grey folder Q Flashcards
Ipratropium group?
Antimuscarinic bronchodilators
Ipratropium 2 main uses?
Asthma
(2) COPD
Ipratropium moa?
Inhibit M1-3 muscarinic
receptors –> bronchodilation
Ipratropium 2 important side effects
Dry mouth
GI upset
Dalteparin class?
low molecular weight heparin
Naftidrofuryl affect on blood vessels?
vasodilation
Dalteparin moa>
inhibits factor X and thrombin
citalopram moa?
SSRI
gliclazide group?
sulfonylurea
gliclazide main use?
diabetes
Amlodipine moa?
Ca2+ channel blocker
Amlodipine main uses?
-2
HTN
ischaemic heart disease aka coronary artery disease
on CXR you see many white clouds/balls.
what is this called?
usual causes?
-2
cannonball metastases
renal or testicular cancer
antidote to heparin?
protamine sulfate
antidote to warfarin?
vit K
someone is bleeding a lot.
what antifibrinolytics can you give that makes more blood clots?
tranexamic acid
surgical treatment for haemoptysis in lungs called?
what does it invole
Bronchial artery embolization
catheter into bronchial artery, find bleeding, and put clot there (metallic coil, or gelatin sponge)
most common infective cause for acute exacerbation of COPD?
haemophilus influenzae
most common viral infective cause for acute exacerbation of COPD?
rhinovirus
acute exacerbation of COPD.
what anti-inflammatory for you give?
- name
- strength
- how long
prednisolone
30mg
7-14 days
2 main pathological features happening inside lungs of acute respiratory distress syndrome?
pulmonary oedema (fluid in alveoli) diffuse lung inflammation
pt has acute respiratory distress syndrome.
what ward do they go to?
ITU
pt has acute respiratory distress syndrome.
with low O2, low BP and is septic.
Mx?
-3 things
give O2
give vasopressors
antibiotics (if infected)
pt has acute respiratory distress syndrome.
what can happen to BP?
low BP
pt has acute respiratory distress syndrome.
what Ix is used to check there is no cardiogenic cause?
pulmonary artery wedge pressure
main imaging test for acute respiratory distress syndrome.
what do you see?
CXR
fluid in lungs/alveoli
pt has acute respiratory distress syndrome.
what do you hear on auscultation?
bilateral lung crackles
acute respiratory distress syndrome mortality rate?
40%
what is allergic bronchopulmonary aspergillosis?
allergic reaction to aspergillus spores
pt has allergic bronchopulmonary aspergillosis.
what are the 2 main abnormal changes that happen inside the lungs?
bronchoconstriction
bronchiectasis
pt has allergic bronchopulmonary aspergillosis.
because this is an allergic reaction,
what leukocyte will be raised?
eosinophils
pt has allergic bronchopulmonary aspergillosis.
because this is an allergic reaction,
what antibody will be raised?
name of test to check if this antibody is raised?
IgE
radioallergosorbent test
1st line drug class allergic bronchopulmonary aspergillosis?
corticosteroids
2nd line drug allergic bronchopulmonary aspergillosis?
-name
group of this drug?
itraconazole
antifungal
alpha-1-antritypin protects against what enzyme?
neutrophil elastase
alpha-1-antritypin deficiency causes what lung problem?
emphysema
alpha-1-antritypin deficiency causes what liver problem?
hepatocellular carcinoma
alpha-1-antritypin deficiency can cause what problem in children?
cholestasis
pt has alpha-1-antritypin deficiency.
1st line lifestyle change?
stop smoking
main Ix to check alpha-1-antritypin deficiency levels?
alpha-1-antritypin concentration (blood test)
what drug can be used prophylactically against altitude sickness?
class?
acetazolamide
carbonic anhydrase inhibitors
drug to treat pulmonary oedema caused by high altitude?
moa/class?
nifedipine
Ca2+ channel blocker
drug to treat cerebral oedema caused by high altitude?
class?
dexamethasone
corticosteroid
3 main symptoms of asthma?
wheeze
tight chest
SOB
spirometry result on asthma, what goes down?
