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**Bank > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Smoking cessation treatment licensed for use in pregnancy

A

Nicotine replacement therapy

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2
Q

COPD treatment - 1st line

A

SABA (salbutamol) prn
or
SAMA (ipratropium) prn

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3
Q

COPD on SABA or SAMA prn - still breathless - no asthmatic features

A

Offer LABA + LAMA

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4
Q

COPD - on SABA or SAMA prn - still breathless - with asthmatic features/steroid responsiveness

A

Consider LABA + ICS

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5
Q

What is Fostair

A

LABA + ICS
(formoterol + beclometasone)

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6
Q

COPD - on LABA + LAMA - symptoms still affecting QOL

A

Consider 3 month trial of LABA + LAMA + ICS

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7
Q

What is Trimbow

A

LABA + LAMA + ICS
(formoterol + glycopyrronium + beclometasone)

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8
Q

What is Ellipta

A

LABA + LAMA + ICS
(vilanterol + umeclidinium + fluticasone)

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9
Q

COPD - on LABA + LAMA - with 1 severe/2 moderate exacerbations in a year

A

Consider LABA + LAMA + ICS

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10
Q

COPD - with no asthmatic features - no improvement after 3 month trial of LABA + LAMA + ICS

A

Revert to LABA + LAMA

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11
Q

COPD with asthmatic features - on LABA + ICS - with symptoms affecting QOL

A

Offer LABA + LAMA + ICS

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12
Q

COPD with asthmatic features - on LABA + ICS - with 1 severe/2 moderate exacerbations in a year

A

Offer LABA + LAMA + ICS

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13
Q

Refer for LTOT assessment in COPD if:

A

FEV1 <30% predicted
Cyanosis
Polycythaemia
Peripheral oedema
Raised JVP
Sats <92% on air

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14
Q

Moderate asthma attack - PEFR

A

50-75% best or predicted

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15
Q

Severe asthma attack - PEFR

A

33-50% best or predicted

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16
Q

Life-threatening asthma attack - PEFR

A

<33% best or predicted

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17
Q

Moderate asthma attack - RR

A

RR < 25/min

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18
Q

Moderate asthma attack - HR

A

HR < 110 bpm

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19
Q

Severe asthma attack - RR

A

RR > 25/min

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20
Q

Severe asthma attack - HR

A

HR > 110 bpm

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21
Q

Speech in moderate asthma attack

A

Speech normal

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22
Q

Speech in severe asthma attack

A

Can’t complete sentences

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23
Q

Features of life-threatening asthma attack - vitals

A

Bradycardia
Dysrhythmia
Hypotension

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24
Q

Features of life-threatening asthma attack - examinaion

A

Silent chest
Cyanosis
Exhaustion

25
Q

Features of life-threatening asthma attack - behaviour

A

Feeble respiratory effort
Confusion
Coma

26
Q

Normal pCO2 (4.6-6.0) is a feature of what degree of asthma attack

A

Life-threatening

27
Q

Respiratory causes of clubbing

A

Lung cancer
CF
Bronchiectasis
Abscess/empyema
TB
Asbestosis, mesothelioma
Fibrosing alveolitis

28
Q

Cardiac causes of clubbing

A

Cyanotic congenital heart disease (Fallot’s, TGA)

Bacterial endocarditis

Atrial myxoma

29
Q

Non cardiac/resp causes of clubbing

A

Crohn’s, UC
Cirrhosis, PBC
Graves’
Whipple’s disease

30
Q

Life expectancy at diagnosis of idiopathic pulmonary fibrosis

A

3-4 years

31
Q

Asthmatic/steroid responsiveness features in COPD

A

History of asthma/atopy

Eosinophilia

FEV1 variation >400ml

> 20% diurnal variation PEFR

32
Q

Mechanism of action of varenicline

A

Nicotinic receptor partial agonist

33
Q

B in CURB-65

A

Systolic <=90 /
Diastolic <=60

34
Q

Point-of-care CRP in pneumonia - when to offer antibiotics

A

> 100 mg/L

35
Q

Point-of-care CRP in pneumonia - when to consider delayed prescription

A

20 - 100 mg/L

36
Q

U in CURB-65

A

Urea > 7 mmol/L

37
Q

Causes of obstructive lung disease

A

Asthma
COPD
Bronchiectasis
Bronchiolitis obliterans

38
Q

Adverse effects of nicotine replacement therapy

A

Flu-like symptoms
Headache
Nausea & vomiting

39
Q

Options for smoking cessation therapy

A

Nicotine replacement therapy
Varenicline
Bupropion

40
Q

Varenicline should be started when

A

1 week before target stop date

41
Q

Varenicline side effects

A

Nausea
Headache
Insomnia/abnormal dreams

42
Q

Varenicline recommended course

A

12 weeks

43
Q

Varenicline in pregnancy

A

Contraindicated

44
Q

Varenicline in breastfeeding

A

Contraindicated

45
Q

Buproprion should be started when

A

1 - 2 weeks before target stop date

46
Q

Bupropion adverse effects

A

Low risk of seizure

47
Q

Bupropion is contraindicated in

A

Epilepsy
Pregnancy, breastfeeding
(relative: eating disorder)

48
Q

All patients >=17y with suspected asthma should have

A

Spirometry with BDR test
+
FeNO test

49
Q

Positive result in FeNO test in adult

A

> = 40 parts per billion

50
Q

Positive result in FeNO test in child

A

> = 35 parts per billion

51
Q

In primary-care management of moderate acute asthma, when should prednisolone be started

A

If PEFR between 50-75%

52
Q

Adult low dose ICS - as budesonide

A

<= 400 mcg / day

53
Q

Adult moderate dose ICS - as budesonide

A

400 - 800 mcg /day

54
Q

Adult high dose ICS - as budesonide

A

> 800 mcg / day

55
Q

Consider referral for LTOT assessment in COPD if

A

FEV1 <50% predicted

56
Q

Adult Low Dose ICS example: Beclometasone diproprionate
(Non-proprietary / Clenil Modulite)

A

Non-proprietary / Clenil Modulite 100mcg/dose x two puffs x twice a day
[=200mcg BD]

57
Q

Adult Medium Dose ICS example: Beclometasone diproprionate
(Non-proprietary / Clenil Modulite)

A

Non-proprietary / Clenil Modulite 200mcg/dose x two puffs x twice a day
[=400mcg BD]

58
Q

Adult High Dose ICS example: Beclometasone diproprionate
(Non-proprietary)

A

Non-proprietary 200mcg/dose x four puffs x twice a day
[=800mcg BD]

59
Q

Adult High Dose ICS example: Beclometasone diproprionate
(Clenil Modulite)

A

Clenil Modulite 250mcg/dose x 2 puffs x twice a day
/
Clenil Modulite 250mcg/dose x 4 puffs x twice a day
[=500mcg-1g BD]

**Bank (74 decks)

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