Buzz words resp Flashcards
right sided pleuritic chest pain
probably pneumonia
stony dull to percuss
pleural effusion
Alveolar bat wings, kerley B lines, cardiomegaly, dilated prominent upper lobe vessels, pleural Effusion
pulmonary oedema
ground glass appearance on X-ray
pulmonary fibrosis and respiratory distress syndrome in new-borns
Ziehl-Neelsen stain positive for acid-fast bacilli
Tuberculosis
caseous necrosis
Tuberculosis
apical disease
most likely (secondary) Tb
apical lesion is called as assman focus
miliary tuberculosis
spread of organism into bloodstream
Positive anti-glomerular basement membrane antibodies
Goodpastures syndrome
Chest infection with a parrot/pigeon as pet
caused by chlamydophila psittaci
Dry cough and diarrhoea after holiday abroad, some indication of water spread
Legionella pneumophila (test urine for antigens
“Tall, thin young man who indulges in marijuana” - or a Mr. Snoop Dogg or Mr.
Martin Mitchell
probably pneumothorax (Marfan’s
Bilateral hilar lymphadenopathy, erythema nodosum, granulomas, fatigue, uveitis and
weight loss
sarcoidosis
Bronchiole wider than neighbouring arteriole (on CT) (signet ring sign)
Bronchiectasis
“D sign on X ray”
empyema
“Steeple” sign on X ray
laryngotracheobronchitis/croup
child with barking cough
croup
Pneumocystis pneumonia
HIV (treat with Co-tramoxazole [± prednisolone if
severe]
Asthma + Nasal Polyps + Salicylate sensitivity
Samter’s Triad
Alcoholic (danger of aspiration pneumonia)
Klebsiella pneumoniae
Red Jelly sputum
Klebsiella Pneumoniae
Mucoid sputum
Chlamydia psittaci
Rusty sputum
Pneumococcal pneumonia
Cannonball metastases (also weight loss and haematuria)
classically from primary
renal cell carcinoma
morning headache
hypercapnia or side effect of nitrates
ACTH secreting lung tumour
small cell carcinoma of the lung
PTH secreting lung tumor
squamous cell carcinoma of lung
increased serum ACE and Ca2+
Sarcoid
Eggshell calcification at hilar region
silicosis
‘Heart-failure cells’ seen in alveolar spaces
found in chronic pulmonary oedema, and associated severe left ventricular heart failure. Also seen in long standing pulmonary hypertension
Ghon Focus
An area of infection and caseous necrosis at the periphery of the lung,
beneath the pleura - found in tuberculosis infection
Assmann Focus
Apical lesion of secondary tuberculous infection
. ‘Coin lesion’ found on chest radiographs
a rounded solitary lesion. The common
lesions are: Primary bronchial or lung carcinoma, Metastatic tumour (esp. of kidney),
Bronchial hamartoma, Carcinoid tumour, Granulomatous inflammation, Lung
abscess
Horner’s Syndrome
Can occur when there is a local spread of cancer to the
intrathoracic nodes or a Pancoast’s tumour. Signs include: ptosis (drooping of the
eyelid), enophthalmos (sunken eye), miosis (small pupil), and lack of sweating on the
ipsilateral (same side as invasion) side of the face. This is due to invasion, of the
cervical sympathetic chain.
. Acute management of Asthma: OSHIT MAN:
a. Oxygen 100% through a non-rebreather mask
b. Salbutamol Nebulised back-to-back.
c. Hydrocortisone IV or Prednisolone PO
d. Ipratropium Bromide Nebulised hourly
e. Theophylline IV or aminophylline IV
f. Magnesium and call an
g. Anesthetic
Thumbprint sign on head x ray
epiglottis
Inspiratory whoop/barking cough
pertussis
Snow storm appearance on x ray
baritosis, silicosis
Management of infective exacerbation of COPD
iSOAP
i - ipratropium
S - Salbutamol
O - Oxygen
A - amoxicillin
P - prednisolone
Non-smoker + lung cancer =
(peripheral) adenocarcinoma
Squamous + Small-cell Lung cancers =
CENTRAL
High d-dimers
suspect (but not diagnose) Pulmonary Embolism (send for CTPA or
V/Q scan
Low d-dimers
exclude Pulmonary Embolism
Large PE:
thrombolysis
Small PE:
Low Molecular Weight Heparin
respiratory alkalosis
panic attack
frank pus on aspiration
empyema
obstructive lung disease- raised eosinophils
asthma
obstructive lung disease- raised neutrophils
COPD
Pickwickian disease (a.k.a Obesity hypoventilation syndrome)
obese people whose
body fat preventing air getting in. Causes sleep apnoea and hypercapnia (high levels
of carbon dioxide in the blood). Buzzword: overnight nasal ventilation
Guillian-Barre disease
disease which causes paralysis. Normally preceded by a
strep. throat/infection of respiratory or GI tract. A.K.A polyneuritis (meaning rapidly
progressive, ascending motor neurone paralysis, beginning in the feet and ascending
to the other muscles)
Coal workers pneumoconiosis -
two types Simple coal worker’s pneumoconiosis
(the disease in its early form) and progressive massive fibrosis (the disease in its later
form).Problems found at the apex of the lung
Adult respiratory distress syndrome
occurs when non-cardiogenic pulmonary
oedema leads to acute respiratory failure. CXR shows bilateral alveolar shadowing
Pulmonary oedema
CXR showing bats wings(perihilar shadowing), upper lobe
venous diversion, fluid in horizontal fissue, kerley B lines (small horizontal lines in
the periphery due to fluid in the interlobular septae and pleural effusions)
Treatment of a pneumothorax
options are observation, needle, chest tube
insertion, surgery
TLCO
how well oxygen can diffuse into the blood
Asbestosis
- problems found at the base of the lung
Treatment of P.E.
- if not immediately life threatening then anticoagulation therapy
(IV warfarin and heparin)
Type 1 diabetic presents with vomiting and not taking her insulin. Dehydrated and
deep labored breathing
metabolic acidosis (diabetic ketoacidosis).
22 year old woman, weight loss, sputum, night sweats, tender well defined nodules on
shins bilaterally
– erythema nodosum
Honeycomb lung
fibrosing alveolitis
Extrinsic allergic alveolitis
granulomatous inflammation of the lungs
Exudate
= (extra) protein > 30
Transudate
= (less) protein < 30
hypercalcaemia from squamous cell carcinoma
moans (constipation, nausea), stones , bones, and groans (confusion, memory loss)
Tb drugs
2 RIPE 4 RI
Rifampin –
side effect of red-orange discoloration of urine and tears, rashes and
hepatotoxicity
Isoniazid
tingling, parasthesiae of the extremities
Pyrazinamide
joint pain, rash, allergic reaction, yellow skin or eyes, worsening gout
Ethambutol –
change in vision, optic neuritis and red-green colour blindness
Causes of Pulmonary Fibrosis- breast
Bleomycin
Radiation
Extrinsic allergic alveolitis
Ankylosing Spondylitis
Sarcoidosis
Tuberculosis
NODOSUM spelt backwards reveals some causes of erythema nodosum, the more
common appear first
Mycobacteria (TB) -
Ulcerative colitis/Crohns disease
Sarcoidosis
Other infections (streptococcus, mycoplasma, EBV)
Drugs including sulphonamides and oral contraceptive pill
Occult malignancy
No cause found/nurturing (pregnancy