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Flashcards in Data - Respiratory Deck (28):
1

Common causes of respiratory acidosis?

Acute ventilatory failure from:
Severe acute asthma
Exacerbation of COPD
Thoracic skeletal abnormality
Neuromuscular disorders (eg muscular dystrophy)

2

Common causes of respiratory alkalosis?

Hyperventilation (anxiety/panic)
CNS causes - stroke, SAH
Salicylate poisoning *early stage

3

Common causes of metabolic acidosis?

Increased production of acids:
- DKA
- Poisoning (ETOH)
- Acute renal failure
- Lactic acidosis, shock, post cardiac arrest
Loss of bicarbonate:
- Renal tubular acidosis
- Severe diarrhoea
- Addison's

4

Common causes of metabolic alkalosis?

Loss of acid:
- Severe vomiting; nasogastric suction
Loss of potassium:
- Excess diuretic therapy
- Hyperaldosteronism
- Cushings
- Liquorice ingestion(!??!?!?!)

5

Dull percussion note chest wall causes

Pulmonary consolidation
Pulmonary collapse
Severe pulmonary fibrosis

6

Stony dull percussion note chest wall causes

Pleural effusion
Haemothorax

7

Hyperresonant percussion note chest wall causes

Pneumothorax

8

Hot potato voice?

Stertor - often due to quinsy

9

Breathlessness in different positions?

Lying - orthopnoea
Upright - platypnoea
Lying on one side - trepopnoea

10

CURB-65?

Confusion
Urea > 7mmol/L
Respiratory rate > 30
BP (systolic) <90mmHg (diastolic) < 60mmHg
Age > 65yrs

11

Red nodules on shins?

Erythema nodosum
Streptococcal infection
Sarcoidosis
TB

12

Respiratory causes of clubbing?

Bronchiectasis
Lung cancer
Interstitial lung disease

13

Coarse flapping tremor?

Asterixis
CO2 retention

14

Cor pulmonale?

Chronic hypoxia in COPD --> pulmonary arterial vasoconstriction--> pulmonary hypertension --> right heart dilatation --> raised JVP

15

Cause of pectus carinatum?

Poorly controlled (severe) childhood asthma
Osteomalacia
Rickets

16

Pectus excavatum cause?

Developmental deformity

17

Tracheal deviation sides and causes?

Toward abnormality
Lung collapse
Upper lobe fibrosis
Pneumonectomy

Away from abnormality
Tension pneumothorax
Massive effusion

18

Tenderness over costal cartilages?

Costochondritis of Tietze syndrome

19

Score used for determining PE risk?

Well's score

20

Crackles causes?

Early inspiratory: small airways disease (bronchiolitis)
Mid - inspiratory: Pulmonary oedema
Fine late inspiratory: pulmonary fibrosis; oedema, bronchial secretions (COPD, pneumonia etc)
Inspiration and expiration: bronchiectasis

21

cANCA positive in?

Granulomatosis with polyangiitis (Wegener's granulomatosis)

22

pANCA positive in?

Microscopic polyangiitis
Churg-Strauss syndrome

23

Borders for insertion of chest drain?

Lateral border of pec major
5th IC space
Anterior border lat dorsi

24

Signs of severe acute asthma?

Peak flow 33%-50% of best
Inability to complete full sentences
Resp rate >25
Heart rate > 110

25

Signs of life threatening acute asthma?

Peak flow <33% of best
SpO2 < 92%
PaO2 < 8
PaCO2 normal!
Silent chest
Poor respiratory effort
Exhaustion

26

When to admit acute asthma?

Admit all life-threatening or near fatal attacks
Admit severe asthma if persisting after initial treatment

27

Management of acute asthma attack?

Oxygen! Get sats between 94-98%
High dose inhaled beta 2-agonists
Steroid therapy
Nebulised ipratropium bromide if severe/life threatening
MgSO4 if not responsive to initial inhaled bronchodilators

28

Management of COPD?

1. SABA or SAMA
2
a) if FEV1 > 50% then LABA or LAMA
b)if FEV1 < 50% then LABA + ICS OR LAMA