Symptoms, Signs, Treatment Flashcards
asthma
1) cough, dyspnoea, chest tightness, wheeze and fatigue in expiration
2) fatigue in expiration and hyper inflated chest
3) SABA, inhaled steroids, LABA, oral steroids (acute exacerbations)
COPD
1) on going productive cough, sputum, recurrent chest infection, shortness of breath, weight and muscle loss, decreased exercise tolerance, ankle swelling and chest tightness
2) increased JVP, cyanosis, cachexia, wheeze, smoker
3) smoking cessation, diet, pulmonary rehab, short acting/long acting bronchodilators and ICS and NIV
COPD exacerbation
1) increasing SOB, change in colour and increase in volume of sputum, more cough
2) SA bronchodilators, nebuliser, oxygen, steroids, antibiotics o palliative management
TB
1) cough, weight loss, fever, night sweats
2) apical fluffy opacities, mediastinal lymphadenopathy, pleural effusion
3) 4:2=2:4
(H+R+Z+E).2=(R+H):4
pneumonia
1) fever, myalgia, rigor, pleuritic chest pain, productive cough, dyspnoea and haemoptysis and sputum
2) tachycardia, tachypnoea, dull on oercussion, bronchial resonance, reduced expansion, increased vocal resonance, crepitations
3) CURBS 0-1: amoxycillin, 2: amoxicillin + clarythromycin, 3-5: co-amoxiclav
acute bronchitis
1) cough and sputum for max 3 weeks
2) supportive management unless it doesn’t go away or fever longer than three days
bronchiectasis
1) productive cough, purulent and smelly sputum, haemoptysis, recurrent LRTI, dyspnoea
2) nail clubbing, cyanosis, coarse crepitations, wheeze, obstructive spirometry
3) prolonged antibiotics (10-14 days)
croup
1) barking cough, worse at night, hoarseness of the voice, fever, cough and rhinitis, respiratory distress
2) inspiratory stridor, child well
3) supportive management + oral dexamethasone
epiglottitis
1) very toxic child, drooling, coughing, sore throat
2) stridor in inspiration
3) immediate intubation and antibiotics (no examination)
bacterial tracheitis
1) sick child, feverish, usually croup that hasn’t gone away
2) antibiotics: co-amoxiclav
bronchiolitis
1) cold like symptoms: fever, congestion, cough, dyspnoea
2) crackles and wheeze
3) supportive management, oxygen and NPA
whooping cough
1) fits of cough followed by vomit, redness in face
2) antibiotics: macrolides (erythromycin, clarythromycin, azythromycin)
children bronchitis
1) loose rattly cough which may lead to vomit
2) no wheeze, no crepitation
3) either supportive or antibiotics (viral or bacterial?)
empyema
1) consequence of pneumonia, chest pain, unwellness
2) aspiration + US and chest drain
pleural effusion
1) pleuritic chest pain, dyspnoea, heamoptysis, dry cough and fever
2) dull on percussion, decreased resonance, decreased expansion, deviated trachea
3) aspiration + US, chest drain, thoracoscopy and pleuradesis
parapneumonic effusion
1) cough, chest pain, fever
2) history of pneumonia
3) drainage and IV antibiotics on area
pneumothorax
1) pleuritic chest pain, cough, dyspnoea, pressure on chest and difficulty inhaling
2) rapid breathing, deviated trachea to collapsed lung, cyanosis
3) do nothing, aspiration, chest drain and oxygen
tension pneumothorax
1) pleuritic chest pain, respiration distress
2) deviated trachea away from collapsed lung, tachycardia, tachypnoea, hypotension, hyper inflated chest and increased JVP
3) chest drain from 2nd intercostal space
pleural plaque
1) asbestos exposure, incidental finding
2) benign mass, discuss and counsel
asbestos pleural effusion
1) diagnose of exclusion and past medical history
2) can solve spontaneously or need to be drained (can progress)
malignant mesothelioma
1) chest pain, cough, weight loss, weakness, fever and dyspnoea
2) pleural effusion, blood stain
3) not much space for surgery, chemotherapy and palliative care
cystic fibrosis
1) recurrent not clearing cough, shortness of breath, chest tightness
2) pancreatic insufficiency, recurrent chest infections, crepitations/wheeze
3) for pancreas: enteric coated enzyme pellet, high energy diet, fat-soluble vitamins and mineral supplements
for chest infections: physiotherapy (clearance of airways), antibiotics (IV or oral), preventing antibiotics (azytrhomycin) supportive management
treatment with drugs (ivacaftor, lumacaftor, tezacaftor)
lung transplant
DAD
1) sever dyspnoea, rapid breathing, low blood pressure
2) restricted spirometry, decreased lung volumes
3) not much, corticosteroids
sarcoidosis
1) cough, sever dyspnoea, fever
2) arthralgia, erythema nodosum, bilateral hilar lymphadenopathy
3) no treatment, NSAID, topical steroids, systemic steroids
corticosteroids
hypersensitivity pneumonitis
1) cough and dyspnoea, fever, unwellness
2) past medical history, tachypnoea, crackles and wheeze
3) antibiotics + stop exposure to antigen
IPF
1) cough an dyspnoea
2) finger clubbing, cyanosis, crackles
3) not much, some respond to steroids
pulmonary embolism
1) -small peripheral: pleuritic chest pain, hemoptisis and cough
- isolated: isolated episodes of dyspnoea
- massive: cardiac arrest or syncope
2) -pyrexia, stony dull at percussion, pleural rub
- tachycardia, tachypnoea, hypoxia
- tachycardia, tachypnoea, hypoxia, hypotension
3) oxygen, low molecular heparin, DOAC, thrombolysis, Pulmonary embolectomy
pulmonary hypertension
1) exertion dyspnoea, chest pain, exertion presyncope or syncope
2) high JVP, loud pulmonary second heart beat sound, hepatomegaly, ankle-oedema, right ventricular heave
3) treating overlying problem, oxygenation, anticoagulants diuretics, phosphodiesterase inhibitors, endothen receptors antagonists
rhinitis
1) runny nose, sore throats itchy eyes
2) supportive management , if gets worse review
otitis media
1) redness inside (inflamed), erythema, drum pushed out
2) analgesia or augmentin (has more side effects)
tonsillitis
1) red swollen tonsils, sore throat, fever, white patches on tonsils, enlarged neck lymph nodes
2) either nothing or 10 days penicillin
pharyngitis
1) headache, runny nose, body ache, general unwellness
2) either nothing or 10 days penicillin
