RESP TREATMETS Flashcards

1
Q

pneumothorax

A

chest drain 4/5 intercostal space mid axillary line

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2
Q

tension pneumothorax

A

chest drain 2nd intercostal space mid clavicular line
16 gage cannula/large bore cannula
guided by US

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3
Q

reticular dysgenesis

A

bone marrow transplant

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4
Q

supportive Kostmann’s Syndrome

A

prophylactic antibiotics and anti fungals

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5
Q

definitive Kostmann’s Syndrome

A

Stem cell transplant and granulocyte colony stimulating factor (G-CSF)

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6
Q

supportive chronic granulomatous disease

A

prophylactic antibiotics and anti fungals

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7
Q

definitive chronic granulomatous disease

A

stem cell transplant

g-IFN therapy

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8
Q

phagocyte deficeincy

A

gene therapy

bone marrow transplant

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9
Q

SCID

A
hospitalised
avoid infection (no vaccines, prophylactic antibiotics and anti fungals)
agressive Tx of infection
antibody replacement - IV Ig
stem cell transplant
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10
Q

DiGeorge Syndrome

A

correct metabolic/cardiac problems
prophylactic antibiotics
early and aggressive Tx of infection
Ig replacement

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11
Q

B cell deficiency

A

aggressive Tx of infection
immunoglobulin replacement
stem cell transplant

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12
Q

anaphylaxis

A

adrenaline

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13
Q

allergy

A

immunotherapy (allergen administered SC injections)

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14
Q

T2 hypersensitivity

e.g. ABO blood reaction

A

immunosuppression

Plasmapheresis

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15
Q

T3 hypersensitivity

e.g. SLE, acute hypersensitivity pneumonitis, farmers/bird fanciers lung

A

avoidance
corticosteroids
immunosuppression
oxygen if acute

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16
Q

Sarcoidosis

A

NSAIDs
bed rest
corticosteroids e.g. oral prednisolone
immunosuppression e.g. methotrexate

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17
Q

Acute cellular or vascular rejection

A

immunosuppression

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18
Q

chronic allograft failure

A

minimise drug toxicity/hypertension/hyperlipidaemia

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19
Q

Flu

A

bed rest
fluids
paracetamol
Antivirals if risk of complications - Oseltamivir, Zanamivir

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20
Q

Atypical pneumonia

A

clarithromycin

tetracycline

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21
Q

legionella

A

erythromycin/clarithromycin

Fluoroquinolone e.g. levofloxacin

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22
Q

Pneumocystis Jiroveci

A

Co-trimoxazole

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23
Q
CAP
HAP 
ASPIRATION PNEUMONIA
EPIGLOTTITIS
SUPRAGLOTTITIS
COPD
A

look at antibiotic man deck

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24
Q

bronchiolitis

A

RSV - supportive Tx // Palivizumab - monoclonal AB not widely used

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25
Q

CF younger patients

Staph. Aureus/ Haemophilus Influenzae

A

flucloxacillin - Staph Aureus

ceftriaxone - haemophilus influenzae

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26
Q

CF older patients
Pseudomonas aeruginosa
Burkholderia Cepacia

A

Ciprofloxacin (oral)
Gentamicin (IV)
Tayzosin (IV)

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27
Q

Whooping cough

A

Erythromycin

clarithromycin

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28
Q

Bronchiectasis

A

Postural drainage
mild - cefaclor/ciprofloxacin/flucloxacillin (if SA)
persistent - ceftazidime

stop smoking, flu and pneumococcal vaccine

29
Q

Bronchiectasis and chronic bronchial sepsis

A

prophylactic antibiotics
gentamicin neb
Pulsed IV ABs
alternating oral ABs

30
Q

large PE

A

thrombolysis

31
Q

small PE

A

LMWH

32
Q

TB + HIV

A

RIPE for life

33
Q

respiratory and non-respiratory TB

A

RIPE - 2 months

RI - 4 months

34
Q

meningitis and CNS TB

A

RIPE 2 months

RI - 10 months

35
Q

latent TB and about to undergo immunosuppression

A

RIPE 3 months prior

36
Q

what is the first line treatment of asthma

intermittent asthma

A

SABA - reliever, PRN

37
Q

what is the second line treatment of asthma

mild persistent asthma

A

ICS - 1st line preventer

38
Q

what 4 drugs could be considered as 3rd line treatment of asthma
controllers
moderate persistent asthma