FEV1
FEV/FVC ratio of asthma?
<0.7
is asthma obstructive or restrictive?
obstructive
suspected asthma in adult,
2 main Ix used to diagnose?
spirometry with bronchodilator reversibility test
FeNO (fractional exhaled nitric oxide)
suspected asthma in adult,
2 main Ix used to diagnose?
positive result for asthma in each?
spirometry with bronchodilator reversibility test - FEV/FVC ratio is < 0.7 & FEV1 improves by 12%
FeNO (fractional exhaled nitric oxide) - adults >40ppb = positive
biggest risk factor for atelectasis?
surgery
what is bilateral hilar lymphadenopathy?
enlarged lymph nodes at both lung’s hila
bilateral hilar lymphadenopathy, most common causes?
-2
sarcoidosis
tuberculosis
1st line drug for bilateral hilar lymphadenopathy that is symptomatic?
-name
prednisolone
1st line Mx for bilateral hilar lymphadenopathy that is asymptomatic?
do nothing
person has bronchiectasis.
hallmark feature on CXR?
tram lines
person has bronchiectasis.
hallmark feature on CXR?
tram tracks
hallmark symptom of bronchiectasis
daily purulent sputum production
person has bronchiectasis.
hallmark feature on CT?
signet ring
what do you give all together to someone having an acute asthma attack?
-4
O2
salbutamol
hydrocortisone
ipratropium
lots of coal dust exposure causes what lung disease?
coal worker’s pneumoconiosis
what is the main white blood cell implicated in coal worker’s pneumoconiosis?
high levels of this wbc in the alveoli causes what basically?
macrophages
alveoli/ lung damage
coal worker’s pneumoconiosis spirometry result and ratio?
low FVC
FEV1/FVC >0.7
is coal worker’s pneumoconiosis obstructive or restrictive?
restrictive
coal worker’s pneumoconiosis, CXR findings?
-2 main features seen
opacities
fibrosis
churg strauss syndrome is aka?
Eosinophilic granulomatosis with polyangiitis
what is churg strauss syndrome?
an antineutrophil cytoplasmic antibodies (ANCA) associated small-medium vessel vasculitis
which antibody is implicated in churg strauss syndrome?
abbreviation for this antibody?
name of blood test to check for this antibody?
antineutrophil cytoplasmic antibodies
ANCA
serum ANCA
what inflammatory maker do you check for in churg strauss syndrome and will be raised?
↑CRP
symptoms of churg strauss syndrome?
-3
allergic rhinitis - sneeze
sinusitis - blocked nose
asthma - wheeze
churg strauss syndrome, what is seen on rhinoscope?
polyps
causes of chronic cough?
smoking ACE-I Upper airway cough syndrome aka post-nasal drip asthma GORD
main 3 lower respiratory symptoms?
nose - runny, blocked, sneezing
sore throat
hoarse voice
main 3 upper respiratory symptoms?
cough
wheeze
dyspnoea/SOB
hypersensitivity pneumonitis is aka?
extrinsic allergic alveolitis
define hypersensitivity pneumonitis aka extrinsic allergic alveolitis?
inflammation of the alveoli and bronchioles caused by immune response to inhaled allergens?
hypersensitivity pneumonitis aka extrinsic allergic alveolitis:
bird fancier’s lung is caused by which allergen?
acvian protein
hypersensitivity pneumonitis aka extrinsic allergic alveolitis:
farmer’s lung is caused by which allergen?
Saccharopolyspora rectivirgula spores
hypersensitivity pneumonitis aka extrinsic allergic alveolitis:
malt worker’s lung is caused by which allergen?
aspergillus clavatus
hypersensitivity pneumonitis aka extrinsic allergic alveolitis:
thermophilic actinomycetes will cause what type of hypersensitivity pneumonitis?
mushroom worker’s lung
define granuloma?
small pocket of macrophages
what is epistaxis?
bleeding from nose
what two drug can be used for daytime sleepiness?
ritalin
modafinil
most common carbon monoxide poisoning symptoms?
headache
carbon monoxide poisoning symptoms?
