Chronic SOB Flashcards
What % FEV1 is diagnostic for asthma?
<70% of expected
Give an example of an inhaled low-dose corticosteroid that might be given in asthma treatment
Beclomethasone
Give an example of a LABA that might be given in asthma treatment
Salmeterol
Recall the steps of management for chronic asthma
SABA SABA + inhaled steroid LABA + inhaled steroid \+ LKT agonists Oral steroid
Recall the PEF indicative of each different severity of asthma
50-75% = moderate 33-50% = acute-severe <33% = life-threatening
Recall the management of acute asthma
Oxygen Nebulised salbutamol and ipratopium bromide Oral prednisolone IV hydrocortisone --> IV MgSO4 --> IV Aminophylline --> ITU and intubation
Which 2 diseases are encompassed by COPD?
Emphysema
Chronic bronchitis
What would be heard on auscultation in COPD?
Coarse crackles
Recall 3 features seen on general inspection in COPD
Tar-staining
Cyanosis
Barrel chest
What would be the percussion finding in COPD?
Hyperresonance
Recall the respiratory causes of clubbing
Malignancy Empyema lung abscess Interstitial lung disease CF Nb. NOT COPD
Recall 4 CVS causes of clubbing
Tetralogy of Fallot
Malignancy
Atrial myxoma
Infective endocarditis
Recall 4 GI causes of clubbing
Malignancy
IBD
Coeliac
Cirrhosis
Which genetic disorder can cause COPD?
Alpha-1 anti-trypsin
Recall the steps of management of COPD (not an acute exacerbation)
- SABA/SAMA
- Add LABA/LAMA
- LABA + LAMA OR LABA + inhaled corticosteroid
- LABA + LAMA + inhaled corticosteroid
Give an example of a SAMA and a LAMA
SAMA: ipratropium bromide
LAMA: tiotropium
What is symbicort?
Combination of LABA and inhaled corticosteroid
What are COPD patients routinely vaccinated against?
Pneumococcus
Influenza
How does management of an acute exacerbation of COPD and asthma differ?
- Initial IV hydrocortisone dose is 200mg in COPD and 100mg in asthma
- Step 2 in asthma is IV MgSO4, but in COPD = IV amoxicillin
- Step 4 in asthma = ITU and intubation, in COPD = BiPAP non-invasive ventilation
What has extrinsic allergic alveolitis recently been renamed as?
Hypersensitivity pneumonitis
Recall 2 drugs associated with ILD
Methotrexate
Amiodarone
What would be seen on general inspection in ILD?
Clubbing
What would be heard on auscultation of the lungs in ILD?
Bi-basal, fine inspiratory crepitations
In what sort of lung disease might ground-glass opacification be seen on CT?
ILD
