Term
|
Definition
exertional dyspnoea
chronic cough with sputum production
wheeze |
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Term
|
Definition
spirometry: FEV1 reduced, FVC normal. FEV1/FVC ratio < 0.7
CXR: hyperinflation, flat hemi diaphragms, black lesions; bulla, decreased lung markings, prominent hill |
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Term
| what grades severity in COPD? |
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Definition
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Term
|
Definition
FEV1
mild FEV1 > 80%
moderate FEV1 50-80%
severe FEV1 30-50%
very severe FEV1 < 30% |
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Term
|
Definition
1st: SABA or SAMA
2nd if FEV1< 50%: combined LABA & INH corticosteroid OR LAMA
2nd if FEV1 > 50%: LABA or LAMA
if on combined LABA and steroid and control is still bad then add LABA irregardless of what FEV1 is. |
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Term
|
Definition
medication
pulmonary rehab
long term oxygen
bullectomy
lung transplant |
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Term
| salmetarol and fluticasone? |
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Definition
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|
Term
| frometarol and budesonide? |
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Definition
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Term
|
Definition
formeterol and beclometasone
in symbicort: budesonide and formetarol |
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Term
inhalers used in COPD
tablets used in COPD |
|
Definition
SABA, SAMA, LABA, LAMA, INH corticosteroid
Tablets: mucolytics, theophylline |
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Term
| non pharmacological mx in COPD |
|
Definition
smoking cessation
pulmonary rehab
O2 therapy
lung transplant |
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Term
|
Definition
| reversible airway obstruction due to bronchial hyperresponsiveness. there is bronco spasms and xs production of secretions blocking airways. |
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Term
|
Definition
atophy
FHX
inner city or socio economic deprivation
obesity
prematurity and low birth weight
smoking
viral infections in early childhood |
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Term
| features increasing likelihood of diagnosis of asthma |
|
Definition
if worse on exertion, cold, post exercise
symptoms worse early in morning or late at night
worse after taking aspirin or beta blockers. |
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Term
| expiratory to inspiratory phase ratio? |
|
Definition
2:1
count one, two on expiration
count one on inspiration. this is a normal ratio |
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Term
|
Definition
spirometry with bronchodilator reversibility
peak flow |
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Term
|
Definition
not breast feeding
maternal smoking
low birthweight
high exposure to allergens
air pollution |
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Term
|
Definition
expiratory wheeze on auscultation
PEFR reduced |
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Term
|
Definition
1st:SABA and low dose ICS
2nd: add LABA
3rd: no response to LABA? stop and increase ICS to medium dose. If response to LABA then cx and increase ICS to medium dose.
alternative: cx with current rx and try LTRA, SR Theophylline or trial of LAMA
4th: trials of increasing steroids to high dose. adding 4th drug like LTRA, SR Theophylline, beta agonist tablet or LAMA..refer
5th: PO prednisolone and refer, |
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|
Term
asthma mx in children < 5 years
LABA not licensed for use in < 5 year olds. |
|
Definition
1st line: saba and very low dose ICS
2nd: LTRA
3rd: increase ICS to low dose and refer
4th: adding 4th drug: SR theophyline, medium dose ICS. |
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Term
|
Definition
1st SABA and very low ICS
2nd: LABA
3rd: if LABA works then cx and increase ICS to low dose. if LABA not working, stop it and increase iCS to low dose
4th: increase ICS to medium dose, add 4th drug SR theophyline. Refer to specialist.
5th: PO steroids |
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|
Term
| pulmonary fibrosis definition |
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Definition
| restrictive lung disease characterised by xs fibrous connective tissue |
|
|
Term
pper zone and lower zone causes of pulmonary fibrosis
CARTEx
CAID (more common) |
|
Definition
CARTEx - upper zone
ankylosing spondylitis
Coal
Radiation
TB
extrinsic alveolitis
CAID - lower
CT diseases (ra, scleroderma)
Asbestos
idiopathic pulmonary fibrosis
Drugs |
|
|
Term
| drugs that can cause pulmonary fibrosis? |
|
Definition
MTX
bloemycin
nitrofurantoin
amiodarone
cyclophosphamide
ergot derivatives |
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Term
| symptoms of pulmonary fibrosis? |
|
Definition
chronic cough
chronic progressive SOB |
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Term
| signs of pulmonary fibrosis |
|
Definition
clubbing
reduced expansion
fine end inspiratory crepitations |
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Term
| signs of causes of pulmonary fibrosis |
|
Definition
clubbing - idiopathic lung fibrosis
hand deformity (RA)
signs of CREST - scleroderma (small mouth, telangiectasia)
butteryfly rash
radiation burns
kyphosis (ankylosing spondylitis) |
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|
Term
| ix in pulmonary fibrosis? |
|
Definition
CXR: to show reticulonodular shadowing
CT: honeycombing, group glass changes
spirometry: restrictive changes
Bloods: ANA, RhF, anti centromere antibody
lung biopsy |
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|
Term
|
Definition
fibrosis is permanent
steroids can help in some cases
anti fibrotic meds e.g perfenidone
rx/withdraw cause
long term O2 therapy
lung transplant |
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|
Term
| what would you do if you found a lung lesion? |
|
Definition
do chest/abdo/pelvis CT + pet to confirm no mets
attain histology
pulmonary function tests to determine FEV1 and if to operate or do further tests |
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Term
|
Definition
CF, yellow nail syndrome, kartegeners
measles, pertussis, TB
HIV, hypogammaglobulineamia |
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|
Term
| symptoms of bronchiectasis? |
|
Definition
heamoptysis
recurrent chest infections
chronic productive cough |
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|
Term
|
Definition
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Term
| signs of cause of clubbing? |
|
Definition
yellow nails: yellow nail syndrome
tall and thin: CF
Dextrocardia: Kartegners syndrome
Tall with long arm span and high arched palate? Marfans |
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Term
|
Definition
CXR: tramlines and ring shadows
CT: signet ring sign and bronchial wall thickening
spirometry: obstructive
to ascertain cause:
sweat test: CF
electrophoresis: hypogammaglobulineamia
sputum culture: to determine any colonising bacteria |
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Term
|
Definition
chest physio
prompt rx of infections
pneumococcal/influenza vaccines
lung resection if medically uncontrolled localised disease |
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