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Year 3 - MedEd Lectures > Resp 1 > Flashcards

Resp 1 Flashcards

1
Q

Which abnormality presents with

Acidosis

Hypercapnia

Hypoxia

?

A

Type 2 Respiratory Failure

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2
Q

Which abnormality presents with

Hypoxia

Normocapnia

?

A

Type 1 Respiratory Failure

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3
Q

What can cause T1 Respiratory Failure?

A

Acute Asthma

Atalectasis (Lung Collapse)

Pulmonary Oedema

Pneumonia

Pneumothorax

PE

ARDS

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4
Q

What can cause T2 Respiratory Failure?

A

Acute Severe Asthma

COPD

Upper Airway Obstruction

Neuropathies - GBS, MND

Drugs (eg. Opiates)

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5
Q

What is the functional difference between the two types of Respiratory Failure?

A

In Type 1 RF, the lungs are still able to compensate for the hypoxia, by increasing ventilation. This leads to normocapnia, or hypocapnia.

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6
Q

How would you treat a case of Tension Pneumothorax?

A

Medical Emergency

Immediate wide bore cannula insertion at the 2nd Intercostal Space

Use an Orange or Grey needle.

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7
Q

How would you treat a symptomatic patient with a small Pneumothorax?

A

Needle Aspiration and O2

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8
Q

How would you treat an asymptomatic patient with a small Pneumothorax?

A

Reassure and discharge

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9
Q

What are the classical presenting features of a Pneumothorax?

A

Sudden-Onset

Unilateral, pleuritic chest pain

Dyspnoea

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10
Q

What are the main risk factors for Pneumothorax?

A

Male

Marfanoid habitus

Smoking

Tall

Skinny

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11
Q

What is the difference between Primary and Secondary Pneumothoraces?

A

Primary - Healthy young people without existing lung pathologies.

Secondary - Pre-existing Lung pathologies, or old long-term smokers.

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12
Q

How does a Tension Pneumothorax present?

A

Symptoms occur due to:

Lung Compression, causing:

  • Severe Dyspnoea
  • Tracheal Deviation away from the lesion
  • Silent Chest, Hyperresonance
  • Reduced expansion on the side of the lesion

Mediastinal Shift:

  • Hypotension
  • Tachycardia
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13
Q

What are the typical presenting features of a Pulmonary Embolism?

A

Pleuritic, unilateral Chest Pain

Hx of bed rest, recent surgery or long-haul travel

Hx of DVT (Leg tenderness/swelling)

Severe, acute dyspnoea

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14
Q

What is thr Well’s Scoring system?

A

Score used to assess the likelihood of a patient having a PE.

Assesses:

Previous Hx

Stasis

Cancer

Medical Opinion

PR

Haemoptysis

Evidence of DVT

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15
Q

How would you investigate a suspected Pulmonary Embolism?

A

Assess the patient’s Well’s Score

If 4 or above: CTPA

If less than 4: D-Dimer

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16
Q

What is the most common ECG finding in patients with a Pulmonary Embolism?

A

Sinus Tachycardia

17
Q

What is a less common, but more classic ECG finding associated with Pulmonary Embolism?

A

S1Q3T3 - Indicative of RV strain

Prominent S wave in lead I

Presence of a Q wave in lead III

Inverted T wave in lead III

18
Q

What are the main preventative measures used to prevent VTE during a hospital admission?

A

Anti-Embolic Stockings

Low molecular weight heparin

19
Q

How would you manage a confirmed case of Pulmonary Embolism?

A

Haemodynamically Stable:

Respiratory Support

Anticoagulation (LMWH/Fondaparinux for 5 days, Warfarin for 3 months)

Haemodynamically Unstable:

Respiratory Support

1) Thrombolysis (IV Alteplase, Streptokinase, rt-PA)
2) Embolectomy

20
Q

What should you do after starting a case of Pulmonary Embolism on first-line treatment?

A

Determine whether the PE was provoked (caused by obvious risk factors)

If not:

  • Screen for Cancer (CT Abdo-Pelvis, Mammogram)
  • Consider Antiphospholipid Testing
  • Consider arranding Hereditary Thrombophilia testing if FHx
21
Q

Define ARDS.

A

Acute Respiratory Distress Syndrome

Non-cardiogenic Pulmonary Oedema

22
Q

What can cause a patient to develop ARDS?

A

Drugs

Barotrauma

Nearly Drowning

Severe burns

Sepsis

Pneumonia

Transfusion Reaction

23
Q

How does ARDS develop?

A

ARDS develops due to a profound inflammatory response in the Lungs.

This leads to:

Diffuse Alveolar damage

The recruitment of Inflammatory Markers

Increased Vascular Permeability

Pulmonary Oedema

24
Q

How does ARDS cause T1RF?

A

Alveolar Oedema increases pressure within the alveoli.

This causes collapse, which decreases the surface area available for gas exchange, and the distance between the capillary and alveoli.

This leads to hypoxia, and T1 resp failure.

25
Q

How would you investigate a suspected case of ARDS?

A

ABG

CXR/CT

Echo

26
Q

What would you see on the CXR of a patient with ARDS?

A

Similar to cardiogenic Pulmonary Oedema:

Alveolar Oedema (Bat Wing Opacities)

Kerley B Lines

Cardiomegaly

Dilated Upper Lobe Vessels

Pleural Effusion

Year 3 - MedEd Lectures (29 decks)

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