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Flashcards in Respiratory Deck (42):
1

ABG in hypoventilation

Respiratory acidosis

2

ABG in APO

Respiratory acidosis

3

ABG in exacerbation of COPD

Respiratory acidosis

4

ABG in pneumonia

Respiratory acidosis

5

ABG in hyperventilation

Respiratory alkalosis

6

ABG in aspirin overdose

Respiratory alkalosis

7

ABG in PE

Respiratory alkalosis

8

ABG in sepsis

Respiratory alkalosis

9

ABG in acute renal/liver failure

Metabolic acidosis

10

ABG in lactic/ketoacidosis

Metabolic acidosis

11

ABG in shock/hypovolaemia

Metabolic acidosis

12

ABG in vomiting

Metabolic alkalosis

13

ABG in chronic diarrhoea

Metabolic acidosis

14

ABG in diuretics

Metabolic alkalosis

15

ABG in hyperaldosteronism

Metabolic alkalosis

16

Causes of high anion gap metabolic acidosis

Methanol
Uraemia (chronic kidney failure)
Diabetic ketoacidosis
Propylene glycol
Infection/iron/isoniazid/inborn errors of metabolism
Lactic acidosis
Ethylene glycol
Salicylates

17

Spirometry findings for asthma

+ 12% and 200mL in FEV1 with bronchodilator

18

Management of COPD

SABA
LAMA/LABA
ICS

19

Management of asthma

SABA
ICS
LABA + ICS

20

Most common cause of cor pulmonale

COPD

21

Organs involved in cystic fibrosis

Respiratory system
Pancreas
Intestine

22

Management of cystic fibrosis

Respiratory:
-Chest physiotherapy
-Inhaled tobramycin (for chronic Pseudomonas infection)
-Anti-inflammatory agent (azithromycin, ibuprofen, prednisolone)
-Lung transplantation

GI:
-Nutritional supplements
-Pancreatic enzymes + H2 antagonist/PPI + fat soluble vitamins
-Ursodeoxycholic acid (for advanced liver disease)
-Antacid/H2 antagonist/PPI (for GORD)

23

Upper lobe fibrosis

S-CHARTS:
-Silicosis
-Coal workers' pneumoconiosis
-Histiocytosis, hypersensitivity pneumonitis
-Ankylosing spondylitis
-Radiation
-TB
-Sarcoidosis

24

Lower lobe fibrosis

RASCO:
-RA
-Asbestosis
-Scleroderma
-Cryptogenic fibrosing alveolitis (IPF)
-Other - amiodarone, methotrexate, nitrofurantoin, bleomycin

25

Apnoea-Hypopnoea Index for OSA

≥15 episodes/hour or ≥5 episodes/hour in symptomatic patient

26

Light's criteria

Exudative if ≥1 of:
-Pleural:serum protein >0.5
-Pleural:serum LDH >0.6
-Pleural LDH >2/3 of upper limit

27

Causes of community-acquired pneumonia

Streptococcus pneumoniae
Haemophilus influenzae
Moxaxella catarrhalis
Influenza
RSV

28

Management of community-acquired pneumonia

Mild:
-Amoxicillin (PO) ± doxycycline (PO)

Moderate:
-Benzylpenicillin (IV) → amoxicillin (PO)
-Doxycycline (PO)

Severe:
-Ceftriaxone/cefotaxime (IV)
-Azithromycin (IV)

29

Management of atypical pneumonia

Azithromycin
Doxycycline
Clarithromycin

30

Causes of hospital-acquired pneumonia

Staph. aureus

Gram-negative bacilli:
-Pseudomonas aeruginosa
-E. coli
-Klebsiella pneumoniae

31

Management of hospital-acquired pneumonia

Mild:
-Augmentin (PO)

Moderate:
-Ceftriaxone/cefotaxine (IV)

Severe:
-Tazocin (IV)

32

Causes of aspiration pneumonia

Anaerobic oral flora ± aerobes

33

Management of aspiration pneumonia

Mild:
-Amoxicillin (PO)

Moderate:
-Benzylpenicillin (IV)

Severe:
-Ceftriaxone/cefotaxime (IV)
-Metronidazole (IV/PO)

34

Signs of PE on ECG

Sinus tachycardia
Right axis deviation
S1Q3T3 - deep S wave in lead I, present Q wave in lead III, T wave inversion in lead III

35

Management of PE

LMWH (IV) for 1 week
Warfarin (PO) 2-3 days after starting LMWH
Thrombolysis - if haemodynamically unstable
IVC filter
Embolectomy

36

Signs of pulmonary hypertension

Split S2
Loud P2
Parasternal heave
Signs of right heart failure
Tricuspid regurgitation

37

Gold standard investigation for pulmonary hypertension

Right heart catheterisation

38

Management of pulmonary hypertension

Treatment of underlying cause
Oxygen
Vasoactive drugs - sildenafil, bosentan, prostacyclines
Lung transplantation

39

Definitive diagnosis of TB

Sputum culture

40

Causes of type 1 respiratory failure (hypoxaemia)

V/Q mismatch - PE, pneumonia, atelectasis
Shunt - sepsis, liver failure
Diffusion impairment - APO, pulmonary fibrosis
High altitude
Alveolar hypoventilation - COPD

41

Causes of type 2 respiratory failure

Reduced minute ventilation - opioids, sedatives, head injury, elevated ICP
Neuromuscular abnormality - myasthenia gravis, Guillain-Barré syndrome
Chest wall abnormality - kyphoscoliosis, ascites
Pulmonary disease - COPD, severe asthma, bronchiectasis, OSA

42

Management of PE

LMWH → warfarin
tPA (if haemodynamically compromised)