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Y3 MedEd > Cough > Flashcards

Cough Flashcards

1
Q

Causes of acute dry cough (4)

A

Asthma
Drugs (ACE inhibitors)
Heart failure
URTI (laryngitis, pharyngitis)

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2
Q

Causes of acute productive cough (2)

A

Pneumonia (LRTI)

TB

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3
Q

Causes of chronic dry cough (4)

A

Asthma
Lung cancer
GORD
Mesothelioma

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4
Q

Causes of chronic productive cough (4)

A

COPD
Bronchiectasis
Lung cancer
Cystic fibrosis

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5
Q

RF for pneumonia (3)

A

Smoking
Travel
Immunocompromised

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6
Q

Causes of atypical pneumonia (4)

A

Mycoplasma pneumonia
Legionella pneumophila
Chlamydia psittaci
Chlamydia pneumoniae

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7
Q

Causes of CAP pneumonia (3)

A

Strep pneumoniae (AKA pneumococcus)
Haemophilus influenzae B
Moraxella catarrhalis

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8
Q

Causes of HAP pneumonia (3)

A

Staph aureus

Pseudomonas aeruginosa

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9
Q

Which organism causes a transverse myelitis pneumonia

A

Mycoplasma pneumoniae

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10
Q

Which organism causes a hyponatraemic pneumonia

A

Legionella pneumophila

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11
Q

Which organisms causes a cavitating lesions pneumonia (2)

A

Staph aureus

Klebsiella

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12
Q

Which organism causes air conditioning associated pneumonia

A

Legionella pneumophila

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13
Q

Which organism causes pet birds associated pneumonia

A

Chlamydia psittaci

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14
Q

What pneumonia is Chlamydia psittac associated with

A

Pet birds

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15
Q

What pneumonia is Staph aureus associated with

A

Cavitating lesions

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16
Q

What is pneumonia Klebsiella associated with

A

Cavitating lesions

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17
Q

What is pneumonia legionella pneumophilia associated with (2)

A

A/C

Hyponatraemia

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18
Q

What is pneumonia mycoplasma pneumonia associated with

A

Transverse myelitis causing pneumonia

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19
Q

What extra symptoms do atypical pneumonias cause (5)

A 
Dry cough
Headache
Diarrhoea
Myalgia
Hepatitis
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20
Q

What are the symptoms of typical pneumonia (5)

A 
Fever
SOB (dyspnoea)
Cough (with green sputum)
Chest pain (pleuritic)
Confusion
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21
Q

What is auscultated in pneumonia (3)

A

Coarse bibasal crackles
Bronchial breathing
Increased vocal resonance

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22
Q

Ix for pneumonia (8)

A 
Bloods
FBC
CRP
ABG
Blood cultures

Sputum MCS
Pleural fluid MCS (via thoracentesis)
CXR

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23
Q

Which extra Ix should you do if you suspect atypical pneumonia and which Ix suggests which pathogen (4)

A

Serology (all)
Urinary antigens (legionella, strep pneumo)
Blood film (mycoplasma – cold agglutins)
LFTs (legionella)

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24
Q

What is used to score pneumonia

A

CURB-65

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25
Q

Acute Mx of pneumonia (4)

A

Oxygen (+ sit up patient)
IV fluids
CPAP (if required)
Surgical drainage (if abscess/empyema)

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26
Q

Mx of CAP pneumonia

A

Amoxicillin (co-amoxiclav if severe)

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27
Q

Mx of HAP pneumonia (2)

A

If staph: Flucloxacillin + gentamycin

If MRSA: Vancomycin

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28
Q

Mx of atypical pneumonia (2)

A

Clarithromycin

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29
Q

Mx of aspiration pneumonia (2)

A

Metronidazole

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30
Q

Which type of pneumonia is metronidazole used for

A

Aspiration

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31
Q

Which type of pneumonia is clarithromycin used for

A

Atypical

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32
Q

Which type of pneumonia is amoxicillin used for

A

CAP

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33
Q

Which type of pneumonia is co-amoxiclav used for

A

Severe CAP

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34
Q

Which type of pneumonia is flucloxacillin used for

A

Staph with gentamycin

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35
Q

Which type of pneumonia is gentamicin used for

A

Staph with flucloxacillin

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36
Q

Which type of pneumonia is vancomycin used for

A

MRSA

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37
Q

What do you generally give pneumonia (2)

