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Flashcards in Summary Deck (86):
1

Symptoms of Coryza

Runny nose
Sneezing
Maliase
Sore nose and throat

2

Complications of Coryza

Sinusitis
Acute bronchitis
Sore ear

3

Treatment of Coryza

Herbal extracts
Bed rest
Fluids

4

What is sinusitis?

Bacterial/fungal infection of the paranasal sinuses

5

Symptoms of sinusitis

Headache
Fever
Facial pain

6

Investigations for sinusitis

CT of paranasal sinuses

7

Treatment

Decongestants
Corticosteroid nasal spray
Broad spectrum antibiotics

8

Treatment of rhinitis

Antihistamines (loratadine)
Topical corticosteroid
Montelukast

9

Treatment of pharyngitis

Phenoxymethylpenicillin

10

Treatment of acute laryngotracheobronchitis

Nebulised adrenaline
Oxygen
Oral corticosteroids (dexamethasone)

11

What organism causes acute epiglottis?

H. influenzae

12

Complications of acute epiglotitis

Meningitis
Diphtheria
Septic arthritis
Osteomyelitis

13

Treatment of acute epiglotitis

Urgent endotracheal intubation
IV antibiotics (ceftazidime, cefttriaxone)

14

Which influenza causes pandemics?

Influenza A

15

Investigations for influenza

Increase in hemaglutinin

16

Treatment of influenza

Bed rest + fluids
Paracetamol
Neuraminidase inhibitors (zanamivir, oselramivir)

17

Treatment of acute bronchitis

No antibiotics unless there is chronic underlying lung disease (amoxicillin)

18

Investigations for pneumonia

CXR
FBC - U + E's, CRP
Sputum culture
CURB65

19

Treatment of CAP with CURB65 score 0-2?

Amoxicillin (doxycycline is allergic)

20

Treatment of CAP with CURB65 score 3-5?

IV co-amoxyclav + clarithromycin/doxycycline
(Levafloxicine if allergic)

21

Antibiotic for staph aureus

Flucloxacillin

22

Antibiotics for pneumocystis

Co-trimoxazole

23

Antibiotic for chylamdia pstacci

Doxycycline/clarithromycin

24

Antibiotics for legionella

Levafloxicin
Consider rifampricin

25

Colour of sputum in COPD normally

Clear/grey

26

Treatment of infective exacerbation of COPD

iSOAP

27

Step 1 asthma treatment

SABA (salbutamol)

28

Step 2 of asthma management

SABA + inhaled steroid (beclomethasone)

29

Step 3 of asthma management

SABA + inhaled corticosteroid + LABA (salmetarol)

30

Step 4 of asthma management

Trials of
- leukotriene receptor antagonist (montelukast)
- theophylline

31

Step 5 of asthma treatment

Oral corticosteroid (prednisolone)

32

Define severe asthma attack

Unable to complete sentences
RR > 25
HR > 110bpm
PEFR

33

Define life threatening asthma attack

PEFR

34

Symptoms of obstructive sleep apnoea

Loud snoring
Daytime sleepiness
,opening headache
Overweight

35

Causes of obstructive sleep apnoea

Obesity
COPD
Respiratory depressants

36

Investigations for obstructive sleep apnoea

Epworth sleepiness scale
> 10-15 apnoeas in any 1 hour of sleep
Overnight pulse oximetry

37

Treatment of obstructive sleep apnoea

Nasal Continuos Positive Airway Pressure (via mask during sleep)

38

Most common cause of bronchiectasis

CF

39

Symptoms of bronchiectasis

Productive cough
Halitosis
Clubbing
Coarse crackles

40

Treatment of bronchiectasis

Postural drainage
Antibiotics
Bronchodilators

41

What is CF?

Mutation in CFTR gene on chromosome 7
Failure of Cl- channels to open
Increased cAMP
Decreased Cl-
Increased Na+
Invpcreased viscosity of airway secretions

42

Investigations for CF

Genetic tests/Family history
Sweat test (>60)

43

Investigations for TB

CXR consolidation
Culture > PCR > ZN stain

44

Side effects of rifampricin

Orange body fluids
Hepatitis
Flu-like illness

45

Side effect of isoniazide

Neuropathy
Agranulocytosis
Allergic reaction

46

Side effects of pyrazinamide

Hepatic toxicity
Reduced renal excretion of urate
Gout

47

Side effects of ethambutol

Colour blindness developing to blindness

48

Symptoms of sarcoidosis

Erythema nodosum
Uveitis
Peripheral lymphadenopathy
Fatigue
Weight loss

49

What type of reaction is sarcoidosis?

