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Z Year 3 Misc > CCC - Respiratory > Flashcards

CCC - Respiratory Flashcards

1
Q

If breathlessness has sudden onset what are DDx?

A
  1. pneumothorax
  2. PE
  3. FB
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2
Q

If breathlessness has a mins/hr onset what are DDx?

A
  1. airways (inflammation/obstruction)
  2. chest infection (pus)
  3. acute heart failure (fluid)
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3
Q

If breathlessness has a days/weeks onset what are DDx?

A
  1. above (chronic/non-resolving)
  2. ILD
  3. Malignancy/large pleural effusion
  4. neuromuscular
  5. anaemia/thyrotoxicosis
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4
Q

What is the management of a pneumothroax primary <2cm?

A

discharge repeat CXR

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5
Q

What is the management of a pneumothroax primary >2cm/SOB?

A

aspiration, if unsuccessful chest drain - analgesia (regular)

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6
Q

What is the management of a pneumothorax secondary <2cm?

A

aspiration

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7
Q

What is the management of a pneumothorax secondary >2cm?

A

chest drain

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8
Q

How do you know if primary or secondary?

A
  • primary: healthy

- secondary: predisposing e.g. COPD

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9
Q

How do you know the distance of the pneumothroax?

A

edge of heart and chest wal

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10
Q

Why might you have recurrent SOB after 2 hrs of chest drain?

A

rexpansion pulmonary oedema

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11
Q

What is a quick way to determine the axis?

A
  1. Lead I and II: overall negative?
    - Yes: axis deviation
  2. Look at avL: overall positive?
    - Yes: left axis deviation
    - No: right axis deviation
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12
Q

What is the inital treatment in PE?

A
  1. LMWH

2. Thrombolysis: if haemodynamic compromise (hypotensive systolic <90 unstable)

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13
Q

Why do you not give warfarin as inital PE management?

A

have a paradoxically pro-thrombotic effect initally

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14
Q

How can you see pulmonary oedema on chest x ray?

A

fluffy shadowing

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15
Q

How can you see a PE on x ray?

A
  1. Area of hypovoelamia (PE)
  2. Western Mark sign
  3. Focus of olgemia
  4. Rarely shown as PE usually normal X ray
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16
Q

When may you see large bollous (bulla) on xray?

A

COPD

17
Q

What should you not put in with large bollous?

A

drain

18
Q

How can you see pulmonary fibrosis on an X ray?

A

reticular nodular shadowing

19
Q

What are DDx of pulmonary fibrosis?

A
  1. connective tissue disease, RA
  2. Drugs
  3. Asbestosis (ship builder)
20
Q

What may hyperexpansion with a flat diaphragm on an xray suggest?

A

COPD

21
Q

What could be a cause of upper lobe consolidation?

A

TB

22
Q

What would interstitial/alveolar shadowing (fluffy) on CXR suggest?

A
  1. heart failure
  2. pneumonia
  3. pulmonary oedema
23
Q

What would homogenous shadowing suggest?

A

pleural effusion

24
Q

What are the different opacities on a CXR you can comment on?

A
  1. Interstitial/alveolar shadowing
  2. Reticulo-nodular shadowing
  3. Homogenous shadowing
  4. Masses/cavitations
25
Q

If you are unsure for a diagnosis what should you state?

A
  1. Infection
  2. Inflammation
  3. Malignancy
26
Q

If there is cardiomegaly what should you say?

A

increase cardiac shadow not big heart as may be normal heart but fluid around
Cardiomegaly or pericardial effusion (likely latter as globular looking)

27
Q

What are DDx of bilateral hilar lymphadneopathy?

A
  1. infection: TB
  2. inflammation: sarcoidosis
  3. malignancy: lymphoma
28
Q

When might there be pleural plaques on CXR?

A

by asbestos (different from asbestosis which is pulmonary fibrosis)

29
Q

What may a blunted costophrenic angle mean?

A

fluid

30
Q

How should you compare L vs R upper/mid/lower zone?

A
  1. alveolar,intersitital shadowing
  2. reticulonodular shadowing
  3. homogenous shadowing
31
Q

What should you look at in the peripheray of a CXR?

A
  1. Pneumothroax
  2. Plueral thickness
  3. Costophrenic angles
  4. Diaphragm
  5. Heart
  6. Mediastinum
32
Q

What is another option for PE management?

A

CTPA

Z Year 3 Misc (11 decks)

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