Sessions 5-8 Rev Flashcards
(37 cards)
What ECG signs of PE
S1Q3T3
Sinus tachycardia
Or Nothing
Respiratory failure seen in PE
Type 1, low paO2, normal or low CO2
Can you rule out possibility of PE if d dimer is normal
No
What would ad ABG for a PE patient show
Respiratory alkalosis (secondary to hyperventilation, CO2 levels decrease, less converted to acid)
45 year old woman on COCP, risk factor for PE
Temporary- COCP
What examination findings would be important in relation to possibility of PE
Leg DVT, chest auscultation, tachycardia, tachypnoea
Chemoreceptors do not respond to
PaO2
Cause of altered ABG whilst on oxygen
Loss of pulmonary arteriole hypoxic vasoconstriction
Decreased ability of oxygenated haemoglobin to carry CO2
Most common cause of DVT, PE in young Europeans
Protein C resistance secondary to factor V Leiden mutation
Equation for partial pressure of oxygen in air
0.209 x atmospheric pressure
Equation for partial pressure of oxygen in URT
0.209 x (atmospheric pressure- SVP)
Why would partial pressure of oxygen be lower in alveoli than in URT
O2 diffusion into capillaries
What mechanism explains hypoxaemia at high altitude
Low partial pressure of oxygen in inspired air
Where should a normal chest drain be inserted for a spontaneous pneumothorax
Where should a needle aspiration be placed for tension pneumothorax
5th intercostal space, mid axillary line
2nd intercostal space, mid clavicular line
Vocal resonance in patient with pleural effusion
Decreased as sound does not travel as well through fluid as air
3 anatomical landmarks of triangle of safety
Pec major
Lat Dorsi
5th intercostal space (nipple)
Key underlying mechanism which causes lung collapse in pneumothorax
Alveolar and atmospheric pressure > intrapleural pressure
Air goes from high to low pressure
Increased intrapleural pressure causes pressure collapse of lung
Lung collapse
A 30 year old lady with known asthma presents to A&E with symptoms consistent with an exacerbation of her asthma. At home, the patient has taken her salbutamol inhaler as instructed, but this hasn’t improved her symptoms.
On examination, her peak flow is 190, Respiratory Rate 25, Hear Rate 120, and O2 Saturation 92% on air. Normally, her peak flow is around 420.
CLASSIFY HER ASTHMA ATTACK
Oxygen sats are life threatening
Next step if a patient is not controlling their asthma with a short acting B2 antagonist like salbutamol
Add an inhaled corticosteroid once inhaler technique checked
Types of respiratory failure in asthma attacks
Mild to moderate asthma attack = type 1 as low CO2 and low O2
Severe = type 2 as high CO2 and low O2
What replace ciliated cells in a disease process
Goblet cells
What is most commonly used to diagnose COPD
CXR
What is often the first sign of COPD
Cough that is worse in the mornings
(Followed by productive cough, SOB at rest, cough worse after exercise)
Which 3 conditions make up Young’s syndrome and Kartagener’s syndrome
Youngs syndrome = Bronchiectasis, sinusitis, reduced fertility in men
Kartageners syndrome = Bronchiectasis, sinusitis, situs inversus
