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Respiratory Medicine > Diagnostics > Flashcards

Diagnostics Flashcards

1
Q

When would you use light’s criteria?

A

Use if protein level of pleural fluid is between 25-35g/L

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2
Q

Protein level in EXUDATIVE effusions

A

Protein > 30g/L

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3
Q

Protein level in TRANSUDATIVE effusions

A

Protein < 30g/L

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4
Q

Haemothorax

A

Pleural Fluid Haematocrit > half peripheral blood haematocrit

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5
Q

Empyema

Perform a diagnostic tap for pleural effusions associated with sepsis of pneumonia

A

Purulent or turbid/cloudy pleural aspirate
OR
pH < 7.2

Rx -> wide bore chest drain

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6
Q

What does serum Beta D Glucan test for?

A

Invasive or disseminated fungal infection

False +ve if contaminated specimens from beta D glucan producing bacteria (e.g. strep pneumoniae, pseudomonas) or fungal contaminants in Abx (co-amoxiclav and tazocin)

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7
Q

Light’s Criteria:

An exudate is likely if at least one of…

A
  • fluid protein/ serum protein > 0.5
  • fluid LDH/ serum LDH > 0.6
  • fluid LDH > 2/3 upper limit normal serum LDH
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8
Q

Causes of upper lobe predominant pulmonary fibrosis

A
  • CF
  • Sarcoidosis
  • Langerhans cell histiocytosis
  • TB
  • Silicosis
  • ABPA
  • Chronic Hypersensitivity Pneumonitis
  • Histoplasmosis
  • Drugs e.g. chemo
  • Ankylosing Spondylitis
  • Progressive Massive Fibrosis (assoc. pneumoconioses)
  • Pleuroparenchymal fibroelastosis
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9
Q

Moderate Acute Asthma

A
  • PEFR 50-75%
  • normal speech
  • RR < 25/ min
  • HR < 110 bpm
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10
Q

Sever Acute Asthma

A
  • PEFR 33-55%
  • incomplete sentences
  • RR > 25/min
  • HR > 110bpm
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11
Q

Life-threatening Acute Asthma

A
  • PEFR < 33%
  • Sats < 92%
  • silent chest, cyanosis, weak respiratory effort
  • bradycardia, dysrhythmia, hypotension
  • exhaustion, confusion, coma
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12
Q

Pulmonary Hypertension (PAH)

A

Sustained elevation in mean pulmonary arterial pressure > 25 mmHg at rest

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13
Q

Group 1: PAH

A
  • idiopathic i.e. primary PAH
  • familial
  • assoc. collagen vascular dx, CHD with systemic to pulmonary shunts, HIV, drugs/toxins, sickle cell dx
  • persistent PAH of the newborn
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14
Q

Group 2: PAH with left heart dx

A
  • e.g. LVSD, mitral stenosis, mitral regurgitation
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15
Q

Group 3: PAH secondary to lung dx/hypoxia

A
  • COPD
  • ILD
  • OSA
  • High altitude
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16
Q

Group 4: PAH due to thromboembolic dx

A

Chronic thromboembolic disease

17
Q

Group 5: PAH miscellaneous

A
  • lymphangiomatosis secondary to carcinomatosis or sarcoidosis
18
Q

Causes of pulmonary eosinophilia

A
  • Churg-Strauss Syndrome/EGPA
  • ABPA
  • Loffler’s syndrome
  • eosinophilic pneumonia
  • hypereosinophilic syndrome
  • Tropical pulmonary eosinophilia
  • Drugs: nitrofurantoin, sulphonamides
  • GPA/ wegener’s (less common)

Respiratory Medicine (5 decks)

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