A

Theophylline (oral)
CysLT RA e.g. montelukast, oral OD
LABA/LAMA
Anti-IgE e.g. omalizumab/Anti-IL5

39
Q

what is the 4th line treatment of asthma

severe persistent

A

oral steroid e.g. prednisolone

40
Q

what is the asthma treatment pyramid

A
Some - SABA
Interesting - ICS
Ladies - LABA
Can - CysLT RA
Tame - Theophylline
A - Anti-IgE
Prince - Prednisolone
41
Q

what is the treatment for acute asthma

A

OSHITMAN
O - Oxygen (atleast 60%)
S - SABA e.g. Salbutamol - high dose nebulised
H- Hydrocortisone IV or oral prednisolone
I - Ipratropium (SAMA) - nebulised
T- Theophylline /aminophylline/magnesium
M- Magnesium Sulfate
AN- ANaesthatist - ITU assisted mechanical intubated ventilation

42
Q

Acute COPD

A

Salbutamol + ipratropium (neb high dose)
oral prednisolone
antibiotic if infective (amoxicillin)
oxygen
physio to help sputum expectoration
non-invasive ventilation to allow higher FiO2
ITU intubated assisted ventilation only if reversible component e.g. pneumonia

43
Q

management of COPD

A

SAMA (mild) - e.g. ipratropium 4 times daily
LAMA - tiotropium once daily, aclidinium BD
ICS - frequent severe exam. e.g. beclametasone
LABA
PDE4 inhibitor e.g. roflumilast oral
Mucolytic e.g. carbocisteine oral
ABs for infective

44
Q

alveolitis

A

systemic corticosteroids e.g. oral prednisolone
oral azathioprine - steroid sparing immunosuppressive
oxygen if hypoxia
treat pulmonary hypertension

45
Q

idiopathic pulmonary fibrosis

(cryptogenic fibrosing alveolitis

A

anti-fibrinotic agents e.g. pirfenidone, nintedanib

46
Q

mesothelioma

A

chemotherapy

47
Q

non-small cell

A

surgery
radiotherapy
Gefitnib - tyrosine kinase inhibitor

48
Q

what is the condition for lung cancer resection

A

must be atleast 2cm of disease free bronchi

49
Q

what is the condition for radiotherapy

A

if target is < 5cm diameter

50
Q

what are 3 types of endobronchial palliative treatments

A

stent insertion for stridor
photodynamic therapy
laser therapy
Radioactive pellets

51
Q

small cell

A

chemo

52
Q

croup (laryngotracheobronchitis)

A

oral steroids e.g. prednisolone

53
Q

sleep apnoea

A

remove underlying cause - lose weight, reduce alcohol

CPAP

54
Q

Asbestosis

A

symptomatic relief

55
Q

Pneumoconiosis

A

remove exposure

56
Q

CF

A
postural drainage and physiotherapy
ABs
salbutamol 
beclometasone
pancreatic enzyme supplements 
vitamins
high calorie diet
57
Q

empyema

A

drainage
IV broad spectrum ABs
oral culture - specific

58
Q

central sleep apnoea

A

NIPPV
treat underlying condition
respiratory stimulant

59
Q

neonatal distress syndrome

A

ventilation and extra O2
artificial surfactant
to prevent - expectant mothers given steroids

60
Q

Rhinitis

A
corticosteroids (beclometasone, prednisolone)
Antihistamines
SAMA - ipratropium
Sodium Cromoglycate
CysLT - montelukast
61
Q

ARDS

A

ICU ventilation

treat underlying cause

62
Q

prevention of transplant rejection

A

ciclosporin

63
Q

most haemophilus influenza are sensitive to…

A

amoxicillin

64
Q

pneumococci are treated with

A

amoxicillin

65
Q

most pneumococci and h. influenza are sensitive to…

A

doxycycline

66
Q

what does Co-amoxiclav cover

A

most H. influenza and coliforms

67
Q

doxycycline covers atypicals except…

A

legionella

68
Q
true/false
Levofloxacin covers...
MSSA
H.influenza
pneumococci
coliforms
legionella
A

true

69
Q

what is the treatment of rhinitis

A

CAICM

corticosteroids
anti-histamine
ipratropium
croons
montelukast