Flashcards in Resp Deck (42)
How do diarrhoea and vomiting affect acid base balance?
Diarrhoea --> lose HCO3 --> metabolic acidosis
Vomiting --> lose H --> metabolic alkalosis
Causes of resp acidosis and alkalosis
Resp acidosis: type 2 resp failure (COPD, severe asthma)
Resp alkalosis: type 1 resp failure (pneumonia, panic attacks)
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
What is the treatment in acute severe asthma?
Oral prednisolone, nebulised salbutamol.
Then IV ipratropium bromide
THen IV magnesium
Define acute severe asthma
Can't complete sentences
Define life threatening asthma
Altered conscious level
Define near-fatal asthma
What is wheeze?
High pitched muscial whistling sound caused by narrowing of bronchial tubes
Why is wheeze more pronounced in expiration?
Because airways are narrower in expiration
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
Most wheeze is ___piratory but wheeze in ____ is __piratory
Most wheeze expiratory, wheeze in stridor is inspiratory (because upper airway issue)
What can cause pink tinged frothy sputum?
What can cause clubbing?
Lung cancer, bronchiectasis, CF, pulmonary fibrosis
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
What lung problems will cause mediastinal shift away from the problem?
Tension pneumothorax and pleural effusion
What lung problems will cause mediastinal shift towards the problem?
Lobar collapse, pulmonary fibrosis
What is hearing bronchial breath sounds in a vesicular location a sign of?
Name continous and discontinuous lung sounds
Continuous: wheezes and stridors
Discontinuous: pleural friction rubs and crackles
What do fine and coarse crackles sound like?
Fine: high and soft
Coarse: loud and low
When do fine crackles, coarse cracles, and pleural friction rubs occur?
Coarse: COPD, bronchiectasis
Pleural friction rubs: pleurisy, PE
Do you know where to find the carina, aortic knuckle, hilar points, aorto-pulmonary window
Identify a CXR pleural effusion
Uniformly white area with concave surface (meniscus sign), costophrenic angles and heart border not visible
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
Name 4 TB drugs
Rifampicin, Isoniazide, Pyrazinamide, Ethambutol
Describe TB pathology
Caseating granuloma with Langhans giant cells, in pulmonary TB the granuloma calcifies to form a Ghon focus. Consolidation
Name a cause of CAP and HAP and treatments
CAP strep pneu treat with amoxicillin (+)
HAP staph aureus treat with co-amoxiclav (+ and -)
Describe a COPD CXR
Flattened hemidiaphragms, wider chest diameter, pulmonary arterial HTN, increased retrosternal space
How to differentiate latent and active TB?
Latent TB + for IFNy and TST but - for sputum culture
Where do TB lesions normally form
Apex of lungs because they're aerobic