Respiratory Medicine — Flashcards

Flashcard 61: What acid base disturbance will a panic attack cause?

Answer: • Respiratory alkalosis

Flashcard 62: What Wells Score would you arrange an immediate CTPA?

Answer: Wells Score >4 points

Flashcard 63: What is the immediate management of a suspected tension pneumothorax?

Answer: Needle decompression – do not wait for investigations

Flashcard 64: What is the first-line antibiotic for low-severity community-acquired pneumonia?

Answer: Amoxicillin

Flashcard 65: How is atelectasis managed?

Answer: Chest physiotherapy, mobilisation, and breathing exercises

Flashcard 66: What is added to SABA in the initial management of acute severe or life-threatening asthma?

Answer: Treatment includes: • High-dose SABA • Ipratropium bromide • Systemic corticosteroids (IV/Oral) • Magnesium sulfate (IV) • Oxygen to maintain SpO2 93-95% (adults)

Extra: In acute severe or life-threatening asthma (Status Asthmaticus), adding Ipratropium bromide to SABA (Short-Acting Beta-Agonists) such as Salbutamol has been shown to reduce hospitalization rates. Intravenous Magnesium Sulfate is also indicated in severe cases not responding to initial inhaled therapy.

Flashcard 67: What spirometry and gas exchange findings are characteristic of pulmonary fibrosis?

Answer: Restrictive spirometry (FEV1:FVC >70%, reduced FVC) and impaired gas exchange (reduced TLCO)

Flashcard 68: What is the definitive management for Recurrent Pneumothorax?

Answer: Video-Assisted Thoracoscopic Surgery (VATS) with Pleurodesis

Extra: Indications for surgery (VATS/Thoracotomy) in pneumothorax include: 1. Second ipsilateral pneumothorax (recurrence) 2. First contralateral pneumothorax 3. Bilateral spontaneous pneumothorax 4. Persistent air leak (>5-7 days) 5. High-risk professions (e.g., pilots, divers)

Flashcard 69: First-line investigation for adults with suspected asthma?

Answer: Spirometry with bronchodilator reversibility (BDR) test.

Extra: According to GINA (Global Initiative for Asthma) and most modern guidelines, the initial objective investigation for asthma in adults is spirometry to look for reversible airflow obstruction. FeNO is often used as a supportive test for eosinophilic airway inflammation but is typically secondary to or performed alongside lung function tests.

Flashcard 70: Patient has a cough, low-grade fever and erythema nodosum, what is the diagnosis?

Answer: • Sarcoidosis