Respiratory

Question 1

Pulmonary embolism s/s

Answer 1

SUDDEN stabbing pain over lung +
Cyanosis, Cough and haemoptysis, SOB, lightheaded, dizzy

Question 2

Where are most DVTs found, caused by what?

Answer 2

Pelvis and calf mus. Prolonged sitting eg. long haul flights

Question 3

Name risk factors for PE(9)

Answer 3

Recent surg, prev PE, Sepsis, trauma
Obese, imob, DKA, varicose veins, AGE 40+

Question 4

What does d dime meas?

Answer 4

R/o low-mod risk of PE/DVT, Affected by trauma recent surg > low specificity

Question 5

What categorises PE seriousness

Answer 5

The size, 40-50% pulmonary inflow obstruction can be fatal

Question 6

PE s/s can be simple as small clots but be aware

Answer 6

Normal VS, swollen painful calf

Question 7

PE assessment

Answer 7

ABCD
ECG 75% have changes w big PES
Bls incl d dimer
Meas calves & CWMS

Question 8

Pneumothorax rx (tension pneumothorax is an emergency and different)

Answer 8

Co drain
If not req, get f/ up CXR
pain relief asap

Question 9

Tx for high risk PE

Answer 9

Thrombolysis -Alteplase done in CCU OR ICU

Question 10

PE definition s/s

Answer 10

Clot stuck in artery of lung

Question 11

What are contradindicstions for thrombolysis

Answer 11

Prev haemorrragic CVA, CV lesion, brain ~Ca,surg,trauma,sig facial trauma
Active bleeding

Question 12

Rx for low risk DVT/PE

Answer 12

Clexane wt based, then warfarin

Question 13

Clexane tips

Answer 13

5 cm away from belly button, scars
Subcutaneous tis of abdo
Swap sites to avoid fatty tis build up so swap sides

Question 14

Def pneumothorax and s/s

Answer 14

condition where air leaks into the space between the lungs and chest wall.
A blunt or penetrating chest injury, certain
medical procedures or lung disease can cause a pneumothorax.

Sharp stab.g CP, SOB, tachycardia, tachypneoic, fatigue, dry cough
Spont pneumo Comm in tall thin men

Question 15

What is a aortic aneurysm

Answer 15

Localised weakness in artery wall causing a bulge; can be thoracic, abdominal Can lead to tea, rupture and clot formation
Pt has hx ATHROSCLEROSIS , HT, H.chol, Marian’s, Turner’s syndrome

Question 16

What can dissecting AA do(5)

Answer 16

Occludes coronary arteries, carotid, spinal, mesenteric, renal arteries

Question 17

AORTIC ANEURYSM s/s, Rx

Answer 17

A:
B: SOB, COUGH, AND
/or haemoptysis,
C: sweaty n/_ tachycardia, reduced femoral carotid pulses
>telemetry
> ECG
>BP both arms
> 2 big IVCs bls incl blue top G&H
D: “tearing pain”

R pain relief if HT needs to be controlled
Stabilise BP
Be cautious with IVF, alerts BP
Likely OT
USS IN ED

Question 18

Where is the pleural space? What is a pleural effusion?

Answer 18

-in between the parietal and visceral layers ard t lungs
-p.eff= accumulation of fluid

Question 19

Causes of pleural effusion

Answer 19

Transudate ~Gradual DC of fluid eg. Ear, liver failure, or.load, atelectasis, nephrotic syn, losing protein
Blood eg. Post op, trauma, malignancy, pulmonary infarct
Infection; pneumonia, tuberculosis
Exudate; empyma, pancreatitis, sub phrenic abscess, parapneumonic effusion

Question 20

Pleural effusion asst

Answer 20

AB; SOB, SOBE, breathe sounds low or absent,dull percussion
C: CP dull ache ECG, maybe tachycardia

Question 21

Pleural effusion treatments

Answer 21

Tx under lying cause, sim need thorancentesis (pleural tap)
Exudate; depends on invx may nd pleural tap or CXR drain

Question 22

If t has on going pleural effusions what is the treatment

Answer 22

Pleurodesis= join parietal and visceral layers tog