Cough (Resp. 3) Flashcards
Give 3 examples of the following pneumonias:
- CAP
- HAP
- Atypical
- CAP: Strep. Pneumoniae, Haemophillus influenza B, moraxella catarrhalis
- HAP: Staph aureus, pseudomonas aeruginosa, Klebsiella
- Atypical: Mycoplasma pneumonia, legionella pneumophila (A/C), chlamydia psittaci (pet birds)
What is difference between X-ray of bronchopneumonia and lobar pneumonia.
- Lobar is homogenous broncho is patchy.
Which scoring system is used for CAP? What score is needed for inpatient stay?
- CURB 65
- 3+ is inpatient stay.
Which antibiotics are used to treat following pneumonias:
- CAP
- HAP
- Atypical
- Aspiration
- CAP: Amoxicillin (co-amoxiclav if severe)
- HAP: Staph: Flucloxacillin + gentamicin. MRSA: Vancomycin.
- Atypical: Clarithromycin
- Aspiration (anaerobes from gut flora): Metronidazole.
In general give amoxicillin and clarithromycin.
Give common pathogen of lung abscess. Give 3 signs.
- Staph aureus
- Swinging fevers, persistent pneumonia, foul-smelling sputum.
Give 6 systemic complications of TB.
- Pneumonia, pleural effusion
- Meningitis
- Erythema Nodosum and clubbing.
- Pott’s disease
- Epididymo-orchitis
- Addison’s disease, renal failure
- Which microscopy stain is used to investigate TB and what is visualised?
- What is found in lymph node biopsy?
- Which blood test screen is used?
- Ziehl-Neelsen stain
- Visualisation of acid-
fast bacilli. - LN biopsy: caseating granuloma.
- IGRA: Interferon gamma release assay.
Give 3 signs of TB on CXR.
Give 1 sign of Miliary TB on CXR.
- Consolidation- heterogenous (patchy)
- Bi-hilar lymphadenopathy
- Upper lobe scarring
- Miliary TB: nodular shadowing. TB where it has spread to lymph nodes.
Give a definition of bronchiectasis.
Give 3 congenital causes of bronchiectasis.
Give 4 acquired causes of bronchiectasis.
- Chronic permanent dilation of airways alongside increased mucus production.
- Cystic fibrosis
- Primary ciliary dyskinesia- Kartagener’s syndrome
- Young’s syndrome.
- Pneumonia
- TB
- Measles
- Pertussis
Give an inspection and an auscultation finding of bronchiectasis.
- Clubbing
- Bibasal crackles
Give 4 respiratory causes of clubbing
Give 4 respiratory causes of bibasal crackles
- Bronchiectasis (cystic fibrosis), lung cancer, TB, IPF
- Pulm. oedema, pneumonia, bronchiectasis, IPF
What is best investigation for bronchiectasis? What is classic sign in this investigation?
What is a test for cystic fibrosis?
- High resolution CT Chest. Signet ring sign.
- Sweat test measures chloride concentration in sweat.
Give 4 pharmacological managements for bronchiectasis.
- Inhaled salbutamol
- Inhaled ABx- oral azithromycin
- Influenza flu vaccine
- IV ABx (acute)- levofloxacin if pseudomonas.
List 4 types of primary lung cancer.
- Small cell: 15%- SIADH, ectopic ACTH.
Non-small cell: - Adenocarcinoma: most common. Goblet cells, peripheral lung.
- Squamous cell carcinoma. Squamous epithelial cells- PTH
- Large cell carcinoma: epithelial cells.
Give 2 local invasion sites of lung cancer.
- Nervous system: horner’s syndrome, left recurrent laryngeal nerve (causes bovine cough).
- Superior vena cava- obstruction.
