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Study Leave semester 2 year 1 > Main resp. diseases > Flashcards

Main resp. diseases Flashcards

1
Q

Lung cancer is the third most common cancer in the UK behind which other cancers

A

breast and cancer

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2
Q

non small cell lung cancer is around 20%

A

no 80%

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3
Q

which three nsclc are there

A

adenocarcinoma
squamous cell carcinoma
large-cell carcinoma

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4
Q

why is SCLC responsible for multiple paraneoplastic syndromes

A

contain neurosecretory granules that can release neuro-endocrine hormones

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5
Q

4 symptoms of lung cancer

A

Shortness of breath
Cough
Haemoptysis
Weight loss

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6
Q

Signs of lung cancer

A

finger clubbing
recurrent pneumonia
wight loss
lymphadenopathy (supraclavicular nodes first to be found on examination)

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7
Q

5 investigations for lung cancer

A

CXR
CT
PET-CT
Bronchoscopy
Histological diagnosis

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8
Q

What’s first line investigation for lung cancer

A

CXR

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9
Q

What are you looking for in a CXR for lung cancer? (4)

A

Hilar enlargement
Peripheral opacity
Pleural effusion
Collapse

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10
Q

What’s the CT for lung cancer?

A

contrast enhanced for lymph node involvement and metastasis

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11
Q

Lung cancer, why PET-CT

A

Has radioactive tracer- attaches to glucose molecules, to see how metabolically active tissues are

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12
Q

Why bronchoscopy with EBUS (endobronchial ultrasound) in lung cancer

A

Detailed assessment of tumor and ultrasound guided biopsy

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13
Q

Histological diagnosis- why in lung cancer

A

Of biopsy, from bronchoscopy or percutaneous. Is it small cell or non-small cell?

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14
Q

Treatment options for small cell lung cancer

A

Radiotherapy and chemotherapy

prognosis rubbish

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15
Q

Treatment options for nsclc? (3)

A

First line = surgery such as lobectomy, segmentectomy, wedge resection

If early enough, radiotherapy

Chemo as adjuvant, or palliative for qol

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16
Q

Otherwise asymptomatic patients in lung cancer could have evidence if:

A

paraneoplastic syndromes
extra-pulmonary manifestations

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17
Q

4 examples of extra-pulmonary manifestations of lung cancer

A

1) recurrent laryngeal nerve palsy (due to tumor)
2) phrenic nerve palsy- nerve compression, diaphragm weakness and SOB
3) superior vena cava obstruction = tumor on it, facial swelling, SOB, distended veins in neck
4) horners syndrome from pancoast tumour on sympathetic ganglion

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18
Q

Someone has lung cancer. They raise their hands, and there is facial congestion and cyanosis. Why?

A

emergency. Pressing on svc

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19
Q

what is mesathelioma

A

affects meothelial cells of the pleura

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20
Q

mesothelioma is strongly linked to what

A

asbestos inhalation

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21
Q

latent period in mesothelioma can be how long

A

even up to 45 years

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22
Q

why chemo in mesothelioma

A

to improve survival, but it is essentially palliative

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23
Q

What is pneumonia

A

infection of the lung tissue

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24
Q

what does pneumonia cause

A

inflammation, sputum filling the airways and alveoli

25
Q

Pneumonia can be seen as what on the CXR

A

consolidation

26
Q

Would haemoptysis ever present in pneumonia?

A

Yes

27
Q

6 ways pneumonia presents

A

SoB
Cough productive of sputum
Fever
Haemoptysis
Pleuritic chest pain
Delirium

28
Q

Complication of pneumonia 5 incl death

A

sepsis
pleural effusion
empyema
lung abscess
death

29
Q

whats delirium

A

acute confusion associated with infection

30
Q

Pleuritic chest pain is worse on expiration or inspiration

A

insp

31
Q

when might you see hypotension (shock) in pneumonia

A

sepsis

32
Q

signs of that may indicate sepsis secondary to pneumonia (3 groups of 2):

A

tachypnoea
tachycardia

hypoxia
hypotension (shock)

fever
confusion

33
Q

3 examination chest signs of pneumonia:

A

1) bronchial breath sounds
2) focal coarse crackles
3) dullness to percussion

34
Q

You might find bronchial breath sounds with pneumonia. What is this caused by?

A

harsh breath sounds, equally loud on inspiration and expiration.

Caused by consolidation of the lung tissue around the airway

35
Q

Focal coarse crackles can be heard in pneumonia. what causes this?

A

These are air passing through sputum in the airways similar to using a straw to blow in to a drink.

36
Q

Why hear dullness to percussion in pnunomia?

A

due to lung collapse and/or consolidation

37
Q

what’s the CURB-65 used for

A

predicting mortality

38
Q

Curb-65 stands for

A

C- confusion (new)
U- urea > 7
R- respiratory rate
B- blood pressure < 90/60
65- older than 65

39
Q

curb score of 2 or more =

A

consider hospital treatment

40
Q

curb score of 3 or more

A

consider intensive care assessment

41
Q

2 common causes of pneumonia

A

streptococcus pneumoniae
haemophilus influenzae

42
Q

would pneumonia ever be associated with cystic fibrosis and if so, what

A

staphylococcus aureus

43
Q

what don’t atypical pneumonias respond to

A

penicillins

44
Q

definition of atypical pneumonia

A

cannot be detected using a gram stain, or be normally cultured

45
Q

three ways atypical pneumonia’s can be treated

A

macrolides
fluroquinolones
tetracyclines

46
Q

Typical exam patient has recently had a cheap hotel holiday and presents with hyponatraemia (low sodium, vomiting, fatigue, headache, confusion) = what lung disease

A

pneumonia

47
Q

5 causes of atypical pneumonia: remember this mnemonic:
legions of psittaci MCQs

A

M= mycoplasma pneumoniae
C= chlamydydophila pneumoniae
Qs= Q fever

48
Q

when might fungal pneumonia occur

A

in patients that are immunocompromised

49
Q

PCP pneumonia occurs in what patients

A

immunocompromised patients

50
Q

People with low CD4 counts are prescribed what to protect against PCP

A

prophylactic oral co-trimoxazole

51
Q

minimum investigations of pneumonia in community

A

CXR
FBC for raised white cells
U&Es for urea
CRP (raised in inflammation and infection)

52
Q

Patients with moderate or severe cases of pneumonia should also have:

A

sputum cultures
blood cultures
legionella and pneumococcal urinary antigens

53
Q

inflammatory markers of pneumonia?

A

white blood cells
CRP

54
Q

Patients that are immunocompromised may not show an inflammatory response and therefore

A

may not have raised inflammatory markers

55
Q

Antibiotics for pneumonia looks like?

A

Mild CAP: 5 day course of oral antibiotics (amoxicillin or macrolide)
Moderate to severe CAP: 7-10 day course of dual antibiotics (amoxicillin and macrolide)

56
Q

pleural effusion

A

abnormal collection of fluid between pleura

57
Q

empyema

A

purulent fluid collection in the pleural space

so basically an infected pleural effusion

58
Q

lung abscess vs empyema

A

lung abscess involves the lung parenchyma, whereas an empyema involves the pleural space

Study Leave semester 2 year 1 (9 decks)

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