Resp Flashcards Preview

Easter revision 2018 > Resp > Flashcards

Flashcards in Resp Deck (42)
Loading flashcards...
1

How do diarrhoea and vomiting affect acid base balance?

Diarrhoea --> lose HCO3 --> metabolic acidosis
Vomiting --> lose H --> metabolic alkalosis

2

Causes of resp acidosis and alkalosis

Resp acidosis: type 2 resp failure (COPD, severe asthma)
Resp alkalosis: type 1 resp failure (pneumonia, panic attacks)

3

Causes of metabolic acidosis and alkalosis

Metabolic acidosis: excess acid production e.g. diabetic ketoacidosis or exercise induced lactic acidosis, or diarrhoea so lose HCO3
Metabolic alkalosis: vom so lose H+, or diuretics

4

What is the treatment in acute severe asthma?

Oral prednisolone, nebulised salbutamol.
Then IV ipratropium bromide
THen IV magnesium
Call ICU

5

Define acute severe asthma

RR >25
HR>110
PEF 33-50%
Can't complete sentences

6

Define life threatening asthma

SpO2 <92%
PEF <33%
Altered conscious level

7

Define near-fatal asthma

High CO2.

8

What is wheeze?

High pitched muscial whistling sound caused by narrowing of bronchial tubes

9

Why is wheeze more pronounced in expiration?

Because airways are narrower in expiration

10

Difference between specific and non-specific triggers of asthma?

Specific are allergens e.g. pollen, house dust mite
Non-specific are irritants e.g. cold weather, exercise

11

Most wheeze is ___piratory but wheeze in ____ is __piratory

Most wheeze expiratory, wheeze in stridor is inspiratory (because upper airway issue)

12

What can cause pink tinged frothy sputum?

LVF

13

What can cause clubbing?

Lung cancer, bronchiectasis, CF, pulmonary fibrosis

14

Why does pursed lip breathing help?

We don't want to release too much air and make alveoli too small because then its harder to inflate them

15

What lung problems will cause mediastinal shift away from the problem?

Tension pneumothorax and pleural effusion

16

What lung problems will cause mediastinal shift towards the problem?

Lobar collapse, pulmonary fibrosis

17

What is hearing bronchial breath sounds in a vesicular location a sign of?

Pneumonia

18

Name continous and discontinuous lung sounds

Continuous: wheezes and stridors
Discontinuous: pleural friction rubs and crackles

19

What do fine and coarse crackles sound like?

Fine: high and soft
Coarse: loud and low

20

When do fine crackles, coarse cracles, and pleural friction rubs occur?

Fine: pneumonia
Coarse: COPD, bronchiectasis
Pleural friction rubs: pleurisy, PE

21

Do you know where to find the carina, aortic knuckle, hilar points, aorto-pulmonary window

good

22

Identify a CXR pleural effusion

Uniformly white area with concave surface (meniscus sign), costophrenic angles and heart border not visible

23

Identify a CXR tension pneumothorax

Air trapped between lung and chest wall, lung outline visible, air is hyperlucent, in tension there is mediastinal shift away

24

Name 4 TB drugs

Rifampicin, Isoniazide, Pyrazinamide, Ethambutol

25

Describe TB pathology

Caseating granuloma with Langhans giant cells, in pulmonary TB the granuloma calcifies to form a Ghon focus. Consolidation

26

Name a cause of CAP and HAP and treatments

CAP strep pneu treat with amoxicillin (+)
HAP staph aureus treat with co-amoxiclav (+ and -)

27

Describe a COPD CXR

Flattened hemidiaphragms, wider chest diameter, pulmonary arterial HTN, increased retrosternal space

28

How to differentiate latent and active TB?

Latent TB + for IFNy and TST but - for sputum culture

29

Where do TB lesions normally form

Apex of lungs because they're aerobic

30

Difference between miliary and extrapulmonary TB

Miliary (disseminated) TB spreads via blood to anywhere
Extrapulmonary TB can occur in the LNs, GI, peritoneum, bones and joints