4th Year Other Flashcards
when is a chest drain needed in pleural effusion
pH <7.2
pleural fluid <2.2mmol/L
LDH >1000IU/L
+ve gram stain/ culture
what does an aspirate of gross pus indicate?
empyema
confusion assessment in CURB65
AMTS <8
side effects of isoniazid
hepatitis and peripheral neuropathy
management of SE in isoniazid
pyridoxine prevents peripheral neuropathy monitor LFT (prior to starting too)
sweat test result in CF
Cl- >60mmol/L
sarcoidosis 4 grades on CXR
grade 1= lymphadenopathy
grade 2= lymphadenopathy + infiltrates
grade 3= infiltrates
grade 4= fibrosis
what is used in a V/Q scan?
radiolabelled albumin
radiolabelled xenon gas
what is riociguat?
guanylate cyclase inhibitor
what is riociguat used in?
pulmonary hypertension to relax vessels
what is Caplan’s syndrome?
RA + pneumoconiosis
what is the PAS stain?
stains for carbohydrate components
which condition has a +ve PAS stain?
alpha1 antitrypsin
management of pseudomonas
ciprofloxacin
small cell paraneoplastic syndromes
SiADH
ACTH
LEMS
squamous cell paraneoplastic syndromes
PTH-rp
TSH
adenocarcinoma paraneoplastic syndromes
gynaecomastia
HPOA
what is varenicline (champix)?
nicotine receptor partial agonist
what are the options for smoking cessation
behavioural therapy
nicotine replacement therapy
champix
bupropion
action of bupropion
SNRI
which smoking cessation techniques are CI in pregnancy?
champix + bupropion
where do the neurovascular bundles run in the ribs?
inferior so needle should be inserted above rib, in the back due to less distress for patient and wider spaces.
what does a chest drain contain?
water to prevent air flowing back into the chest
what causes histoplasmosis?
pigeon droppings
what is allergic bronchopulmonary aspergillosis? ABPA
hypersenstivity reaction 1 and 3 to the fungus aspergillus
who gets ABPA?
asthmatics CF damp buildings soil, compost, plants air conditioning
major and minor features of ABPA
major= hx of asthma, central bronchiectasis, pulmonary opacities, eosinophilia, immediate skin reactivity and increased IgE
what can EVAR not be performed?
if aneurysm is above the renal arteries
CI to lung cancer surgery
SVC obstruction
FEV1 <1.5L
malignant pleural effusion
vocal cord paralysis
what is mikulicz syndrome?
enlargement of parotid and lacrimal glands due to sarcoid, TB or lymphoma
what is Heerfordt’s syndrome?
parotid enlargement, fever and uveitis secondary to sarcoidosis
what is used to guide antibiotics in acute bronchitis?
CRP >100mg/L (give immediately)
when to consider atelectasis?
72 hours post-op
needs upright position and physio
what is seen on ECG in PE
S1Q3T3
what is the result of PFTs in neuromuscular disorders?
restrictive
how to calculate pack years?
pack (20 cigs) / years
how to tell the difference on CXR between collapse and effusion/ pneumothorax?
collapse trachea is pulled towards
effusion trachea is pushed away
