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Medicine for Finals > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Wells Score

A

Signs and symptoms DVT (+3)
PE is most likely diagnosis (+3)
HR >100 (+1.5)
Immobilization >3d or surgery within previous 4wks (+1.5)
History of DVT or PE (+1.5)
Haemoptysis (+1)
Malignancy within previous 6mo (+1)

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2
Q

PE: investigation in low probability cases (Wells Score <3)

A

CXR to rule out other causes
D dimer

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3
Q

PE: investigation in high probability cases (Wells Score >3)

A

CXR to rule out other causes
CTPA

If poor renal function: V/Q scan

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4
Q

PE: management in provoked cases

A

DOAC for 3mo

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5
Q

PE: management in unprovoked cases

A

DOAC for 6mo

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6
Q

PE: management in cardiovascularly compromised patients

A

thrombolysis

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7
Q

PE: ECG changes

A

Sinus tachycardia
RBBB and/or RAD
S1 Q3 T3 pattern (S wave in lead 1, Q wave and T inversion in lead 3)

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8
Q

PE: ECG changes

A

Sinus tachycardia
RBBB and/or RAD
S1 Q3 T3 pattern (S wave in lead 1, Q wave and T inversion in lead 3)

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9
Q

bronchiectasis: causes

A
  • idiopathic (50%)
  • impaired mucociliary clearance (CF, Kartagener’s syndrome, immunoglobulin deficiency)
  • post-infectious
  • obstruction
  • GORD
  • inflammatory disease (e.g. RA)
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9
Q

bronchiectasis: causes

A
  • idiopathic (50%)
  • impaired mucociliary clearance (CF, Kartagener’s syndrome, immunoglobulin deficiency)
  • post-infectious
  • obstruction
  • GORD
  • inflammatory disease (e.g. RA)
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9
Q

bronchiectasis: causes

A
  • idiopathic (50%)
  • impaired mucociliary clearance (CF, Kartagener’s syndrome, immunoglobulin deficiency)
  • post-infectious
  • obstruction
  • GORD
  • inflammatory disease (e.g. RA)
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10
Q

common opportunistic infections in bronchiectasis

A

Haemophilus influenzae

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11
Q

common opportunistic infections in cystic fibrosis

A

Pseudomonas, Aspergillosis

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12
Q

bronchiectasis: complications

A
  • haemoptysis
  • persistent infection (Haemophilus)
  • empyema
  • respiratory failure
  • cor pulmonale
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13
Q

bronchiectasis: management

A
  • inhaled corticosteroids
  • bronchodilators
  • chest physiotherapy
  • flu vaccination
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14
Q

COPD: risk factors

A
  • smoking
  • α1-antitrypsin deficiency
15
Q

COPD: diagnosis

A

FEV1:FVC <0.7

16
Q

COPD: stratification

A

FEV1 >80% = mild
FEV1 <80% = moderate
FEV1 <50% = severe
FEV1 <30% = very severe

17
Q

COPD: management

A
  • smoking cessation
  • bronchodilators
  • inhaled corticosteroid
  • pneumococcal and influenza vaccine
18
Q

COPD: complications

A
  • infective exacerbation
  • acute respiratory failure
  • pulmonary hypertension and right heart failure
  • pneumothorax
  • secondary polycythaemia
19
Q

COPD: common opportunistic infections

A

Strep pneumoniae
Haemophilus influenzae

20
Q

asthma: features of moderate attack

A

PEFR 50-75%

21
Q

asthma: features of severe attack

A

PEFR 33-50%
RR > 25/min
HR > 110/min
Can’t complete full sentences

22
Q

asthma: features of life-threatening attack

A

PEFR <33%
SaO2 < 92%
Silent chest, cyanosis

23
Q

asthma: features of near fatal attack

A

PEFR <33%
PaCO2 - raised

24
Q

asthma: management of asthma attack

A
  1. Admit if life-threatening OR non-responsive to initial therapy
  2. O2
  3. Bronchodilator (SABA)
  4. Oral prednisolone

Consider other bronchodilators (ipratropium bromide, magnesium sulfate IV, aminophylline IV)

25
Q

pneumonia: CURB-65 criteria

A

Confusion
Urea >7
RR >30
BP (Systolic) <90
Age >55

26
Q

interstitial lung disease: causes associated with upper zone disease

A

PENTA

  • pneumoconiosis (coal workers, silicosis)
  • extrinsic allergic alveolitis (farmers, Pigeon fanciers)
  • aNkylosing spondylitis
  • TB
  • Aspergillus
27
Q

interstitial lung disease: causes associated with lower zone disease

A

STAIR

  • sarcoid
  • toxins
  • asbestos
  • idiopathic
  • Rheumatoid
28
Q

interstitial lung disease: drug causes

A
  • amiodarone
  • methotrexate
  • sulfasalazine
  • nitrofurantoin
29
Q

interstitial lung disease: spirometry findings

A

restrictive pattern
reduced FEV1 and FVC with preserved ratio

30
Q

interstitial lung disease: management

A

allergic disease = steroids, trigger avoidance, immunosupression (cyclosporine)

idiopathic disease = fibrinolytics, vaccination, smoking cessation, pulmonary rehabilitation

31
Q

pleural effusion: transudative causes

A
  • kidney failure
  • heart failure
  • hypoalbuminaemia (liver failure, nephrotic syndrome)
  • hypothyroidism
  • Meig’s syndrome (ovarian mass)
32
Q

pleural effusion: exudative causes

A
  • haemothorax
  • mesothelioma
  • pneumonia (abscess or empyema)
  • TB
  • PE
33
Q

pleural effusion: Light’s Criteria for an exudate

A

Effusion:serum protein >0.5
Effusion:serum LDG >0.6
Effusion LDH <2/3rds ULN

34
Q

pleural effusion: distinguishing exudate from transudate

A

protein < 25 = transudate
protein >35 = exudate
intermediate = Light’s Criteria

35
Q

pleural effusion: management

A
  1. treat underlying cause
  2. chest drain
  3. pleurodesis
36
Q

primary pneumothorax: management

A

Asymptomatic = discharge
<2cm = 2wk OPD follow-up
>2cm = needle aspiration

Medicine for Finals (10 decks)

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