Resp Flashcards by Aaska Banthiya

salmeterol is

LABA

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ipratropium is a

SAMA

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3 types of non small cell lung cancers

adenocarcinoma
squamous cell carcinoma
large cell carcinoma

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latent period in mesothelioma

45 years

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lung cancer extrapulmonary manifestations

recurrent laryngeal nerve palsy
phrenic nerve palsy
superior vena cava obstruction
horners syndrome
SIADH
cushings syndrome
hypercalcaemia
lambert eaton myasthenic syndrome

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sign for superior vena cava obstruction and how it is done

pembertons sign
raising hands over your head causes facial congestion and cyanosis

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what tumor causes horners syndrome and what does it press on

pancoast tumor pressing on the sympathetic ganglion

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lambert eaton myasthenic syndrome pathophysiology

antibodies against small cell lung cancer cells cause sx of:
proximal muscle weakness
diplopia
ptosis
slurred speech
dysphagia
autonomic dysfunction

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non small cell lung cancer mx

surgery if isolated to one area
radiotherapy
chemotherapy

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small cell lung cancer mx

chemotherapy and radiotherapy

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what type of surgery is done for lung cancer

thoracotomy
VATs- keyhole

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what does a thoracotomy scar suggest

lobectomy
pnuemonoectomy

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what is a pneumonectomy

removal of an entire lung

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HAP is classified as how many hrs post admission

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what bacteria is aspiration pneumonia associated with

anaerobic bacteria

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urea in CURB65

above 7

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resp rate in CURB65

30 bpm or above

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BP in CURB65

less than 90 systolic
60 or lower diastolic

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age in CURB65

65 or older

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CURB65 scores and mx

0-1= treat at home
2 or above= consider hospital admission
3 or above= consider intensive care

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what abx are used in atypical pneumonia

macrolides
fluoroquinolones
tetracyclines

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atypical pneumonia does not respond to

amoxicillin

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coxiella burnetti/ q fever pneumonia is associated with

farmers

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CAP duration of abx

5 days

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pneumonia complications

sepsis ARDs pleural effusion empyema lung abscess

bicarbonate level in chronic co2 retainers

high

hyperventilation causes was resp imbalance

alkalosis

raised aldosterone causes what on blood gas

metabolic alkalosis H+ is secreted

resp system support from least to most invasive

oxygen therapy high flow nasal cannula NIV intubation and mechanical ventilation ECMO

different methods of oxygen therapy

nasal cannula simple face mask venturi mask non rebreather mask

what is used to connect lungs to ventilator in mechanical ventilation

endotracheal tube tracheostomy

what does low FVC and low FEV1:FVC indicate?

combination of restrictive and obstructive lung disease

how is peak flow measured

3 attempts and take the highest one

what wheeze is heard in asthma

widespread polyphonic expiratory wheeze

what is reversibility in asthma testing

>12% increase in FEV1

FeNO diagnostic of asthma

above 40 ppb

peak flow variability for asthma

more than 20%

how to diagnose asthma

1. FeNO and spirometry with bronchodilator reversibility 2. if uncertain after this, peak flow variability 3. if uncertain after this direct bronchial challenge test

LAMA example

tiotropium

LABA example

salmeterol

LTRA example

montelukast

peak flow in moderate asthma exacerbation

50-75% best or predicted

peak flow in severe asthma exacerbation

33-50% best or predicted

unable to complete sentences indicates what grade asthma attack

severe

peak flow in life threatening asthma

<33%

features of life threatening asthma attack

silent chest peak flow <33% o2 sats <92% tired confused or agitated haemodynamic instability

severe asthma attack mx

oxygen therapy nebulised salbutamol nebulised ipatropium bromide IV mag sulf IV salbutamol IV aminophylline

how does salbutamol affect potassium levels

hypokalemia

after how many attacks does someone with asthma need to be referred to a specialist

2 attacks in 12 months

3 pathologies in COPD

airway obstruction chronic bronchitis emphysema

MRC dyspnoea scale

1= breathless on strenuous exercise 2= breathless on uphill 3= breathless on flat 4= breathless over 100m on flat 5= cant leave house due to breathlessness

how is severity measured in COPD

FEV1 stage 1= >90% predicted stage 2= 50-79% predicted stage 3= 30-49% predicted stage 4= <30% predicted

COPD initial medical management

SABA and SAMA

second line COPD mx no asthma features

LABA and LAMA

second line COPD mx with asthma features

LABA and ICS

what is carbocistine

mucolytic agent

what should be monitored in COPD patients taking prophylactic abx

ECG liver function

cor pulmonale pathophysiology

pulmonary hypertension causes RV to pump less blood this causes back pressure into the right atrium, then vena cava then the systemic venous system

what is cor pulmonale causes by

respiratory disease

what murmur can you get in cor pulmonale

tricuspid regurgitation

contraindications to NIV

untreated pneumothorax any structural abnormality affecting the face, airway or GI tract