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Cough Flashcards

1
Q

List causes of acute/dry coughs

A 
Asthma
URTI - pharyngitis, laryngitis, tracheitis
Lung cancer
Pulmonary edema
Drug-induced
Smoke/toxin inhalation 
Small PE
Inhaled foreign body
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2
Q

List causes of acute/productive cough

A

LRTI - pneumonia, bronchitis
COPD
TB

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3
Q

List causes of chronic/dry cough

A 
Asthma
GORD
COPD
Lung cancer
Post nasal drip 
Drug induced
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4
Q

List causes of chronic/productive cough

A

Bronchiectasis
TB
Lung cancer
CF

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5
Q

What are the common causative organisms of Bronchiectasis?

A

H. influenzae
S. pneumoniae
S. aureus
P aeruginosa

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6
Q

RF for Bronchiectasis?

A 
CF
Primary ciliary dyskinesia
Alpha-1-antitrypsin
Foreign body obstruction 
Connective tissue disease like Rheumatoid
Tumour
Immunosuppression
Immunodeficiency
Measles
Influenza
Pertussis
Bacterial pneumonia
Aspergillus
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7
Q

What are the symptoms of Bronchiectasis?

A

Persistent cough
SOB
Mucopurulent sputum - green or rust coloured
Haemoptysis

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8
Q

What are the signs of Bronchiectasis?

A

Crackles
Presence of an underlying disorder
Fever

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9
Q

What is the CXR sign for Bronchiectasis?

A

Tram-track sign

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10
Q

What is high-resolution CT sign for Bronchiectasis?

A

Signet ring sign - brochoarterial ratio is dilated massively

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11
Q

How do you manage patients with Bronchiectasis?

A

Exercise
Nutrition
Airway clearance - postural drainage or percussion
Inhaled bronchodilator - Salbutamol
Inhaled hyperosmolar agent - Hypertonic saline
or antibiotics

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12
Q

What are the most common causative agents of community acquired pneumonia?

A

Streptococcus pneumoniae

Haemophilus influenzae

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13
Q

List the HAP pathogens

A

ESKAP

E. coli
Staphylococcus aureus
Klebsiella pneumoniae
Acinetobacter speices
Pseudomonas aeruginosa
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14
Q

List the atypical pneumonia pathogens

A

Maniacs Chop Legs

Mycoplasma pneumoniae
Chylamydiaphila pneumoniae
Legionella pneumophilla
Coxiella burnetti

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15
Q

List the signs of pneumonia

A 
Productive cough
Coloured sputum
SOB
Pain on inspiration 
Pleuritic chest pain
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16
Q

What are the symptoms of Pneumonia?

A

Fever
Confusion
Dull percussion
Bronchial breathing on percussion

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17
Q

Swinging fever in a patient suspected of pneumonia there is likely to be?

A

An empyema

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18
Q

What are some of the complications of pneumonia?

A

Respiratory failure
Sepsis

Pleural effusion
Empyema
Lung abscess
Organising pneumonia

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19
Q

Abx treatment for pneumonia

A
  1. Mild: oral amoxicillin OR oral clarithyromycin OR doxycyclin
  2. Moderate: oral/IV amoxicillin + macrolide (clarithyromycin) or doxycyclin
  3. Sever: IV co-amoxiclav + macrolide (clarithyromycin) OR IF PENICILLIN ALLERGY IV cephalosporin + clarithyromycin
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20
Q

What are the Ix for Legionella pneumonia?

A

Sputum culture
Urine antigen
Hyponatraemia
Bi-basal consolidation

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21
Q

What is the treatment for Legionella?

A

IV fluoroquinolones (CIPROFLOXACIN) + Macrolide (CLARITHYROMYCIN)

22
Q

What does Pneumocystis Jirovercii cause?

A

Pneumocystis pneumonia (PCP)
Opportunistic infective organism
It is a fungus

23
Q

Who is at risk of infection by Pneumocystis Jirovercii?

A 
Immunosuppresed patients
HIV
On long-term corticosteroids 
Monoclonal anitbody therapy 
Methotrexate
24
Q

What is the treatment of Pneumocystis Jirovercii?

