Stages Flashcards
Obstructive Sleep Apnoea Severity:
Desaturation rate / AHI:- 0-5 Normal 5-15 Mild 15-30 Moderate >30 Severe
Moderate Asthma
Moderate Essentially increasing symptoms, no features of severe Able to speak, complete sentences HR <110 RR <25 PEF 50 - 75% predicted or best SaO2 > 92% (no need for ABG) PaO2 > 8kPa
Severe Asthma
Severe Any one of Unable to speak, unable to complete sentences HR >110 RR >25 PEF 33 - 50% predicted or best SaO2 > 92% PaO2 > 8kPa
Life threatening Asthma
Life threatening Any one of Grunting Impaired consciousness, confusion, exhaustion HR >130, or bradycardic Hypoventilating PEF < 33% predicted or best Cyanosis
SaO2 < 92%
PaO2 < 8kPa
PaCO2 normal (4.6 - 6.0kPa)
Near Fatal Asthma
Near Fatal
Raised PaCO2
Stages and associated remission rates of Sarcoidosis = Stage 1:
Stage 1 = 55-90%
Stages and associated remission rates of Sarcoidosis = Stage 2:
Stage 2 = 40-70%
Stages and associated remission rates of Sarcoidosis = Stage 3:
Stage 3 = 10-20%
Stages and associated remission rates of Sarcoidosis = Stage 4:
Stage 4 = 0%
Score 0-1 Pneumonia
0-1 low risk - could be treated in community
Risk of death < 3%
Score 2 Pneumonia
2 moderate risk - hospital treatment usually required.
Risk of death = 9%
Score 3-5 Pneumonia
3-5 high risk of death and need for ITU
Risk of death = 15-40%
Pneumonia Scoring System
CURB 65 C confusion U blood urea > 7mmol/L R respiratory rate ≥ 30/min B systolic BP < 90 mmHg, diastolic blood pressure < 60mmHg 65 age ≥ 65
Treatment CURB 0 – 1
Antibiotic: Amoxicillin
Penicillin Allergy: Clarithromycin or Doxycycline
Duration: 5 days
Treatment CURB 2
Antibiotic: Amoxicillin + clarithromycin (atyp)
Penicillin Allergy: Levofloxacin
Duration: 5-7 days
Treatment CURB 3 – 5
Antibiotic: Co-amoxiclav + clarithromycin (atyp)
Penicillin Allergy: Levofloxacin or Co-trimoxazole
Duration: 7-10 days.
Pneumonia supportive management and route consideration:
IV v Oral
Oxygen, fluids (IV or oral)
Antipyretics, NSAIDs
Intubation and ventilation
Tumour stages of Lung Cancer:
T1, T2, T3, T4
T1
= < 3 or
= Tumour ≤ 3 cm in greatest dimension,
surrounded by lung or visceral pleura
= NO bronchoscopic evidence of involvement
of the X main bronchus X
- T1a minimally invasive adenocarcinoma
Tumor <=1 cm in greatest dimension - T1b Tumor <=2 cm
- T1c<=3 cm
T2
Tumour >3 cm but 5 cm or
tumour with any of the following
features (T2 tumors with these features are classified T2a if ≤5 cm)
- Involves main bronchus, but NOT X carina X
- Invades visceral pleura
- Associated with atelectasis or obstructive
pneumonitis that extends to the hilar region
involving part or all the lung
– T2a Tumor >3 cm but <4 cm in greatest
dimension
– T2b Tumor»_space;4cm but <5 cm in greatest
dimension
T3
Tumour >5 cm but <7cm or one that
directly invades any of the following:
- chest wall (including superior sulcus tumors)
- phrenic nerve
- parietal pericardium
or - separate tumor nodule(s) in the SAME LOBE as the primary
T4
Tumour >7cm or invades any of the following: Diaphragm MEDIASTINUM * heart great vessels trachea recurrent laryngeal nerve esophagus vertebral body CARINA * separate tumour nodules in a different ipsilateral lobe
Node & Metastatic (N & M) stages of Lung Cancer?
N0, 1, 2, 3,
M0, 1, 1a, 1b, 1c.
N0
- No regional lymph node
metastases
N1
- Ipsilateral peribronchial
- Hilar
- Intrapulmonary nodes
- Including by direct
extension
N2
- Ipsilateral mediastinal
- Subcarinal
N3
- Contralateral mediastinal
- Contralateral hilar
- Scalene
- Supraclavicular
M0
No distant metastasis
M1
Distant metastasis
M1a
NEAR
Separate tumour nodule(s) in a contralateral lobe
Tumour with pleural or pericardial nodules
or malignant pleural or pericardial effusion
M1b
1 DISTANT
- single distant metastasis
M1c
> 1 DISTANT
- multiple distant metastases
Stage IV Cancer
any T any N M1
5 year prognosis = 1%
COPD Stage 1: Mild
FEV1 = or > 80% predicted
COPD Stage 2: Moderate
FEV1 = 50-79% predicted
COPD Stage 3: Severe
FEV1 = 30-49% predicted
COPD Stage 4: Very Severe
FEV1 < 30% predicted