Buzzwords Flashcards
Right sided pleuritic chest pain
Most likely pneumonia
Alveolar bat’s wings, Kerley B lines, Cardiomegaly, Dilated Prominent upper lobe vessels, pleural Effusion (A, B, C, D, E)
Pulmonary oedema
Ground-glass appearance on X-ray
Pulmonary fibrosis and respiratory distress syndrome of the newborn
Ziehl-Neelson stain positive for acid fast bacilli
TB
Caseous necrosis
TB
Apical disease
Most likely (secondary) TB; apical lesions is called an Assmann focus!
Miliary Tuberculosis
Spread of organism into the bloodstream. If organism spread via pulmonary artery, miliary dessemination into the lung occurs. If organims spread via pulmonary vein, there is systemic dissemination to the liver, spleen and kidneys
Positive anti-glomerular basement membrane antibodies
Goodpasture’s 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
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 effects of organic nitrates
ACTH secreting lung tumour
Small cell carcinoma of the lung
PTH secreting lung tumour
Squamous cell carcinoma of lung
Small-cell carcinoma
Neuroendocrine, highly malignant and may be associated with ectopic endocrine syndromes
Increased serum ACE and Ca2+
Sarcoid
Eggshell calcification at hilar regions
Silicosis
Heart-failure cells seen in alveolar spaces
Macrophages that have absorbed haemosiderin - 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. Note: Ghon focus rupture (rare) through the visceral pleura into the pleural cavity will produce tuberculosis pleurisy.
Assmann focus
Apical lesion of secondary tuberculosis infection
Coin lesion found on chest radiographs
A rounded solitary lesion. The common lesions are: primary bronchial or lung carcinoma, metastatic tumour (especially 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 face. This is due to invasion of the cervical sympathetic chain.
Acute management of asthma: OSHIT MAN
Oxygen 100% through a non-rebreather mask Salbutamol nebulised back-to-back Hydrocortisone IV or prednisolone PO Ipratropium Bromide nebulised hourly Theophylline IV or aminiophylline IV Magnesium and call an Anaesthetist
Thumbprint sign on head x-ray
Epiglottitis
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 and lung cancer =
Peripheral adenocarcinoma
Squamous and 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
PE risk factors (8 H’s)
Hereditary e.g. factor V Leiden History - previous DVT or PE Hypomobility e.g. fracture or long trip Hypovolaemia e.g. dehydration Hypercoaguability e.g. smoking Hormones e.g. Oestrogen Hyperhomocysteinemia Hyperviscosity states e.g. malignancy , post surgery
Stony dull to percuss
Pleural effusion
