Management

Question 1

What antibiotic would you usually prescribe for patients that have a Bronchiectasis diagnosis?

Answer 1

AMoxicillin

Question 2

For patients with long term severe Bronchiectasis what long term medication may that be on?

Answer 2

Antibiotics

Question 3

What is the first test that you should do if you suspect your patient has asthma?

Answer 3

A peak flow test

Question 4

What test should you carry out after a peak flow test?

Answer 4

Spirometry

Question 5

What position should your patient be in when they carry out a peak flow?

Answer 5

Standing up position

Question 6

What type of blow should a patient do when carrying out a peak flow?

Answer 6

Short and sharp breath, like shooting a dart

Question 7

What does a spirometry test measure?

Answer 7

The amount of air you can blow out of your lungs and how fast you can blow it out

Question 8

What can spirometry help you determine?

Answer 8

Whether the patient has an obstructive or restrictive defect

Question 9

Can every patient carry out a spirometry?

Answer 9

No, if they have underlying health conditions they shouldn’t carry it out e.g., angina, heart problems, pneumothorax or a late term pregnancy

Question 10

What factors are associated with a patients predicted spirometry graph?

Answer 10

Age, sex and height

Question 11

Once you have done the initial spirometry what should you do next?

Answer 11

Administer a bronchodilator and repeat the test

Question 12

What type of defect will have a larger reduction in FEV1?

Answer 12

Obstructive airway defect

Question 13

How long should you wait after administering a SABA to redo the spirometry?

Answer 13

15 minutes

Question 14

What are the first line treatments for patients that have just had an asthma diagnosis?

Answer 14

~Start ICS for 6 weeks
~Complete serial peak flow readings

Question 15

What are the 4 different types of treatment that we use to treat asthmatic patients?

Answer 15

~Short acting beta 2 agonists (SABAs)
~Long acting beta 2 agonists (LABAs)
~Muscuranic antagonists
~Inhaled corticosteroids (ICS)

Question 16

Once you have decided on the treatment for the patient what do you need to decide on next?

Answer 16

The type of inhaler that the patient needs

Question 17

What are the main 3 different types of inhalers?

Answer 17

Dry powder, metered dose and soft mist

Question 18

What’s the preferred type of inhaler for asthmatic patients?

Answer 18

Dry powder inhalers

Question 19

What effect can patients experience from using a metered dose inhaler?

Answer 19

Freon’s effect

Question 20

What is the Freon’s effect?

Answer 20

When the drug just sits at the back of your throat and you end up just coughing it up, so it does not have any relief for the patients symptoms

Question 21

What colour is a SABA inhaler (eg salbutamol)?

Answer 21

Blue

Question 22

What colour is an ICS inhaler (eg beclomethasone)?

Answer 22

Brown

Question 23

What colour is a LABA inhaler (eg salmeterol)?

Answer 23

Green

Question 24

What colour is a LABA/ICS inhaler (eg fostair)?

Answer 24

Pink

Question 25

What colour is a LABA/ICS inhaler (eg seretide)?

Answer 25

Purple

Question 26

How should a patient breath in when they are taking their inhaler?

Answer 26

Slow and steadily

Question 27

How long should you hold your breath after taking an inhaler?

Answer 27

10 seconds

Question 28

What is usually prescribed to a young patient to help them with taking their inhaler?

Answer 28

A spacer device

Question 29

When a patient is admitted with an acute asthma attack, what’s the first line treatment you should use?

Answer 29

High dose Beta 2 agonists as a nebuliser

Question 30

What does the protein level of a pleural effusions have to be to indicate they are exudate?

Answer 30

>30 g/L

Question 31

What does an exudate fluid indicate usually?

Answer 31

This is the inflammation ones e.g., cancer, infection, PE and autoimmune

Question 32

What does the protein level of a pleural effusions have to be to indicate they are transudate?

Answer 32

<30 g/L

Question 33

What does a transudate fluid indicate usually?

Answer 33

This is all your failures e.g., CHF, liver disease, nephrotic syndrome and end stage kidney disease