Respiratory Flashcards
(39 cards)
1
Q
What is Goodpasture’s Syndrome?
A
- autoimmune anti glomerular basement membrane disease
- antibodies attack basement membrane in lungs and kidneys
- bleeding lungs, glomerulonephritis, kidney failure
2
Q
Presentation of Goodpasture’s
A
- haemoptysis
- haematuria
- dyspnoea
- glomerulonephritis
- chest pain
- fever
- fatigue
3
Q
Investigations for Goodpasture’s
A
lung and kidney biopsy → anti-GBM antibodies
4
Q
Treatment for Goodpasture’s
A
- supportive
- corticosteroids
- immunosuppresants
- removal/replacement of plasma → plasmapheresis
5
Q
What is hypersensitivity penumonitis?
A
- type 3 hypersensitivity reaction
- alveolar and bronchial inflammation after exposure to inhaled allergen
6
Q
Presentation of hypersensitivity
A
- dyspnoea
- cough
- fever
- malaise
- weight loss
7
Q
Investigations for hypersensitivity pneumonitis
A
bronchoalveolar lavage
- raised lymphocytes
- raised mast cells
8
Q
Treatment of hypersensitivity pneumonitis
A
- remove allergens
- steroids
9
Q
What are examples of occupational lung disorders
A
- silicosis
- asbestosis
- bird fanciers lung
10
Q
What is pharyngitis?
A
rapid onset of sore throat and pharyngeal inflammation +/- exudate
11
Q
Common causes of pharyngitis
A
- EBV
- adenoviruses
- enteroviruses
- group A streptococcus
12
Q
Symptoms of pharyngitis
A
- sore throat
- fever
- headache, nausea, abdominal pain → kids
- rhinorrhoea, nasal congestion, cough → viral
13
Q
What factors suggest a group A strep pharyngitis?
A
- pharyngeal exudates
- cervical adenopathy
- fever
- absence of cough/rhinorrhoea
14
Q
Diagnosis of pharyngitis
A
- clinical symptoms consistent with group A strep infection
- rapid antigen detection test for group A strep
- -ve → conventional throat culture
15
Q
Treatment of pharyngitis
A
- supportive → analgesia
- if group A strep, add Abs
16
Q
What is sinusitis?
A
- inflammation of mucous membrane of nasal cavity and paranasal sinuses
- AKA acute rhinosinusitis
17
Q
Causes of sinusitis
A
- streptococcus pneumoniae
- haemophilus influenzae
- rhinoviruses
- can progress to secondary bacterial infection
18
Q
Risk factors for sinusitis
A
- nasal pathology → septal deviation, nasal polyps
- recent local infection → rhinitis, dental extraction
- swimming
- smoking
19
Q
Viral presentation of sinusitis
A
- symptoms <10 days
- clear nasal discharge
- fever
- sore throat
20
Q
Bacterial presentation of sinusitis
A
- symptoms >10 days
- purulent nasal discharge
- dental/facial pain
- headache
21
Q
Investigations of sinusitis
A
- clinical diagnosis
- distinguish viral vs bacterial
22
Q
Management of sinusitis
A
viral
- self limiting disease
- treatment is symptomatic
bacterial
- symptom-based therapy
- Ab generally avoided but can shorten infection
23
Q
What is acute otitis media?
A
- inflammation of the middle ear
- associated with effusion, signs of infection
24
Q
Causes of acute otitis media
A
viral
- RSV
- rhinovirus
- adenovirus
- influenza
most common bacterial
- H.influenzae
- S.pneumoniae
- moraxella catarrhalis
25
Risk factors for acute otitis media
- young
- male
- smoking
- frequent contact with other children
- family history
26
Presentation of acute otitis media
- otalgia
- preceding URTI symptoms
- fever
- sleep disturbance
- irritability in children
27
Diagnosis of acute otitis media
otoscopy → bulging and erythema of tympanic membrane
28
Management of acute otitis media
1. regular analgesia
- amoxicillin
- consider admitting kids \<3 months/ 3-6 months with temp 39+
29
What is acute epiglottitis
- inflammation of epiglottis
- airway emergency
- typically 2-6, can be younger
30
causes of acute epiglottitis
- inflammation of supraglottis
- classically with H.influenzae
- can be S.pneumoniae
31
Presentation of acute epiglottitis
- acute onset high fever
- toxic appearance
- tripoding
- sore throat
- dysphagia and painful
- difficulty breathing
- decreased oral intake
- stridor
32
Diagnosis of acute epiglottitis
- laryngoscopy during intubation in an OT
- lateral neck radiography → thumb print sign
33
Management of acute epiglottitis
1. secure airway
2. IV Abs
3. supplemental O2
- maybe heliox and corticosteroids
34
What is whooping cough?
- URT infection
- caused by Bordetlla pertussis → gram -ve bacteria
- children/pregnant women are vaccinated against pertussis
35
Presentation of whooping cough
- typically starts with mild coryzal symptoms → low grade fever, mild dry cough
- followed by paroxysmal cough
- patients produce large inspiratory whoop at end of cough
- can faint/develop PTX
- infants may present with apnoeas instead of cough
35
Presentation of whooping cough
- typically starts with mild coryzal symptoms → low grade fever, mild dry cough
- followed by paroxysmal cough
- patients produce large inspiratory whoop at end of cough
- can faint/develop PTX
- infants may present with apnoeas instead of cough
36
Presentation of whooping cough
- typically starts with mild coryzal symptoms → low grade fever, mild dry cough
- followed by paroxysmal cough
- patients produce large inspiratory whoop at end of cough
- can faint/develop PTX
- infants may present with apnoeas instead of cough
37
Diagnosis of whooping cough
- nasopharyngeal/nasal swab with PCR testing/bacterial culture
- if cough present for \>2 weeks, can test for anti-pertussis toxin IgG
38
Management of whooping cough
- simple supportive care
- vulnerable/acutely unwell/infants may need admission
- macrolide Abs can be given early on
- close contacts given prophylactic Abs if vulnerable
key complication = bronchiectasis
