Summary Flashcards
Symptoms of Coryza
Runny nose
Sneezing
Maliase
Sore nose and throat
Complications of Coryza
Sinusitis
Acute bronchitis
Sore ear
Treatment of Coryza
Herbal extracts
Bed rest
Fluids
What is sinusitis?
Bacterial/fungal infection of the paranasal sinuses
Symptoms of sinusitis
Headache
Fever
Facial pain
Investigations for sinusitis
CT of paranasal sinuses
Treatment
Decongestants
Corticosteroid nasal spray
Broad spectrum antibiotics
Treatment of rhinitis
Antihistamines (loratadine)
Topical corticosteroid
Montelukast
Treatment of pharyngitis
Phenoxymethylpenicillin
Treatment of acute laryngotracheobronchitis
Nebulised adrenaline
Oxygen
Oral corticosteroids (dexamethasone)
What organism causes acute epiglottis?
H. influenzae
Complications of acute epiglotitis
Meningitis
Diphtheria
Septic arthritis
Osteomyelitis
Treatment of acute epiglotitis
Urgent endotracheal intubation IV antibiotics (ceftazidime, cefttriaxone)
Which influenza causes pandemics?
Influenza A
Investigations for influenza
Increase in hemaglutinin
Treatment of influenza
Bed rest + fluids
Paracetamol
Neuraminidase inhibitors (zanamivir, oselramivir)
Treatment of acute bronchitis
No antibiotics unless there is chronic underlying lung disease (amoxicillin)
Investigations for pneumonia
CXR
FBC - U + E’s, CRP
Sputum culture
CURB65
Treatment of CAP with CURB65 score 0-2?
Amoxicillin (doxycycline is allergic)
Treatment of CAP with CURB65 score 3-5?
IV co-amoxyclav + clarithromycin/doxycycline
Levafloxicine if allergic
Antibiotic for staph aureus
Flucloxacillin
Antibiotics for pneumocystis
Co-trimoxazole
Antibiotic for chylamdia pstacci
Doxycycline/clarithromycin
Antibiotics for legionella
Levafloxicin
Consider rifampricin
Colour of sputum in COPD normally
Clear/grey
Treatment of infective exacerbation of COPD
iSOAP
Step 1 asthma treatment
SABA (salbutamol)
Step 2 of asthma management
SABA + inhaled steroid (beclomethasone)
Step 3 of asthma management
SABA + inhaled corticosteroid + LABA (salmetarol)
Step 4 of asthma management
Trials of
- leukotriene receptor antagonist (montelukast)
- theophylline
Step 5 of asthma treatment
Oral corticosteroid (prednisolone)
Define severe asthma attack
Unable to complete sentences
RR > 25
HR > 110bpm
PEFR
Define life threatening asthma attack
PEFR
Symptoms of obstructive sleep apnoea
Loud snoring
Daytime sleepiness
,opening headache
Overweight
Causes of obstructive sleep apnoea
Obesity
COPD
Respiratory depressants
Investigations for obstructive sleep apnoea
Epworth sleepiness scale
> 10-15 apnoeas in any 1 hour of sleep
Overnight pulse oximetry
Treatment of obstructive sleep apnoea
Nasal Continuos Positive Airway Pressure (via mask during sleep)
Most common cause of bronchiectasis
CF
Symptoms of bronchiectasis
Productive cough
Halitosis
Clubbing
Coarse crackles
Treatment of bronchiectasis
Postural drainage
Antibiotics
Bronchodilators
What is CF?
Mutation in CFTR gene on chromosome 7 Failure of Cl- channels to open Increased cAMP Decreased Cl- Increased Na+ Invpcreased viscosity of airway secretions
Investigations for CF
Genetic tests/Family history Sweat test (>60)
Investigations for TB
CXR consolidation
Culture > PCR > ZN stain
Side effects of rifampricin
Orange body fluids
Hepatitis
Flu-like illness
Side effect of isoniazide
Neuropathy
Agranulocytosis
Allergic reaction
Side effects of pyrazinamide
Hepatic toxicity
Reduced renal excretion of urate
Gout
Side effects of ethambutol
Colour blindness developing to blindness
Symptoms of sarcoidosis
Erythema nodosum Uveitis Peripheral lymphadenopathy Fatigue Weight loss
What type of reaction is sarcoidosis?
