Respiratory Flashcards
(21 cards)
What are the most common causes of an acute cough (<3 weeks)?
Viral upper respiratory infection, acute bronchitis, pneumonia, postnasal drip, and asthma.
What are the three most common causes of a chronic cough (>8 weeks) in adults?
Postnasal drip (upper airway cough syndrome), asthma, and gastroesophageal reflux disease (GERD).
What is the recommended treatment for a chronic cough due to GERD?
Lifestyle modifications (avoiding acidic foods, elevating the head of the bed) and proton pump inhibitors (PPIs) like omeprazole.
What are the hallmark signs of an acute asthma exacerbation?
Wheezing, dyspnea, prolonged expiratory phase, accessory muscle use, and decreased peak expiratory flow rate (PEFR).
What is the first-line treatment for an acute asthma exacerbation?
Short-acting beta-agonist (SABA) such as albuterol, oxygen, and systemic corticosteroids if moderate to severe.
What are the signs of impending respiratory failure in an asthma exacerbation?
Silent chest (absent wheezing), altered mental status, cyanosis, and inability to speak in full sentences.
What are the most common pathogens causing community-acquired pneumonia (CAP)?
Streptococcus pneumoniae, Haemophilus influenzae, and Mycoplasma pneumoniae.
How does the presentation of typical pneumonia differ from atypical pneumonia?
Typical pneumonia (e.g., S. pneumoniae) presents with lobar consolidation, fever, productive cough, and pleuritic chest pain, while atypical pneumonia (e.g., Mycoplasma, Chlamydia) presents with diffuse infiltrates, dry cough, and milder symptoms.
What is the first-line outpatient treatment for community-acquired pneumonia in an otherwise healthy adult?
Amoxicillin + Azithromycin, doxycycline
What is the most common cause of acute bronchitis?
Viruses (influenza, rhinovirus, RSV, coronavirus).
How is acute bronchitis differentiated from pneumonia?
Acute bronchitis has a prolonged cough (>5 days) with wheezing and no consolidation on exam or imaging, while pneumonia presents with fever, crackles, and infiltrates on chest X-ray.
What is the recommended treatment for acute bronchitis?
Supportive care (hydration, NSAIDs, dextromethorphan for cough), as antibiotics are rarely indicated unless secondary bacterial infection is suspected.
What are the hallmark symptoms of a pulmonary embolism?
Sudden-onset dyspnea, pleuritic chest pain, tachycardia, hypoxia, and hemoptysis.
What clinical decision rule can be used to assess the probability of PE?
Wells Criteria: >6 points = high risk, 2-6 = moderate, <2 = low risk.
What is the gold standard diagnostic test for pulmonary embolism?
CT pulmonary angiography (CTPA), though a ventilation-perfusion (V/Q) scan is used when CTPA is contraindicated (e.g., renal failure, contrast allergy).
What are the common causes of a spontaneous pneumothorax?
Primary: Tall, thin young men (often smokers). Secondary: COPD, cystic fibrosis, trauma, or mechanical ventilation.
What are the clinical signs of a pneumothorax?
Sudden-onset unilateral pleuritic chest pain, decreased breath sounds, hyperresonance to percussion, and absent tactile fremitus on the affected side.
What are the key findings of a tension pneumothorax?
Severe respiratory distress, hypotension, tracheal deviation away from the affected side, and jugular venous distention (JVD).
Why is a tension pneumothorax considered a medical emergency?
It causes progressive intrathoracic pressure buildup, leading to mediastinal shift, impaired venous return, and cardiovascular collapse.
What is the immediate treatment for a tension pneumothorax?
Needle decompression in the second intercostal space at the midclavicular line pr 4th or 5th intercostal space anterior axillary line, followed by chest tube placement.
Why should a patient with a pneumothorax be carefully evaluated before air transport?
Air travel or aeromedical evacuation can worsen a pneumothorax due to gas expansion at higher altitudes, requiring prior decompression and stabilization.
