Diagnosis
A previously well 26 year old female presents to her GP with shortness of breath at rest which worsened on exertion, non-productive cough and pleuritic pain. She is on the OCP. She had a ACL repair 8 days ago.
Pulmonary embolism
What are the 3 primary factors for thrombosis?
Endothelial injury, altered blood flow, hypercoagulability
A patient has been diagnosed with COPD and requires a preventative inhaler. What is the first line (give class and example of medication)?
LAMA (tiotropium, glycopyrronium or umeclidinium) or LABA (indacaterol)
A 46 year old female presents to her GP with red, itchy watery eyes and clear watery nasal discharge.
Allergic rhinitis
A patient is diagnosed with singer’s nodules asked what might have caused them. List the two most common reasons.
Voice overuse (singing or yelling), and smoking
What is the most common side effect of inhaled glucocorticoids when used in asthma prevention? AND what strategies do you give to patients to prevent this?
Oropharyngeal candidiasis – wash your mouth after using and use a spacer (if possible)
A 54 year old male presents to his GP with worsening dyspnoea leading to decreased exercise tolerance and cough that is intermittently productive and has been present for about 2 years. He has smoked one pack a day since aged 14.
Emphysema->COPD
A patient is diagnosed with a PE. What treatment do you recommend (at least 3 things)?
Oxygen, analgesia, prevention of clot extension (heparin, LMWH, warfarin), in some circumstances thrombolysis is possible
What are the complications of influenza (list 3)?
Pneumonia, pericarditis, myocarditis
A 1 year old boy is brought to the ED department at 11pm with a barking cough. The patient has had cold symptoms the last couple of days, but otherwise been feeling well. Tonight he has a barking cough and stridor.
Croup
What are the 3 most common community acquired bacterial pathogens associated with sinusitis?
Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis
What are the classifications of pneumonia based on distribution?
Lobar, Broncho and interstitial
A 5 year old boy is brought to the ED department with a high grade fever and sore throat that came on suddenly. The end-of-bed-o-gram reveals the patient drooling and leaning forward in a ‘tripod’ posture.
Epiglottitis
A sputum sample is obtained from your patient and reveals creola bodies, charcot-leyden crystals and curschmann’s spirals. What is the most likely diagnosis?
Asthma
Describe the pathophysiology of bronchiectasis.
Chronic inflammation->release of cytokines->damage ciliated epithelium->dilated airway filled with mucus.
Chronic inflammation->release of cytokines->destruction of elastin in bronchial wall->fibroblast deposit collagen