extra resp Flashcards
(53 cards)
if COPD exacerbation pt has v low o2 sats what do u do
give high flow o2 through non rebreathe mask, don’t give Venturi bc pt will die of hypoxia before they die of hypercapnia
SOB, insignificant smoking history, abnormal LFTs
alpha 1 antitrypsin deficiency
COPD pt with low pH, high CO2, very high bicarb
acute on chronic resp acidosis
The HCO3- is high confirming a partially compensating metabolic alkalosis. Since metabolic compensation takes time to occur, the very high level of bicarbonate is suggestive of a chronic respiratory acidosis, most likely due to the patients COPD.
asthma gold standard diagnostic tests
FeNO test and spirometry with bronchodilator reversibility
what is BE and what does BE>+3 or <-3 suggest
The base excess is defined as the amount of H+ ions that would be required to return the pH of the blood to 7.35 if the pCO2 were adjusted to normal
a base excess > +3 = metabolic alkalosis
a base excess < -3 = metabolic acidosis
base excess also indicates chronic nature of the condition
tx after asthma exacerbation
prednisolone for 5 days
what is a specific complication of copd seen on blood count
raised haematocrit - copd can cause polycythaemia
if you have asthma suspicion but spirometry and bronchodilator reversibility is insignificant, what is the next step
FeNO testing
A negative result on spirometry does not exclude asthma as a diagnosis, and should be further investigated
which asthma exacerbation pts should be admitted into hospital
‘Admit people with a moderate asthma exacerbation
with worsening symptoms despite initial bronchodilator treatment and/or
who have had a previous near-fatal asthma attack.’
abg for diabetic ketoacidosis
metabolic acidosis with increased anion gap
which exacerbation is IV mgso4 used in
asthma not copd
should theophyllines be used for copd exacerbations
no
Trials evaluating the effect of IV aminophylline in exacerbations of COPD have failed to show benefits beyond those induced by inhaled bronchodilator and glucocorticoid therapy.
next step in copd exacerbation if doesn’t respond to medical tx
NIV
which smoking cessation med should not be used in epilepsy
bupropion
what can be sued to asses whether an acute bronchitis pt needs abx, and what is the first line abx for acute bronchitis
crp level
doxycycline
what is Carbocisteine
mucolytic agent
what medication can be given to reduce the risk of COPD exacerbations in patients with severe COPD and a history of frequent COPD exacerbations
Oral PDE-4 inhibitors such as roflumilast
what increase in FEV1 after bronchodilator inhalation is seen in asthma
An increase in the FEV1 of 12% or more after inhalation of a short-acting bronchodilator is indicative of asthma
which CURB65 score pts are admitted into hosp
score of 2 or more –> admit
what sport is banned for life after a pneuomthroax
deep sea diving
advice given after resolution of spontaneous pneumothorax
stop smoking
life long ban on deer water diving
can fly 1 week after resolution cxr
tx for moderate or severe sleep apnoea
CPAP
COPD pts at which pH receive the most benefit from NIV
7.25-7.35
which cancer is Alpha-1 antitrypsin deficiency a risk for
hepatocellular carcinoma