-4
headache
N&V
confusion
vertigo
pt has suspected carbon monoxide poisoning.
what should you measure in their blood?
what test will measure this?
carboxyhaemoglobin levels
venous or arterial blood gas analysis
carbon monoxide poisoning, gold.S Ix?
venous or arterial blood gas analysis
what is sarcoidosis?
diagnosis of exclusion of granulomatous lung disease from unknown aetiology
what category of diagnosis is sarcoidosis?
diagnosis of exclusion
cause of sarcoidosis?
unknown
ethnicity at risk of sarcoidosis?
afro-Caribbean
gender at risk of sarcoidosis?
female
age group at risk of sarcoidosis?
young adults
symptoms of sarcoidosis?
-2
erythema nodosum
lupus pernio
auscultate pt with sarcoidosis, what do you hear?
-2
wheeze and rhonci
what is lupus pernio?
raised, purple lesions on skin of face
difference between wheeze and rhonci?
what structural changes in airways causes wheeze and rhonci?
wheeze - high pitched
rhonci - low pitched
narrowed airway
1st line Ix for sarcoidosis?
CXR
1st line MX for sarcoidosis?
- drug class
corticosteroids
what is a pneumothorax?
air in pleural space
what is a primary pneumothorax?
resp illness not present
what is a secondary pneumothorax?
resp illness present
tension pneumothorax Mx?
asap decompression with needle
Immediate supportive Mx for a pneumothorax?
give Ox
conclusive Mx for a pneumothorax?
-2 options
needle aspiration or chest drain
what happens to trachea in pneumothorax?
shifts to contralateral side
in pneumothorax what do you notice on percussion?
why?
ipsilateral side hyper-resonant
this side has more air
gold.S Ix for PE?
CTPA
best blood test to check PE?
D-dimer
PE symptoms?
-3
bed side PE observations?
-2
pleuritic chest pain
haemoptysis
SOB
tachycardia
tachypnoea
PE Mx acute?
- drug name
PE Mx 24 hours after above drug given?
- drug name
low molecular weigh heparin
warfarin
massive PE Mx?
thrombolysis
most common cause of bronchiolitis in children?
respiratory syncytial virus
severity and prognosis for most respiratory syncytial virus infections?
mild
& self limiting
what is rhinorrhoea?
nose filled with mucus
is respiratory syncytial virus usually an upper or lower resp tract infection?
lower resp tract infection?
respiratory syncytial virus symptoms?
cough
wheeze
rhinorrhoea
high respiratory rate
child with respiratory syncytial virus comes to GP.
GP’s 1st line Ix?
pulse oximeter
child with respiratory syncytial virus.
1st line Mx to relieve rhinorrhoea?
suction bulb
for a moderate respiratory syncytial virus infection.
what drug do you give?
- name
- class
prednisolone
corticosteroids
what category of diagnosis is influenza?
clinical diagnosis
influenza symptoms?
-5
rhinorrhoea cough fever headache myalgia
1st line Mx for most influenza pts?
- 2 drugs
- give names
paracetamol or ibuprofen
what antiviral Mx can be used for more severe influenza?
oseltamivir
hallmark feature of measles?
koplik (red) spots in mouth then rash
what type of blood Ix is used to confirm measles?
what are you checking for in the blood sample?
ELISA - enzyme-linked immunosorbent assay
measles specific IgM antibodies
1st line Mx for most measles patients?
- 2 drugs can be given (give names)
supportive - paracetamol or ibuprofen
asides from supportive Mx for a measles pt what other thing must be done?
why?
inform public health of infection
measles is a notifiable disease
you percuss pleural effusion.
sound?
dull
Ix to diagnose parainfluenza virus?
RT-PCR (polymerase chain reaction)
Ix for parainfluenza virus?
supportive only
age group effected by parainfluenza virus mainly?
infants
1st line Mx for pleural effusion caused by malignancy?
thoracentesis
pt has TB.
drugs for first 2 months?
drugs for next 4 months?
1st 2 months: Rifampicin Isoniazid Pyrazinamide Ethambutol
then next 4 months:
Rifampicin
Isoniazid
special test used for TB?
mantoux test