1
Q
DDX asthma
A
COPD PE Pneumonia Pneumothorax Hysteria/ anxiety Lung ca GERD HF
2
Q
Important asthma questions
A
Other atopic Smoker What brings it on Nb inhaler questions Nb GP/ hospital questions Candidiasis Cushings Family history
3
Q
Dx asthma
A
FBC Biochem PFTs: spirometry, reversibility, exercise test, histamine challenge Peak flow meter O2 says AbG VQ CXR Skin testing IgE/ RAST
4
Q
Tx asthma symptom relief
A
SA bronchodilators- salbutamol, terbutaline
Inhaled abticholinergics- ipratropium
5
Q
Tx asthma maintenance
A
Bronchodilators
- salmeterol, formeterol
- xanthines- theophylline
Anti- inflammatory
- ICS: budesonide, beclomethasone, fluticasone
- leukotriene antagonists- montelukast
6
Q
COPD symptoms
A
SOB
Productive cough– worse in morning
Chest tightness
Wheeze
7
Q
DDX COPD
A
HF
MI
Pneumonia
PE
8
Q
Dx COPD
A
FBC - Hct Biochem Spirometry- 30-50-80 ABG Pulse oximetry AAT levels CXR HRCT- emphysematous Bullae ECG ECHO RH catheterization 6MWD
9
Q
Nb questions COPD
A
Smokers Need oxygen, inhaler, nebulised GP/ AE/ ICU Exercise tolerance Coal work Genetic AAT deficiency
10
Q
Tx COPD
A
Stages 1: SA bronchodilator 2: SA + LA + cardiopulmonary rehab 3: ICS repeated exacerbations 4: long term O2 Lung volume reduction surgery Lung transplant
11
Q
O2 levels
A
8kPa
12
Q
CO2 levels
A
6kPa
13
Q
PC ILD
A
SOB
+- dry cough
Extra pulmonary CTD symptoms
14
Q
DDX ILD
A
List all CWP—> onwards
COPD
Diaphragm paralysis
Pneumonia
15
Q
Important questions ILD
A
Smoker Occupation Hobbies Drugs CTD Asbestos TB
16
Q
Dx ILD
A
Labs -autoantibodies - anaemia - pan - ESR/ CK - ACE/ calcium PFTS- spirometry ABGs Bronchoscopy HRCT, CXR- late Lung bx -- VATS Shirmer and rose Bengal stain ECHO
17
Q
Tx ILD
A
Steroids CTD- corticosteroids, azathioprine, cyclosporine, cyclophosphamide Oxygen Lung transplant Palliative
Poor– antifibrotic- N- acetylcysteine
18
Q
CF investigations
A
Siblings Newborn Sweat test- -40mmol= normal Positive nasal PD 2 identifiable CFTR
CXR US Barium enema Genotype PFTS BAL sputum Immuno reactive trypsinogen
19
Q
CF exacerbations tx
A
Inhaled bronchodilators Increased frequency airway clearance Chest physio Dornase Alfa Oral antipseudomonals
20
Q
CF maintenance tx
A
Aquadek Dornase Alfa Antibiotics Bronchodilators Insulin Bisphosphonates Ursofalk Ivacaftor
21
Q
Asthma symptoms
A
SOB
Wheeze
Non productive cough– worse at night/ early morning
+ chest tightness