Type IV hypersensitivity reaction

50

Investigations of sarcoidosis

CXR
Restrictive lung pattern
Increased serum ACE
Increased Ca2+

51

Treatment of sarcoidosis

Corticosteroids

52

What type of reaction is SLE?

Type III hypersensitivity

53

Symptoms of SLE

Joint pain
Fatigue
Skin rash
Pleurisy

54

Symptoms of idiopathic pulmonary fibrosis

Progressive breathlessness
Dry cough
Cyanosis
Fine bilateral end-inspiratory crackles
Clubbing
Associated with autoimmune diseases

55

Investigations for IPF

CXR - initially ground glass --> honeycombs get
CT (bilateral thick walled cysts)
Restrictive lung pattern (decreased CO transfer)
Anti-nuclear antibodies

56

Treatment of IPF

Corticosteroids (prednisolone)
Anti-fibrotic (pirfenidone)

57

What type of reaction is extrinsic allergic alveolitis?

Type III hypersensitivity

58

Investigations of extrinsic allergic alveolitis

CXR - fluffy upper zone nodular shadows
CT - ground glass opacity
Restrictive lung pattern (decreased CO transfer)
Raised leukocytos and T cells

59

Investigations for coal workers pneumoconiosis

Rheumatoid factor and ANAs positive

60

Symptoms of asbestosis

Progressive breathlessness
Clubbing
Bilateral basal end-inspiratory crackles

61

Treatment of asbestosis

No treatments
Corticosteroids can help symptoms

62

Where do you needle aspirate a pneumothorax?

2nd intercostal space mid-clavicular line

63

Where do you insert a chest drain for a pneumothorax?

5 PTH intercostal mid-axillary line

64

What is empyema usually a complication of?

Pneumonia

65

Treatment of empyema

Surgical drainage

66

What is Type I respiratory failure?

Hypoxia with normal or low PaCO2

67

Causes of type I respiratory failure

Pneumonia
Pulmonary oedema
PE
Fibrosing alveolitis
Asthma
Emphysema
ARDS

68

What is Type II respiratory failure?

Hypoxia + hypercapnia

69

Causes of Type II respiratory failure

Pulmonary disease
Neuromuscular disease (GB, MG)
Thoracic wall disease

70

What causes ARDS

Stiff lungs due to gas exchange impairment (lung injury, sepsis and pneumonia) fibrous exudate lines alveolar walla CN impairs gas exchange , destroying alveoli

71

Treatment of ARDS

Treat underlying condition
Diuretics
Inhaled NO (vasodilator improves V/O) aerosolised surfactant

72

What is cor pulmonale?

Right heart failure due to pulmonary hypertension

73

Symptoms of pulmonary hypertension/cor pulmonale

Progressive breathlessness
Ankle oedema
Para sternal heave
Tricuspid regurgitation
Pulmonary hypertension
RV Hypertrophy
Elevated JVP
Ascites

74

Treatment of cor pulmonale

Anticoagulants
Diuretics
Oxygen during plane travel

75

Symptoms of PE

Sudden breathlessness
Sudden chest pain + haemoptysis
Fever
Pleural rub
Raised JVP

76

Investigations for PE

D-dimer
V/Q scan

77

Treatment of PE

Oxygen
Anticoagulant
IV fluids
FIBRINOLYTIC/THROMBOLYTICS (streptokinase)

78

Symptoms of pulmonary oedema

Breathlessness
Orthopnoea
Cough + haemoptysis (pink frothy sputum)
Leg/abdominal swelling
Pale skin

79

Treatment of pulmonary oedema

Diuretics
Oxygen

80

Symptoms of lung cancer

Cough
Breathlessness
Haemoptysis
Chest pain
Wheeze
Hoarseness
Dysphasia
Clubbing

81

Hoarseness is caused by compression of what nerve?

Recurrent laryngeal nerve

82

What do small cell carcinomas secrete?

ACTH

83

What is the most common type of lung cancer?

Squamous

84

Most common cancer in non smokers

Adenocarcinoma

85

When is surgery contraindicated in lung cancer?

Tumour is near hilum
Evidence of metastasis
FEV1 > 1.5L
Vocal cord paralysis

86

What is Coryza?

Acute viral infection of the nasal passages (common cold)