A

High dose co-trimoxazole

25
Pseudomonas aeruginosa is a HAP and is associated with what oversight in hospital settings?
Failure of people to wash their hands enough or sterilise medical equipment satisfactorly
26
In what patients is Pseudomonas aeruginosa seen?
CF and bronchiectasis patients
27
What is the treatment of Pseudomonas aeruginosa?
Piptazobactum (Piperacillin + Tazobactum)
28
Which micro-organism is associated with close community settings - boarding schools, army bases, universities?
Mycoplasma pneumonia
29
What is the Ix for Mycoplasma pneumonia
CXR PCR Cold agglutinins
30
What is the treatment for Mycoplasma pneumonia?
Clarithyromycin or Erythromycin
31
Which micro-organism is common in IVDU?
Staphylococcus aureus
32
What is the treatment of Staphylococcus aureus?
Flucloxacillin | Vancomycin if MRSA
33
List the RF for TB
``` Contact with high risk groups - from high incidence areas HIV infection DM CKD Malnutrition Drug/alcohol misuse Homelessness/hostels/overcrowding Recent travel ```
34
What are the symptoms of TB?
``` Dry cough that can become productive Cough is 2-3 weeks in duration Drenching night sweats FLAWS Haemoptysis (only in 10% at the end stage) ```
35
What are the signs of TB?
Fever Bronchial breathing Crackles Erythema nodosum
36
What are the Ix for TB?
Obs CXR - consolidation with/without cavitation, pleural effusion, thickening/widening of mediastinum Sputum culture - acid-fast bacilli using Ziehl-Neelsen staining on Lowenstein-Jensen slopes Alternative: Auramaine-rhodamine staining or Middlebrook agar Nucleic Acid Amplification Test -
37
What is lung cancer?
Cancer of the epilthelial cells of the lower respiratory tract
38
What are the 4 main types of lung cancer?
``` Small cell Non-small cell (80%): Adenocarcinoma Squamous cell carcinoma Large cell carcinoma ``` Metastases Mesothelioma
39
What are the RF for Lung cancer/bronchial carcinomas?
``` Cigarette smoking Radon exposure Asbestos Polycyclic aromatic hydrocarbons Ionising radiation Occupation exposure to arsenic, chromium, nickel, petroleum, products and oils Pulmonary fibrosis HIV Genetic factors ```
40
List the features of Small Cell Lung cancer
15% of primary lung cancers Strongest association with smoking Arise in the centre (smallest want to be centre of attention) Rapid growth Highly malignant May produce endocrine hormones like ACTH and ADH
41
List the features of Adenocarcinomas
``` Most common type in non-smokers Most common type in WOMEN (even female smokers) Peripheral lung Pleural involvement Metastasise often ```
42
List the features of Squamous cell carcinoma
25% of lung cancer Associated with male smokers Associated with smoking Involve central lung
43
List the features of Large cell carcinoma
Can arise centrally or peripherally Poor prognosis 10% of primary lung cancers are large cell
44
What are the extrapulmonary manifestations of bronchial carcinoma?
``` Weight Loss Anorexia Ectopic ACTH SIADH Hypercalcaemia Hypoglycaemia Thyrotoxicosis Gynaecomastia Encephalopathies Myelopathies Microcytic and normotcytic anaemia DIC TTP Haemolytic anaemia Clubbing ```
45
What are the symptoms of Lung cancer?
``` Cough SOB Haemoptysis FLAWS Pleurtic chest pain Monophonic wheeze Hoarse voice ```
46
What are the investigations done for lung cancer?
``` Obs CXR CT Sputum cytology Bronchoscopy Biopsy ```
47
What two diseases can arise from exposure to asbestos?
Abestosis | Mesothelioma
48
What are the differences between Abestosis and Mesotheliomas?
Asbestosis: Interstitial fibrosis Absestos fibers get into the alveoli Strong correlation with smoking Mesothelioma: Malignancy of the epithelial lining of the LUNGS Weak correlation with smoking
49
What are the RF for Mesothelioma
Exposure to asbestos (Can lie dormant for 20-40 years) Patient "worked in shipyard or construction"
50
What are the signs and symptoms of Mesothelioma?
Dry cough SOB Muffled breath sounds on auscultation Result of pleural effusion
51
What are the Ix for Mesothelioma?
CXR CT Thickened pleural plaques Fibrosis from the asbestosis
52
What are the Ix for Asbestosis?
CXR CT -advanced asbestosis appears as whiteness on CT -Severe honeycomb appearance

MED ED/CONDITIONS (5 decks)

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