the common cold is usually caused by what virus
rhinovirus
what bacteria is epiglottitis commonly caused by
H influenzae
what are the clinical features of asthma
wheeze
chest tightness
breathlessness
cough
what investigations can help confirm asthma
spirometry
challenge test
peak expiratory flow rate monitoring
what is the treatment for acute asthma
O2
nebulised SABA
IV aminophylline
Antibiotics if there is infection
what are the main pathological features of COPD
mucous hypersecretion
tissue destruction
small airway inflammation and fibrosis
what are the clinical features of COPD
tightness wheeze SOB hyperinflated chest central cyanosis productive cough accessory muscle use prolonged expiration cor pulmonale
what are investigations that can be done to diagnose COPD
spirometry ABG-arterial blood gas FBC-look for hypoxia CXR Echo-cor pulmonale
what lifestyle factors can a patient change to improve their symptoms of COPD
if obese lose weight
stop smoking
pulmonary rehabilitation
what is the management of COPD in general
patients offered vaccines for flu etc pulmonary rehabilitation therapy SABA LABA- if symptoms get worse high does inhaled steroid if FEV1
how are exacerbation’s of COPD managed
O2
nebulised bronchodilator
iv Aminophylline
antibiotics if there is infection
what are the causative agents of pneumonia
strept pneumonia
staph aereus
haemophillus influenzae
what are the investigations to diagnose TB
3 sputum specimens:
- sputum smear with Ziehl Neilsen stain
- sputum culture
- sputum PCR
CXR
CT scan of thorax
bronchoscopy
pleural aspiration and biopsy
what are the TB drugs used for 4 months
Rifampicin
Isoniazid
Ethambutol
Pyrazinamide
what are the TB drugs used for 2 months
Rifampicin
Isoniazid
what are the side effects of Rifampicin
Orange irn bru tears and urine
induces liver enzymes
OCP ineffective
Hepatitis
what are the side effects of Isoniazid
hepatitis
peripheral neuropathy
what are the side effects of Ethambutol
optic neuropathy
what re the side effects of pyrazinamide
gout
what are features a patient may present with that suggest lung cancer
heamoptysis
weight loss
poor appetite
breathless and cough
what are extrapulmonary signs a patient may have lung cancer
finger clubbing
HTPA
cervical lymphadenopathy
superior vena cava obstruction
Horners syndrome can be a sign of lung cancer, what is Horners syndrome
drooping of the upper eyelid
lack of sweating in the face
constricted pupil
what is Horners syndrome caused by
damage to the sympathetic nerves in the neck possibly lung cancer metastasis
what is Pancoasts syndrome
Wasting of the small muscles in the hand in apical lung cancer invading the brachial plexus
where is lung cancer most likely to spread to
Brain
Bones
adrenal glands
Liver
what is the 5 year survival rate for lung cancer
fewer than 10% of patients with lung cancer still alive at 5 years
how would you treat epiglottitis
avoid instrumentation monitor for respiratory failure O2 if needed iv antibiotics according to culture specimens may need steroids for pharyngeal oedema
what antibiotics could you give for epiglottitis
augumentin and cephlasporin
what are the symptoms of glandular fever
fever sore throat fine red rash puffy eyes lyphadenopathy inflammation of the liver
what tests could be done to diagnose glandular fever
monospot test
blood film
look for Epstein Barr virus
what are the likely pathogens to cause rhinosinsitis
haemophillus influenzae
moraxella catarrhalis
streptococcus pneumoniae
what virus usually causes the common cold
rhinovirus
why wouldn’t you give penicillin like ester such as ampicillin in glandular fever
it can result in a rash
what is one of the key driver mutations that occur in approx 35% of smoking induced lung cancer
KRAS
apart from KRAS what are 4 other well known key driver mutations in the development of lung cancer
EGFR
BRAF and HER2
ALK rearrangements