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Year 4 - 5 Qs A Day > 2/5 > Flashcards

2/5 Flashcards

1
Q

How are patients managed with carbon monoxide poisioning?

A

High flow O2

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2
Q

Azithromycin - what should be tested for first before using as prophylactic AB?

A

ECG - check for long QT as can worsen

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3
Q

What other conditions can cause a raised D-dimer?

A

Malignancy
Heart failure
Surgery
Pregnancy
Pneumonia
DIC

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4
Q

Explain the treatment pathway for PE

How does AC management change afterward if patient with antiphospholipid syndrome or pregnant?

A
  1. Immediate DOAC as soon as suspicion
  2. If massive PE w/ haemodynamic compromise -> thrombolyse w/ atelepase

Then start on DOAC (3mnth provoked, 6 month unprovoked)

Antiphospholipid - warfarin
Pregnant - LWMH

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5
Q

CTPA or VQ scan in pregnant?

A

VQ - lower dose of radiation - important to ask pt if they could be pregnant

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6
Q

Write out asthma severity chart for wall

A
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7
Q

What are the features of bronchiectasis?
What could be heard on auscultation?

A

Persistent and purulent cough with large volumes of sputum
Dysponea
Haemoptysis

Coarse crackles and wheeze
~clubbing

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8
Q

What sign is seen on CT for bronchiestasis? - method of diagnosing

What can be seen on CXR?

A

Signet ring sign

CXR - tram-track opacities + ring shadows

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9
Q

Most common organism found in bronchiectasis?

What can colonise?

A

Haem influenzae

Pseudomonas colonisation

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10
Q

Hypersensitivity pneumonitis is scarring in the lungs caused by certain allergens.

What are the allergens in each of the following:
- Bird-fancier
- Farmer’s lung
- Mushroom worker’s lung
- Malt worker’s lung

A

Bird droppings
Mould in hay
Mushrooms
Mould in barley

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11
Q

egg-shell calcification of the hilar lymph nodes and upper zone fibrosing (v different to hypersensitivity pneumonitis/IPF)

A

Silicosis

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12
Q

What is acute bronchitis why is it not pneumonia?

A

Acute bronchitis - basically presents as a bad cold - most likely viral infection which causes inflammation of bronchi and trachea. Self-limiting normally over in 3 weeks

On examination
- wheeze BUT NO other chest signs e.g. dullness, crepe, bronchial breathing
- systemic features may be absent in bronchitis but unlikely in pneumonia

Clinical diagnosis

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13
Q

Yellow fingernails
Bronchiectasis
Lymphoedema

What is this?

A

Yellow finger syndrome

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14
Q

What is the management of acute bronchitis?

A

Good self-care
- analgesia
- rest and good fluids

Sometimes ABx if v unwell or co-morbidities - if use doxy.

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15
Q

Use doxycycline in pregnancy?

A

NO NO NO

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16
Q

List conditions which mean you can’t drive or need to inform the DVLA

A

Resp
Cough syncope
OSA

Cardio
Unstable angina
MI
Angioplasty
AAA

Neuro
Stroke
TIA
Epliepsy/seizures

ENT
Dizziness

Optho
Sight worse than 6/12 bilaterally
Glucoma

Endo
Diabetes

17
Q

FEV and FVC for obstructive and restrictive

A

FEV and FVC reduced in restrictive so ratio stays >0.7

FEV1 reduced but FVC stays the same (in asthma) or not as reduced as FEV1 (in COPD) - so ratio <0.7

18
Q

When do patients with COPD need Long term O2 therapy?

A

4 Bs

  1. Blood (polycythemia)
  2. Breathlesnness
  3. Ballooning (peripheral oedema)
  4. Blue (cyanosis)
19
Q

What score is used to measure sleepiness in OSA?

A

Epworth sleepiness scale

20
Q

Resp rate of what in CURB score?

A

30

21
Q

If CTPA has shown that there is no PE but signs of DVT. What happens next?

A

NOT routine practice to repeat CTPA

Perform a USS to assess for DVT

22
Q

Foul smelling sputum

A

Lung abscess

23
Q

Go through how to read a CXR

A

ABCDE

Airway
- adequacy of penetration - should just be able to see spinal processes
- trachea - any deviation
- rotation - how close are clavicles to the spine
- additional equipment - any tubes in place etc?

Breathing
- bones - able to see 10 posterior ribs each side?
- lung vessels branch out okay?
- borders - heart borders, costophrenic angles crisp?

Circulation
- heart - <1/2 of chest? 2/3rds to L and 1/3rd to R?
- hilar vessels at similar level

Diaphragm
- R > L ? (as it should be)

Everything else
- further describe USING ZONES

24
Q

You have to be careful with consolidation as have to have air bronchograms going through to use that word. What word can describe white on CXR instead?

A

Opacifications

25
Q

What causes dermatomyositis in 25% of cases?

A

Malignancy - hence CT CAP should be ordered when diagnosed

26
Q
A

Year 4 - 5 Qs A Day (122 decks)

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