A

amoxicillin + clarithromycin

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38
Q

Complications of pneumonia (5)

A 
Pleural effusion
Pneumothorax
Lung abscess (often Staph aureus)
Empyema
Sepsis
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39
Q

Which complications of pneumonia do staph commonly do (4)

A

Lung abscess (often Staph aureus)
Swinging fevers
Persistent pneumonia
Foul-smelling sputum

40
Q

Which parts of the body can TB affect (8)

A 
Lungs
Brain
Heart
Spine
Skin
Testes
GI
Kidneys
41
Q

What are the effects of TB on the skin (2)

A

Erythema Nodosum

Clubbing

42
Q

What are the effects of TB on the brain

A

Meningitis

43
Q

What are the effects of TB in the lungs (2)

A

TB pneumonia

Pleural effusion

44
Q

What are the effects of TB on the GI system (2)

A

Peritonitis

Ascites

45
Q

What are the effects of TB on the heart (3)

A

Pericardial effusion
Constrictive pericarditis
Normocytic anaemia

46
Q

What are the effects of TB on the spine (3)

A

Pott’s disease
Spinal cord compression
Osteomyelitis

47
Q

What are the effects of TB on the spine (2)

A

Epididymo-orchitis

Infertility

48
Q

What are the effects of TB on the kidney (2)

A

Renal failure

Addison’s disease

49
Q

Ix for TB not bloods (4)

A

Sputum MCS (x3 samples)
(microscopy with Ziehl-Neelsen stain
= enables visualisation of acid-fast bacilli)

CXR

Lymph node biopsy (caseating granuloma)

Mantoux/tuberculin skin test (TST)

IGRA

50
Q

What stain is used to detent TB in sputum

A

Ziehl-Neelsen stain

51
Q

What bloods do we take to detect TB and what are the results (2)

A

FBC
High WCC
CRP
High

52
Q

What is seen in the CXR of TB (5)

A 
Consolidation (patchy/heterogenous)
Bi-hilar lymphadenopathy
Upper lobe scarring
(Cavitating lesions)
(Pleural effusions)
53
Q

What is seen in the CXR of miliary TB

A

Nodular shadowing

54
Q

Define bronchiectasis

A

chronic condition that causes permanent dilation of the airways, alongside increased mucus production

55
Q

Congenital causes of bronchiectasis (3)

A

CF
Primary ciliary dyskinesia (AKA Kartageners syndrome)
Youngs syndrome

56
Q

What is the triad in primary ciliary dyskinesia (Kartagener’s syndrome)

A

Triad:
PCD
Sinusitis
Situs inversus

57
Q

What is the triad in Youngs syndrome

A

Bronchiectasis
Sinusitis
Infertility

58
Q

Acquired causes of bronchiectasis (6)

A 
Pneumonia
TB
Measles 
Pertussis
Allergic bronchopulmonary aspergillosis (ABPA)
Immunocompromised (e.g. HIV)
59
Q

Symptoms of bronchiectasis (6)

A 
Chronic cough (+green sputum)
Haemoptysis
SOB
Chest pain
Fever
Weight loss
60
Q

Signs of bronchiectasis (2)

A

Clubbing

Bibasal crackles

61
Q

Ix for bronchiectasis (not bloods, 4)

A

Sweat test
(Cystic fibrosis)

Sputum MCS

CXR
HR-CT chest (best method

62
Q

How do you test for CF

A

Sweat test

63
Q

What is the classic sign seen on CT of bronchiectasis

A

Classic feature

Signet ring sign

64
Q

Conservative Mx of bronchiectasis (4)

A

Exercise
Good diet
Good hydration
Airway clearance

65
Q

How can you practise airway clearance for bronchiectasis (3)

