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MedEd > Cough > Flashcards

Cough Flashcards

1
Q

Acute Dry cough differentials?

A

URTIs e.g. laryngitis or pharyngitis

Drugs e.g. ACEi

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2
Q

Chronic Dry cough differentials?

A

Lung cancer
GORD
Mesothelioma

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3
Q

Mixed Dry and Productive cough differentials?

A

Mixed Dry = HF and asthma

Mixed productive = HF and COPD

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4
Q

Productive acute cough differentials?

A

Pneumonia (LRTI) or TB

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5
Q

Productive Chronic cough differentials?

A

Lung cancer, bronchiectasis or CF

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6
Q

Most common cause of CAP?

A

Strep pneumoniae

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7
Q

Scoring system for CAP severity?

A

CURB-65

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8
Q

Pneumonia CAP causes?

A

Strep pneumoniae (gram +ve diplococci), haemophilus influenzae B (gram -ve rod) and Moraxella catarrhalis

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9
Q

Atypical Pneumonia causes?

A 
Mycoplasma pneumonia (associated with transverse myelitis)
Legionella pneumophila (Air conditioning, associated with Hyponatraemia and abnormal LFTS)
Chlarmydia psittaci (pet birds)
Chlamydia pneumoniae
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10
Q

Hospital acquired pneumonia causes?

A 
Staph aureus (Cavitating lesions)
Pseudomonas aeruginosa
Klebsiella (alcoholic rf, cavitating legions association)
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11
Q

Cause of aspiration pneumonia?

A

Anaerobes from gut flora

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12
Q

Symptoms of typical pneumonia?

A

Typical = fever, SOB, cough (green), pleuritic chest pain and confusion

Atypical = dry cough, headache, diarrhoea, myalgia and hepatitis.

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13
Q

Signs of pneumonia?

A

Inspection = resp distress, cyanosis and increased HR and RR, decreased O2 and BP if septic

Reduced chest expansion an dull percussion over consolidation

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14
Q

Auscultation of pneumonia?

A 
Basal crepitation (coarse)
Bronchial breathing and increased vocal resonance
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15
Q

Investigations for pneumonia?

A

Obvs, sputum MCS, bloods, pleural fluid mcs via thoracocentesis ad CXR

Bloods = high wcc, high crp and T1RF on ABG

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16
Q

Atypical pneumonia symptoms and organism investigations?

A

Symptoms = Atypical = dry cough, headache, diarrhoea, myalgia and hepatitis.

Serology, urinary antigens for legionella, blood film of cold agglutins for mycoplasms and LFTs for legionella

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17
Q

Types of pneumonia on the XRAY?

A

Lobar and bronchopneumonia (patchy)

Can see consolidation of air bronchograms

18
Q

Management for pneumonia?

A

CURB 65 = confusion <8 AMTS, urea >7mmol/L, RR>30, BP<90/60mmHg and Age >65

1 = GP
2= A&E
4+ = admission +-ICU
19
Q

Acute pneumonia management?

A

Oxygen (sit up)m IV fluid, analgesics and ABx

CPAP if required

20
Q

Causative organism Abx?

A 
CAP = amoxicillin (co-amox)
Atypical = clarithromycin
Staph = flucloxacillin
MRSA = vancomycin
Pseudomonas = tazocin + gentamicin

Aspiration pneumonia = metronidazole

21
Q

Pneumonia complications?

A

Plural effusion
Empyema
Sepsis
Lung abscess (staph aureus) = swinging fever, persistent pneumonia and foul smelling sputum

22
Q

RFs and Signs/symptoms for TB?

A

Travel, south asians, immunocompromised

FLAWS, SOB, COugh _ green sputum, HAEMOPTYSIS and lymphadenopathy

23
Q

List of TB complications?

A

TB pneumonia, pleural effusion, meningitis, erytherma nodosum, clubbing, peritonitis, ascites,

Potts disease and addisions disease

24
Q

TB investigations?

A

Obvs, sputum MC&S and microscopy with Ziehl-neelsen stain

Bloods and CXR

Lymph node biopsy for caseating granuloma
Mantoux ad IGRA

25
Q

TB CXR features?

A

Consolidation, bi hilar lymhadenopathy, upper lobe scarring, cavitating lesions and pleural effusions.

Miliary TB = nodular shadowing

26
Q

Congenital causes of bronchiectasis?

A

CF
Primary Ciliary dyskinesia (kartageners) = triad of bronchiectasis, sinusitis, situs inversus

Youngs syndrome = bronchoectasis, sinusitis, infertility

27
Q

Acquired bronchiectasis causes?

A

Infection e.g. pneumonia, TB, measles and percussis

Lung cancer

28
Q

Symptoms of bronchiectasis?

A

Chronic cough + green sptum, haemoptysis, SOB, fever and weight loss

Signs = clubbing and auscultation (basal crepitations)

29
Q

Resp clubbing causes?

A

Bronciectasis, IPF, lung cancer and TB

30
Q

Causes of basal crepitations?

A

HF, pneumonia, bronchiectasis and IPF

31
Q

Bronchiectasis investigations?

A

Usual bvs, sputum MCS, sweat test for CF and genetic testing

Gold standard is High resolution CT . Maybe CXR

Classical sign is signet ring sign

32
Q

Bronchiectasis management?

A

Conservative: exercise, vaccinations (influenza), airway clearance: chest physiotherapy, high frequency oscillation devices, nebulised hypertonic saline

Pharmacological: IV ABx (acute infection) or oral Abx (prophylactic e.g. azithromycin)

Surgical: localised resection

33
Q

Bronchiectasis complications?

A

Recurrent infectios, cor pulmonale (RHF) or respiratory failure

34
Q

Lung cancer breakdown and RFs?

A

Primary = Small cell (15%)?endocrine cells e.g. SIADH, ectopic ACTH

Non-small cell cancer: Adenocarcinoma (goblet cells in peripheral). SqCC (Squamous epithelial, PTHrp), Large cell carcinoma (epithelial cells)

RFs: Smoking or asbestos (sqcc)

35
Q

Primary tumour symptoms?

A

Cough dry or productive, Haemoptysis, SOB, weight loss, loss of appetite and night sweats.

36
Q

Local invasion and met symptoms?

A

Local: nervous (Horners syndrome)(left recurrent laryngeal nerve = bovine cough)
Superior Vena Cava (SVC obstruction)

Bone = pain/fratures
Brain = headaches, blurry vision
Liver = hepatomegaly
Lymphadenopthy

37
Q

Signs of lung cancer?

A

Clubbing and lymphadenopathy.
Dull percussion
Creps and increased vocal resonance

38
Q

Lung Cancer investigations?

A

Obvs, Bloods e.g. FBC, calcium, ALP or LFTs, Imaging = CXR, CT, CAP, PET

Caclium and ALP possibly high. LFTs possible deranged

Biospy = bronchoscopy or transthoracic needle

39
Q

CXR for lung cancer?

A

Primary = consolidatn, bi-hilar lyphadenopathy, pleural effusions, cavitating lesions usually Sqcc

Secondary = con shaped lesions e.g. cannonball mets

Atelectasis = Sails sign

40
Q

Mesothelioma specifics?

A

Asbestos exposure

Pleural friction rub on auscultation

Thoracoscopy and histology are definitive diagnosis

41
Q

Mesothelioma CXR features/

A

pleural thickening, pleural plaques and pleural effusions

MedEd (32 decks)

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