extras Flashcards
flow volume loop not meeting at left side where started to breathe in?
air trapping
which aspergillus in ABPA
aspergillus fumigatus
Testing what rules out ABPA
if serum IgE total not over 1000 and not on steroids, excludes
smoking reduces risk what lung disease
extrinsic allergic alveolitis
AKA
hypersensitivity pneumonitis
do you get eosinophilia in EAA/hypersens pneumonitis?
NO!!
look for serum precipitins
obst or restrict LFTs
Loeffler syndrome AKA simple pulmonary eosinophilia
over a few weeks onset not that symptomatic transient pulmonary infiltrates no effusion periph eosinophilia BAL eosinophilia check for drugs and parasites get better on own
chronic eosinophilic pneumonia
over weeks to months
often a history of asthma
periph eosinophilia and on BAl
PHOTOGRAPHIC NEGATIVE OF PULMONARY OEDEMA
IgE up but not that high eg no more than 2000
dramatic steroid response
should be a differential for ABPA
acute eosinophilic pneumonia
1-5 days onset
looks like pulm oedema on imaging
GET PLEURAL EFFUSIONS ALMOST ALWAYS, with MARKED EOSINOPHILIA
NORMAL periph eosinophils or if there are some then hyeprsegmented
BAL mixed including eosinophils
rapid steroid response
IgE up a bit
could be differential for hypersens pneumonitis (both normal eosinophils)
sinusitis in CS vs wegners
destructive in wegners
renal disease in CS vs wegeners
CS proteinuria but not normally renal failure
ARDS criteria
acute onset
bilat infiltrates
non cardiogenic
pO2/FiO2 under 200
causes
infection massive transfusion trauma stroke pancreatitis bypass
pneumonia and hyponatraemia think
legionella
deranged LFT in pneumonia think
mycoplasma
legionella
erythema multiforme with pneumonia think
mycoplasma
GBS with pneumonia thnk
mycoplasma
myo/pericarditis with pneumonia think
mycoplasma
aspergilloma presents how
weight loss, cough, haemoptysis with mass in someone who used to have TB
how does lung carcinoid present
40-50 year old non smoker with long history of cough and recurrent haemoptysis
central and often not seen onCXR
cherry red ball on bronch
no carcinoid syndrome unless liver mets
resect
good survival if no mets
most common organism in bronchiectasis
haemophilus
good evidence for non CF bronchiectasis doing physical training
if aspirate pneumothorax but then still there to under 2cm, what do you do?
Can still discharge home as long as otherwise ok
causes of a transudate
there are four
meigs
hypoalbuminaemia
heart failure
hypothyroidism
hyponatraemia in lung cancer
small cell
CO2 in the blood mostly carried as
BICARBONATE IONS
some of it binds to to haemaglobin as carbamino compound which decreases its affinity for oxygen
Diphragmatic paralysis- when is the restriction the most severe
When lying down (gets worst by 30-50%)
suspect resp muscle weakness, what should you check
MIP MEP SNIP
Sleep changes in old people
increase latency of sleep onset
more arrousals
deepest non REM sleep reduced or absent but REM same
MOST cases of familial pulmonary hypertension are a mutation in what
BMPR2
Bone morphogenic protein receptor 2
ALK-1 most common if have coexistent hered haemorrhagic telangiectasia
Narcolepsy CSF finding
Reduced hypocretin (a wakefulness protein)
HLA is HLA DQB1 0602
Do bronchodilators help CF kids?
30% may help
often paradoxical increase in obstruction
poor prognostic markers in mesothelioma
male anaemia extensive disease poor performance status high PET uptake increase WCC high plt sarcomatoid histo findings increase COX2 expression VEGF expression P16 INK4a gene Simian virus 40 presence increase vascularity
Major risk factor for Bronchiolitis obliterans after lung transplant
acute cellular rejection
Lymphocytic bronchiolitis
reflux
hard to see on biopsy so use FEV1 as surrogate marker
