Respiratory 🫁 Flashcards
(54 cards)
What is Samter’s Triad?
Asthma
Aspirin sensitivity
Nasal polyps
Causes of upper lobe fibrosis
CHARTS C- Coal miner’s pneumoconiosis H- Histocytosis / Hypersensitivity pneumonia A- Ankylosing spondylitis R- Radiation T- TB S- Silicosis / Sarcoidosis
What abx combination do you use for TB?
RIPE
Rifampicin
Isoniazid
Pyrazinamide (this is just vit B6, give as Isonazid is B6 inhibitor)
Ethambutol
If active, give all for 2 months, then R + I for 4 months
If latent, give R + I for 2 months
What inhalers can give you oral thrush?
ICS
What is pleurodesis?
A procedure that adheres a lung to your chest wall using a sclerosing agent (like chalk) to prevent fluid or air from continually building up around lungs.
Used for recurrent pneumothoraces or pleural effusions
What is a bleb?
A bleb is a collection of air within the layers of visceral pleura.
*NOTE: in breasts it is a milk blister
What is a transudate?
An effusion containing <30g/L of protein.
Excess fluid production of low protein and low cell count
Occurs in non-inflammatory conditions
What causes transudative pleural effusions?
Increased venous pressure —> heart failure, fluid overload, constrictive pericarditis (push out into pleura)
Low oncotic pressure —> hypoproteinaemia, cirrhosis, nephrotic syndrome, malabsorption (can’t pull out of pleura)
Hypothyroidism
What is Meig’s syndrome?
The triad of:
- Ovarian benign tumours causing
- Pleural effusion +
- Ascites
Occurs when the thoracic duct is disrupted and chyle accumulates in the pleural space.
Can be due to trauma or tumours (Chylothorax)
What are exudative effusions?
Effusions containing >30g of protein
EXudate —> EXcess protein
What causes exudative pleural effusion?
Reduced removal of fluid from lymphatic system due to infection/lymphoma
Increased leakiness of pleural capillaries 2* to infection, inflammation or malignancy
Also: pneumonia, TB, SLE, RA, carcinoma or mets
What is the Px of pleural effusion?
- SOB
- Pleuritic chest pain
- Reduced O2
- Cyanotic
- Reduced air sounds
- Stony dull percussion
- Reduced tactile / vocal fremitus
What is the max vol of pulmonary oedema you can remove via pleural tap at once?
2L
Due to risk of re-expansion pulmonary oedema if greater vols
What is re-expansion pulmonary oedema?
An uncommon complication of drainage of a pneumothorax or pleural effusion.
Px: cough, chest discomfort, hypoxaemia. If severe, shock + death.
Usually within 24hrs of thoracentesis
What is a chylothorax?
Occurs when the thoracic duct is disrupted and chyle accumulates in the pleural space due to trauma in the thoracic duct, tumours or TB
Pulmonary oedema Px?
Dyspnoea
Haemoptysis
Bibasal crackles and S3 heart sound
TB Px?
Feer Night sweats Anorexia Weight loss Haemoptysis
What cause of haemoptysis is strongly associated with an acute history of purulent cough?
Lower respiratory tract infection
What type of coughs seen in Bronchiectasis?
Long history of cough and daily purulent sputum production.
May also have haemoptysis.
Px of Aspergilloma (clump of fungus in pre-existing lung cavity - caused by Aspergillus fungi)?
PMH of TB, lung cancer or CF
Cough
Severe haemoptysis
Chest XR shows rounded opacity
Px of Granulomatosis with polyangiitis?
- Upper resp tract: epistaxis, sinusitis, nasal crusting
- Lower resp tract: dyspnoea + haemoptysis
- Glomerulonephritis
- Saddle-shape nose deformity
- Also: vasculitic rash, eye involvement, CN lesions
Goodpastures Px:
- Haemoptysis
- Systemically unwell: fever, nausea
- Glomerulonephritis
If a pt with COPD is breathless on SABA/SAMA + LABA = ICS, what do you do?
Add a LAMA Eg Tiotropium.
What type of drug is Formoterol
LABA
