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__Y6 Finals Revision > __Y6 Resp > Flashcards

__Y6 Resp Flashcards

1
Q

Resp causes of clubbing

A

Supparative - Bronchiectasis, abscess, empyema, CF
Malignancy - Lung cancer, mesothelioma
Pulmonary fibrosis

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2
Q

Differentiating between pulm fibrosis crackles and mucus plugging?

A

Get patient to cough

If sounds clear (or change) with coughing then likely related to broncheictasis or mucus plugging

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3
Q

↓air entry, dull perc, ↓vocal res

A

Effusion

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4
Q

Bronchial breathing (±crackles), dull perc, ↑vocal res

A

Consolidation

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5
Q

Fine crackles, clubbed

A

Pulmonary fiboriss

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6
Q

Coarse crackles, clubbed, ++phlegm

A

Bronchiectasis

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7
Q

Spirometry

Obstructive vs restrictive
+ examples of each

A

FEV1/FEV ration <70% = obstruction (fixed: COPD, reversible: asthma)

FEV1/FVC ratio >70% = restrictive or normal (fibrosis, ILD, thoracic restriction)

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8
Q

Different types of CT and indication for each?

A

High resolution - more detail, bigger slices
eg. bronchiectasis or IPF

Volume CT - lower quality but thinner slices
eg. nodules, lung cancer
can give contrast (vasc)

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9
Q

CXRshows ring shadows and tramlines?

A

Bronchiectasis

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10
Q

Bronchiectasis on CXR?

A

Ring shadows and tram lines

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11
Q

Cardinal signs of hyperinflation x3

A

Reduced cricosternal distance
Loss of cardiac dullness
Displaced liver edge

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12
Q

COPD classification system?

A

GOLD

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13
Q

Name of criteria for pulm effusion transudate/exudate

A

Light’s criteria

includes serum/pleural fliud protein, serum/pleural fluid LDH

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14
Q

Diagnosis?

Pink face, fine tremor, tar staining
Symmetrical hyperinflate chest expansion
Widespread polyphonic expiratory wheeze

A

COPD

pink face with secondary polycythaemia vera

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15
Q

COPD vs asthma x5

A

Airway reversiblity
Diurnal variation in asthma, variable breathlessness
COPD almost all smokers
COPD rare

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16
Q

Grading of SOB

A

MRC scale 1-5

1: SOB strenuous exercise
2: hurrying or hill
3: walks slower than contemporaries
4: stops after walking 100m or few mins
5: SOB on ADLs/too breathless to leave house

17
Q

When to give long term O2 threapy?

A
  1. non smoker and PaO2 <7.3 despite max tx
  2. PaO2 7.3-8 + PPPP: Peripheral oedema, pulm HTN, PCV, Poor O2 at night
  3. Terminally ill pt
18
Q

Define bronchiectasis?

A

Chronic permanent dilatation of the bronchi

Caused by repeated cycles of airway infection and inflammation

19
Q

Causes of bronchiectasis

A

Infections - bacterial pneumonia, TB, viruses
Congenital - CF, A1-AT, Kartegner’s
Rheumatic

20
Q

Clubbing + crackles

A

Bronchiectasis, malignancy, fibrosis, abscess

21
Q

Clubbing, fine end inspiratory crackles

+ rheumatoid hands

A

Pulmonary fibrosis

22
Q

Pulmonary fibrosis on CT?

A

Ground glass shadowing

Bibasal reticulonodular shadowing on CXR
If advanced – honeycombing of the lung

23
Q

Causes of pulmonary fiboriss

A

Specific - occupational (/environmental pollutants), hypersensitivity pneumonitis (bacterial/fungal), drugs (methotrexate, steroids, amiodarone, chemo, isoniazid), infection
Systemic (CTD) - RA, SLE, sarcoid, UC
Other - idiopathic PF

24
Q

Pleural effusion

Transudate vs. exudate?

protein level and causes?

A

Transudate (<25g/L albumin) → cardiac failure, renal failure, liver failure (low alb)

Transudate more likely if bialteral

Exudate → infection, malignancy, autoimmune, infarction (PE), inflammation, iatrogenic (drugs e.g. nitrofurantoin)

Use Light’s criteria - includes pleural fluid protein:serum protein, pleura LDH:serum LDH

25
Q

Consolidation on x-ray where you cannot see the R heart border?

A

Middle lobe

26
Q

Score for pneumonia severity

A 
Confusion
Urea >7
RR >30
BP <90/60
>65 years
27
Q

Mode of death in tension pneumothorax

A

IVC compression

28
Q

Signs of CO2 retention (x5)

A 
Flap/asterixis
Bounding pulse
Vasodilatation (warm hands)
Papilloedema (late sign)
Mental changes - confusion, drowsiness, LOC
29
Q

Life threatening acute asthma exacerbation signs

A

OH PAACCES
Any one of:

O2 <92%
Hypotension

PEFR <33%,
Arrythmia
Altered consciousness
Cyanosis
Confusion
Exhaustion/poor resp effort
Silent chest
30
Q

Acute severe asthma exacerbation signs

A

Any of:

PEFR 33-50%
RR>25
HR >110

Inability to complete full sentences
Accessory muscle use

31
Q

Management of acute COPD exacerbation

A
  • Salbutamol 5mg/4h and Ipratropium 0.5mg/6hr nebs
  • Hydrocortisone 200mg IV AND Prednisolone 30mg PO (continue for 7-14 days)
  • Abx if evidence of infection (amoxicillin, alt. clarithro/doxy)
  • Physiotherapy for sputum expectoration

Controlled oxygen therapy if SaO2 <88% or PaO2 <7 kPa

32
Q

Features of Pancoast’s syndrome (x3)

A

L sided apical lung tumour
Horner’s syndrome
Wasting of small muscles of hand

33
Q

Endocrine manifestations of lung cancer

A

Ectopic ACTH → Cushing’s syndrome

SIADH → hypernatraemic

PTHrP → hypercalcaemia

__Y6 Finals Revision (14 decks)

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