Type IV hypersensitivity reaction
Investigations of sarcoidosis
CXR
Restrictive lung pattern
Increased serum ACE
Increased Ca2+
Treatment of sarcoidosis
Corticosteroids
What type of reaction is SLE?
Type III hypersensitivity
Symptoms of SLE
Joint pain
Fatigue
Skin rash
Pleurisy
Symptoms of idiopathic pulmonary fibrosis
Progressive breathlessness Dry cough Cyanosis Fine bilateral end-inspiratory crackles Clubbing Associated with autoimmune diseases
Investigations for IPF
CXR - initially ground glass –> honeycombs get
CT (bilateral thick walled cysts)
Restrictive lung pattern (decreased CO transfer)
Anti-nuclear antibodies
Treatment of IPF
Corticosteroids (prednisolone)
Anti-fibrotic (pirfenidone)
What type of reaction is extrinsic allergic alveolitis?
Type III hypersensitivity
Investigations of extrinsic allergic alveolitis
CXR - fluffy upper zone nodular shadows
CT - ground glass opacity
Restrictive lung pattern (decreased CO transfer)
Raised leukocytos and T cells
Investigations for coal workers pneumoconiosis
Rheumatoid factor and ANAs positive
Symptoms of asbestosis
Progressive breathlessness
Clubbing
Bilateral basal end-inspiratory crackles
Treatment of asbestosis
No treatments
Corticosteroids can help symptoms
Where do you needle aspirate a pneumothorax?
2nd intercostal space mid-clavicular line
Where do you insert a chest drain for a pneumothorax?
5 PTH intercostal mid-axillary line
What is empyema usually a complication of?
Pneumonia
Treatment of empyema
Surgical drainage
What is Type I respiratory failure?
Hypoxia with normal or low PaCO2
Causes of type I respiratory failure
Pneumonia Pulmonary oedema PE Fibrosing alveolitis Asthma Emphysema ARDS
What is Type II respiratory failure?
Hypoxia + hypercapnia
Causes of Type II respiratory failure
Pulmonary disease
Neuromuscular disease (GB, MG)
Thoracic wall disease
What causes ARDS
Stiff lungs due to gas exchange impairment (lung injury, sepsis and pneumonia) fibrous exudate lines alveolar walla CN impairs gas exchange , destroying alveoli
Treatment of ARDS
Treat underlying condition
Diuretics
Inhaled NO (vasodilator improves V/O) aerosolised surfactant
What is cor pulmonale?
Right heart failure due to pulmonary hypertension
Symptoms of pulmonary hypertension/cor pulmonale
Progressive breathlessness Ankle oedema Para sternal heave Tricuspid regurgitation Pulmonary hypertension RV Hypertrophy Elevated JVP Ascites
Treatment of cor pulmonale
Anticoagulants
Diuretics
Oxygen during plane travel
Symptoms of PE
Sudden breathlessness Sudden chest pain + haemoptysis Fever Pleural rub Raised JVP
Investigations for PE
D-dimer
V/Q scan
Treatment of PE
Oxygen
Anticoagulant
IV fluids
FIBRINOLYTIC/THROMBOLYTICS (streptokinase)
Symptoms of pulmonary oedema
Breathlessness Orthopnoea Cough + haemoptysis (pink frothy sputum) Leg/abdominal swelling Pale skin
Treatment of pulmonary oedema
Diuretics
Oxygen
Symptoms of lung cancer
Cough Breathlessness Haemoptysis Chest pain Wheeze Hoarseness Dysphasia Clubbing
Hoarseness is caused by compression of what nerve?
Recurrent laryngeal nerve
What do small cell carcinomas secrete?
ACTH
What is the most common type of lung cancer?
Squamous
Most common cancer in non smokers
Adenocarcinoma
When is surgery contraindicated in lung cancer?
Tumour is near hilum
Evidence of metastasis
FEV1 > 1.5L
Vocal cord paralysis
What is Coryza?
Acute viral infection of the nasal passages (common cold)