A

Chest physiotherapy
High frequency oscillation devices
Nebulised hypertonic saline

66
Q

Medical Mx of bronchiectasis (4 and 1 more acute)

A

Inhaled salbutamol
Inhaled ABx (prophylactic)
(Oral azithromycin)
Influenza flu vaccine

IV ABx (acute)
     (IV levofloxacin – if pseudomonas)
67
Q

Complications of bronchiectasis (3)

A

Persistent infections
Cor pulmonale (RHF)
Respiratory failure

68
Q

Surgical Mx of bronchiectasis

A

Localised resection

69
Q

What type of cell is small cell lung cancer

A

Endocrine cells

70
Q

What type of cell is adenocarcinoma lung cancer

A

Goblet cells

71
Q

What type of cell is squamous cell carcinoma

A

Squamous epithelial cells

72
Q

What type of cell is large cell carcinoma

A

Epithelial cells

73
Q

Associations of small cell lung cancer (2)

A

SIADH, ectopic ACTH

74
Q

Associations of adenocarcinoma

A

Peripheral lung

75
Q

Associations of SqCC

A

PTHrp

76
Q

Which lung cancer is associated with PTHrp

A

SqCC

77
Q

Which lung cancer is associated with SIADH

A

Small cell lung cancer

78
Q

Which lung cancer is associated with ectopic ACTH

A

Small cell lung cancer

79
Q

RF of lung cancer (3)

A

Age
Smoking
Asbestos exposure (particularly SqCC)

80
Q

Which lung cancer is the most associated with asbestos exposure

A

SqCC

81
Q

Symptoms of a primary lung cancer (6)

A 
Cough (dry or productive)
Haemoptysis
SOB
Weight loss
Loss of appetite
Night sweats
82
Q

Symptoms of a local invasion of a lung cancer (2)

A 
Nervous system (Horner’s syndrome) 
      (left recurrent laryngeal nerve = bovine cough)
Superior vena cava (SVC obstruction)
83
Q

Where do lung cancers usually metastasise (4)

A

Bone (bone pain, fractures)
Brain (headaches, blurry vision)
Liver (hepatomegaly)
Lymphadenopathy

84
Q

What is heard on auscultation of a lung cancer (4)

A

Wheezing
Increased vocal resonance
(Pleural effusion =decreased vocal resonance)
Crackles

85
Q

Lung cancer blood tests and results (4)

A

FBC
Calcium
ALP
LFT

86
Q

Lung cancer blood tests results:
Ca
ALP
LFT

A 
High (bone mets)(PTHrp)
May be high
(bone metastases)
Deranged
(liver metastases)
87
Q

What is seen in primary lung cancer CXR (5)

A 
Consolidation (usually heterogenous)
(Bi-hilar lymphadenopathy)
(Upper lobe scarring)
(Cavitating lesions – usually SqCC)
(Pleural effusions)
88
Q

What is seen in primary lung cancer CXR (5)

A 
Consolidation (usually heterogenous)
(Bi-hilar lymphadenopathy)
(Upper lobe scarring)
(Cavitating lesions – usually SqCC)
(Pleural effusions)
89
Q

Define mesothelioma

A

malignant neoplasm of mesothelial cells of the pleura (rare condition)

90
Q

RF of mesothelioma

A

Asbestos exposure

91
Q

Symptoms of mesothelioma (5)

A 
Cough (dry)
SOB
Weight loss
Loss of appetite
Night sweats
92
Q

What is heard on auscultation of mesothelioma that is a dead give away

A

Pleural friction rub

93
Q

Which bloods do you take for mesothelioma (4)

A

FBC
Calcium
ALP
LFT

94
Q

Mesothelioma results:
Calcium
ALP
LFT

A

High PTHrp
ALP may be high
LFT may be deranged if liver mets

95
Q

Main Ix for mesothelioma (2)

A

CXR

CT chest

96
Q

Ix for mesothelioma (4)

A

CXR
CT chest

Pleural fluid (cytology)(via thoracentesis)
Pleural biopsy

Y3 MedEd (34 decks)

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