Archive for the ‘Respiratory’ Category

Respiratory history

July 17, 2012

CAPTION

  • Cough +/- sputum, purulent, blood
  • Atopy or allergy
  • Pain –site and if pleuritic
  • Timing of breathlessness e.g. nocturnal / acute
  • Infective prodrome or not including gastrointestinal symptoms
  • Other similar episodes
  • Normal state and treatment –usual morbidity / co-morbidity

Contributing factors to disease:

STOP

  • Social –smoking, drugs, alcohol
  • Travel
  • Occupation
  • Pets

Pneumonia complications

June 8, 2012

SLAP HER

  • Septicaemia – spread from lung parenchyma, can lead to metastatic infection e.g. endocarditis
  • Lung abcess – look for swinging fever, foul-smelling sputum, weight loss, haemoptysis, pleuritic chest pain
  • Atrial fibrilation esp. in elderly, may require beta-blocker
  • Pericarditis/myocarditis may complicate pneumonia
  • Hypotension – may be due to dehydration and sepsis-induced vasodilatation
  • Empyema – if recurrent fever, yellowish pleural effusion aspirated
  • Respiratory failure – type 1 is common, act if PaCO2 >6kPa

That smug feeling when you slap that bitch right in the kisser!

 

Restrictive lung disease causes

April 24, 2012

SPICE

  • Space-occupying lesion e.g. tumour, cyst
  • Pleural disease e.g. effusion, pneumothorax
  • Interstitial lung disease e.g. fibrosis, oedema
  • Chest wall disease e.g. kyphosis, neuromuscular disease
  • Extrathoracic conditions e.g. obesity, ascites, pregnancy

Hypoxaemia causes

April 23, 2012

LAVISH

  • Low inspired O2 ( decreased PiO2)
  • Alveolar hypoventillation
  • Ventilation/perfusion (V/Q) mismatch
  • Impaired diffusion
  • SHunt e.g. pulmonary AV shunt, pneumonia, oedema

Life-threatening breathing injuries

April 21, 2012

Important to rule out the following during primary survey

ATOM FC

  • Airway obstruction
  • Tension pneumothorax
  • Open pneumothorax
  • Massive haemorrhage (>1500ml)
  • Flail chest – abnormal breathing within lung tissue
  • Cardiac tamponade

Fine crackles causes

March 1, 2012

Fine crackles, the 2 F‘s:

  • Fibrosis
  • Failure (cariac)

Coarse crackles may indicate airway pathology e.g. pneumonia/bronchiectasis.

Crackles always occur during inspiration.

Clubbing – respiratory causes

February 27, 2012

Newly Sprouted Fingers

  • Neoplasia – bronchial carcinoma, mesothelioma
  • Suppurative lung disease – cystic fibrosis, bronchiectasis, abscess, empyema
  • Fibrotic lung disease – cryptogenic fibrosing alveolitis, connective tissue disease (e.g. RA, SLE)

Acute asthma management

February 24, 2012

O SHIT!

  • Oxygen
  • Salbutamol nebuliser
  • Hydrocortisone IV
  • Ipratropium bromide
  • Theophylline

Sarcoidosis features

February 15, 2012

SARCOID

  • Skin – erythema nodosum
  • Arthritis esp. of feet, hands
  • Respiratory – bilateral hilar lymphadenopathy, pulmonary infiltrates
  • Cardiac – heart block, VT, heart failure
  • Ocular – anterior uveitis, can lead to blindness
  • Intracranial (brain) – chronic meningitis, seizures, neuropathy
  • Derangement of liver and renal function – hepatic granuloma (70% patients), hypercalcaemia (can lead to kidney stones and nephrocalcinosis)

Stridor causes

February 10, 2012

Stridor is A Very WELSH Condition

  • Acute epiglotitis (acute stridor)
  • Vocal cord paralysis (chronic stridor)
  • Web, laryngeal (chronic)
  • External compression e.g. vascular ring (chronic)
  • Laryngomalacia (chronic)
  • Subglottic stenosis (chronic)
  • Hypocalcaemia (chronic)
  • Croup (acute)