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Respirology > General > Flashcards

General Flashcards

0
Q

Most common causes for common cold

A

Rhinovirus Coronavirus RSV Influenza HMPV …

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1
Q

Increased incidence of colds

A

Mannose binding lectin deficiency

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2
Q

False negative sweat chloride

A

Malnutrition Edema Insufficient sweat Hyponatremia CFTR mutation but normal sweat

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3
Q

OSA symptoms

A

Morning headache FTT Pulmonary HTN Neurocognitive effect Growth Obesity/HTN Fatigue Apnea-hypopnea index=if under 12 > 1.5 per hour, if greater than 12 > 5 per hour

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4
Q

Pneumothorax causes

A

Primary- idiopathic sub pleural bleb, marfan, erlers danlos Secondary-CF, pneumonia, asthma, malignancy Ecstasy

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5
Q

Anterior mediastinal mass

A

5 t s Teratoma Thymoma Terrible lymphoma Thymus Thyroid T cell leukaemia Cystic hygroma Intrathoracic goiter

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6
Q

Posterior mediastinum mass

A

Neurogenic tumours Neurofibroma

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8
Q

Penicillin allergic pneumonia treatment

A

Azithromycin Clarithromycin

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9
Q

what is pulsus paradoxus? and when does it occur?

A

> 10 mmgh - large decrease in systolic blood pressure and pulse wave amplitude during inspiration. Cardiac tamponade, severe dyspnea, obesity, and positive pressure ventilator support, constrictive pericarditis, tension pneumo, large PE

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10
Q

what PFT features will be affected in restrictive lung disease

A

decreased TLC, VC and resting lung volume

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11
Q

what PFT features will be affected in OBSTRUCTIVE lung disease

A

decreased peak exp flow and FEV1

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12
Q

what are the bad bugs for CF?

A

staph aureus H.Flu Pseudomonas aeroginosas Burhoderia cepacia Stenotrophomonas Maltophilia Aspergillus

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13
Q

what are the genetics of CF

A

AR in CFTR gene on long arm of Chrom 7 3 base pair deletion Delta 508 - 70%

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14
Q

which CF bugs are associated with worst outcome

A

Pseudomonas Burkoderia cepacia

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15
Q

what autoimmune disorders can present with hemoptysis?

A

HSP idiopathic pulmonary hemosiderosis Goodpasture’s Wegener’s SLE polyarteritis nodosa

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16
Q

causes of cough in first month of life

A

CRADLE CF Resp infection-viral Aspiration - swallowing issues, GERD, TEF, FB Dyskenisia - ciliary Lung and airway malformation - laryngeal web, malacia, Edema - cardiac

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17
Q

what causes exudative pleural effusion

A

All high! prot, sp gravity… pneumonia TB Malignancy SLE Chylothorax

18
Q

what causes transudate pleural effusions

A

CHF hypoproteinemia state cirrhosis upper airway obstruction

19
Q

what is Kartagener Syndrome

A

Version of primary ciliary dyskinesia situs inversus chronic sinusitis bronchiectasis

20
Q

which is more specific - intradermal skin test for allergies or Prick skin test

A

prick skin test

21
Q

which is more sensitive - in vitro testing for allergies or skin testing?

A

Skin Testing!

22
Q
A
23
Q

Allergic Bronchopulmonary Aspergillosis

What are the clinical features?

A

hypersensitivity reaction to Aspergillus in CF

leads to inflammation and obstruction

Rx: steroids and antifungal (Voriconazole)

24
Q

What are causes of restrictive lung disease?

A

they have decreased lung compliance

  • neuromuscular weakness
  • alveolar filling process: lobar pneumonia, pulm edema
  • pleural disease
  • thoracic narrowing - scoliosis
  • abdo distention
25
Q

what are causes of Chronic Cough

A
  1. asthma
  2. post nasal drip
  3. post infectious tussive syndrome
  4. GERD
  5. tracheoesophageal fistula
  6. tracheomalacia
  7. chronic infection
  8. FB
  9. psychogenic
  10. environmental
26
Q

patients with congenital central alveolar hypoventilation syndrome have a increased risk of..

A

Hirschsrpung and neural crest tumors

defect in PHOX2B

27
Q

what are secondary causes of central hypoventilation

A
  1. narcotics
  2. Chiari malformation
  3. inc ICP
  4. CNS tumour
  5. mitochondrial/metabolic disorder
  6. dysautonomia
28
Q

what syndrome is associated with choanal atresia

A

10-20% with Choanal atresia have CHARGE syndrome

Coloboma,

Heart disease,

Atresia choanae,

Retarded growth(development, CNS anomalies or

Genital anomalies or hypogonadism or both, and

Ear anomalies or deafness or both

29
Q

what are causes of vocal cord paralysis?

A
  1. left recurrent laryngeal nerve is more susceptible
  2. trauma - thoracic procedure
  3. mediastinal lesion
  4. Central - chiari malformation, hydrocephalus, intracranial hemorrhage
30
Q

how does vocal cord paralysis present?

A

biphasic stridor

weak cry

hoarsness

aphonia

inc risk of aspiration

should improve in 3-6 mo, likely permanent after 1 year

31
Q

what is the most common cause of tracheal compression

A

anomalous innominate artery-arises more distally than normal from aortic arch

32
Q

when is a cough deemed chronic?

A

> 4-8 weeks

33
Q

What are CXR findings suggestive of foreign body aspiration

A
  1. localized emphysema
  2. pneumonia
  3. atelectasis
  4. normal
34
Q

what electrolyte abnormality would you expect with CF

A

hyponatremic

hypochloremic

metabolic alkalosis

35
Q

what % of CF can be missed with the newborn screen?

A

5%

36
Q

what are prognostic factors for CF?

A

MAles do better

FEV1

Burkohderia Cepacia

pneumotorax

nutrition status

DM

37
Q

if a patient comes to you with year round wet cough and nasal congestion, recurrent AOM. What should you think of?

A

primary ciliary dyskinesia

Hx of neonatal resp distress and 47% have laterality defects

Dx on electron microscopy

38
Q

if a patient has recurrent aspiration pneumonias, what is in your DDX

A
  1. laryngeal cleft - VACTRL, CHARGE, midline defects
  2. H type fistula - gold standard is rigid brnch
39
Q

what are features of psychogenic cough

A

honking

disapears at night

no other features

worse with stress

can last months to years

all investigations are normal

40
Q

what are 3 important investigatons to do for chronic wet cough?

A

CXR

PFT and bronchodilator response

Sweat test

41
Q

for CF with resp exacerbation. What Abx choice?

A

cetfatzidine + Tobramycin for pseudomonas

+ Staf aureus coverage

Respirology (2 decks)

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