symptoms
asymptomatic
dysponea
chest pain
spontaneous pneumothroax signs
decrease expansion
hyperresonance percussion
decrease breath sounds
trachial deviation
hypercapnia symptoms
headache
tachycardia
vasodilation
hypoxia symptoms
breathlessness
restlessness
aggitation
confusion
pulmonary embolism investigations
CT bloods d-dimer ABG ECG
pneumothroax and trachial deviation
away from affected side
