Cardio and Resp Revision Flashcards
(27 cards)
COPD Treatment
Short-acting bronchodilators / anticholinergics (block Ach)
Long acting b-agonists (can also be used acutely)
Inhaled steroids when FEV1 < 50%
Aminophylline
Oxygen Therapy
COPD
Progressive airflow obstruction 2ry to parenchymal damage.
Breathlessness, cough, sputum, wheeze, crackles
CXR, FBC, ECG
*FEV<80%
*FEV1/FVC <0.7 (Obstructive)
TLC increased since air is trapped in lungs
a1-antitrypsin deficiency
controls enzyme breakdown in liver
Autosomal recessive
Asthma
Chronic reversible inflammation of airways increased sensitivity to various stimuli leading to variable airway obstruction
RF - Atopy and family history
Triggers: Dust, Emotion, Exercise, Cold, NSAIDs
Symoptoms: Chest tightness, wheeze, cough, dyspnoea, Tachypnoea, Tachycardia, Cyanosis
FBC (Eosinophils), CRP,
*Peak Expiratory Flow Rate
Spirometry
Asthma Treatment
Short acting inhaled b-agonist
Low dose steroid inhaler
Long acting b agonist & higher steroid dose inhaler
Higher steroid dose & leukotriene receptor
Oral steroids and immunosupresssants
Steroid Side Effects
Osteoporosis, DM, Hypertention
Oral candidiasis, Easy bruising
Pneumonia
Incidence Increases in Diabetics, COPD, elderly, alcoholics
Symptoms:
Cough, fever, dyspnoea, tachypnoea, pleuritic pain, myalgia
Signs:
Crepitations, Bronchial breathing, Diarrhoea, Abd Pain
Pneumonia Score
CURB 65 Confusion Urea >7mmol/L Respiratory rate >30/min Systolic BP <90 Diastolic BP <60 Age > 65
CURB 1/2 Admitted >3Urgent
Pneumonia Treatment
Mild: Amoxicillin, Clarithromycin
Severe: Co-amoxiclav/3rd generation cephalosporin + erythromycin/clarithromycin
TB Symptoms and Signs
Tachypnoea, Cough, Haemoptysis, Lethargy, Weakness, WL, anorexia, night sweets, fever
Crepitations in upper zones, lymphadenopathy
TB Investigations
Mantoux
CXR
Sputum microscopy and culture for
AFB (Acid Fast Bacilli)`
Exudate
>35g/L Carcinoma Pneumonia TB, SLE, Mesothelioma Pancreatitis Amiozarone
Transudate
<25 g/L protein
HF, PE, Cirrhosis
Hypothyroidism, Hypoalbuminaemia
Peritoneal Dialysis
Pleural Effusion Signs
Breathlessness,
Tracheal Deviation
Stony Dull Percussion note
Diminished breath sounds
Pneumothorax RF
COPD, Young men, Asthma, Carcinoma, CF, TB
connective tissue disease
Intercostal Drains
Pulmonary Fibrosis
Aetiology: Pet, Allergen exposure
Amiodarone, Vasculitis, Sarcoidosis, SLE, Lymphoma
Signs: *Cough, SOB, Pleurisy
- Fine end-inspiration crepitations - IPF*
- Finger clubbing, WL, fatigue, Hypoxaemia
Investigations: *Calcium and ACE levels
Treatment: Steroids and Azathioprine
Pulmonary Sarcoidosis
Multisystem Disorder
Accumulation of non-caseating granulomas and T-lymphocytes
Erethyma nodosum and
*Bilateral hilar lymphadenopathy (+/- Infiltrates)
Fever, Malaise, WL, Dyspnoea, Cough
CF
Increased re-absorption of Na and water; increasing the viscosity of airway secretions
Pulmonary Embolism Ix
D-Dimer
ABG
ECG
V/Q Scan
Doppler USS
Pulmonary Hypertension - Cor Pulmonale
Right-sided 4th Heart Sound RV Heave and Ischaemia - Angina Tricuspid regurgitation Peripheral Oedema Raised JVP Dyspnoea, Fatigue, Weakness
Left Side HF
Dyspnoea, Orthopnoea,
Paroxysmal Nocturnal Dysonoea,
Fatigue, Lung Crepitations
Pleural Effusion, Cyanosis
RIght Side HF
Peripheral Oedema Abd Distension/Ascites Hepatomegaly - tender and pulsatile Hepatojugular reflux Raised JVP
HF Treatment
Diuretics
B-Blockers
Digoxin
Glyceryl Nitrate (GTN)
Ischaemia
Thrombosis
Emboli, Aortic Stenosis - Flow is limited
Anaemia
