Miscellaneous Flashcards
What are the respiratory clauses of nail clubbing?
Lung cancer Pyogenic conditions: cystic fibrosis, bronchiectasis, abscess, empyema Tuberculosis Asbestosis, mesothelioma Fibrosing alveolitis
What is Kartagner’s syndrome?
Primary ciliary dyskinesia
What are the features of Kartagner’s syndrome?
Dextrocardia or complete situs inversus
Bronchiectasis
Recurrent sinusitis
Subfertility (secondary to diminished sperm motility and defective ciliary action in the fallopian tubes)
What conditions cause fibrosis predominatly affecting the upper zones?
CHARTS
Coal workers' pneumoconiosis Histiocytosis/hypersensitivity pneumonitis (EAA) Ankylosing spondylitis Radiation Tuberculosis Silicosis Sarcoidosis
What conditions cause fibrosis predominantly affecting the lower zones?
More common conditions
Idiopathic pulmonary fibrosis
Connective tissue disorders e.g. SLE
Asbestosis
Drug induced: amiodarone, bleomycin, methotrexate
What is microscopic polyangiitis?
Small-vessel ANCA vasculitis?
What are the features of microscopic polyangiitis?
Renal impairment: raised creatining, haematuria, proteinura
Fever
Systemic symptoms: letherapy, myalgia, weight loss
Rash: palpable purpura
Cough, dyspnoea, haemoptysis
Mononeuritis multiplex
What are the investigations of microscopic polyangiitis?
pANCA
cANCA
What is Psittacosis?
An infection caused by chlamydia psittaci (atypical pneumonia).
What is the pathology of Psittacosis?
Transmission from birds or bird secretions
What are the symptoms of Psittacosis?
Flu-like symptoms (90%): fever, headache, myalgia Respiratory symptoms (82%): dyspnoea, dry cough, chest pain
What are the signs of Psittacosis?
Chest: unilateral crepitation and vesicular breathing
Abdomen: hepatomegaly and splenomegaly
What are the investigations of Psittacosis?
Raised inflammatory markers
Chest x-ray: consolidation (90%)
Confirm with serology
What is the treatment of Psittacosis?
1st line: doxycycline (tetracyclines)
2nd like: erythromycin (macrolides)
What conditions can cause a respiratory acidosis?
COPD
Decompensation in other respiratory conditions e.g. life-threatening asthma / pulmonary oedema
Neuromuscular disease
Obesity hypoventiation syndrome
Sedative drugs: benzodiazepines, opiate overdose.
What conditions can cause a respiratory alkalosis?
Anxiety leading to hyperventilation Pulmonary embolism Salicylate poisoning CNS disorders Altitude Pregnancy
When should immediate antibiotic prescribing approach be considered?:
Children <2 years with bilateral acute otitis media
Children with otorrhoea who have acute otitis media
Patients with acute sore throat/acute pharyngitis/acute tonsillitis when 3 or more centor criteria are present.
If the patient is at risk of developing complications or and systemically unwell this immediate approach may also be appropriate.
(T1T2DM, HF, oral glucocorticoids)
(otherwise a delayed approach may be better)
What are the centor criteria?
Presence of tonsillar exudate
Tender anterior cervical lymphadenopathy or lymphadenitis
History of fever
Absence of cough
If there is a centor criteria score of 3 or more, what is the likely cause of a sore throat?
Group A Beta-haemolytic Streptococcus
What are the respiratory manifestations of RA?
Pulmonary fibrosis Pleural effusion Pulmonary nodules Bronchiolitis oblitereans Methotrexate pneumonitis Pleurisy Caplan's syndrome Infection secondary to immunosuppresion
What is silicosis?
A fibrosing lung disease caused by the inhalation of fine particles of silica.
What occupations are at risk of developing silicosis?
Mining
Slate works
Foundries
Potteries
What are the chest x-ray features of silicosis?
Fibrosing lung disease
‘Egg-shell’ calcification of the hilar lymph nodes
What drugs can be used in the aid of smoking cessation?
Nicotine replacement therapy
Varenicline
Bupropion
