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Phase 2A (HV) > Miscellaneous- Resp > Flashcards

Miscellaneous- Resp Flashcards

1
Q

What is the pharmacological tx for idiopathic pulmonary fibrosis

A

Pirfinedone

Nintedanib

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2
Q

Sign of strep pneumonia infection

A

Herpes labialis- blisters on lower lip

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3
Q

Which lung cancer most common in non-smokers

A

Adenocarcinoma

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4
Q

CXR signs/appearance of idiopathic pulmonary fibrosis

A

Honeycombing and ground glass appearance in lung parenchyma

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5
Q

Sings of sarcoidosis

A 
Erythema nodosum
Bihilar lymphadenopathy
Lupus Pernio- plaques of discolouration on cheeks, ears and nose
Facial palsy
Signs of hypercalcaemia 
Arrhythmias
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6
Q

Sx of sarcoidosis-

A 
Fever
Dry cough 
Uveitis
Weight loss
Malaise 
Polyarthralgia
SOB
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7
Q

What is sarcoidosis

A

A multi system chronic granulamatous disorder affecting skin, eyes and lungs

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8
Q

Features of Churg-Strauss syndrome

A

Nasal congestion
Adult onset asthma
Peripheral neuropathy
Glomerulonephritis

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9
Q

Gs investigation for bronchiectasis

A

HRCT- high resolution CT

Thickened dilated airways w or w/o fluid levels

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10
Q

What may you see on a CXR in someone with bronchiectasis

A

Kerley b lines

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11
Q

What nature can pleural fluid be off?

A

Transudative

Exudative

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12
Q

List 4 causes of transudative pleural fluid effusion

A

Hypothyroidism
Heart failure
Hypoalbuminaemia
Meigs syndrome

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13
Q

List causes of an exudative pleural effusion

A 
RIPPELD
Rheumatoid arthritis 
Infections 
Pancreatitis 
PE
Lung cancer 
Dressler’s syndrome
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14
Q

A stony dull percussion indicates what

A

Pleural effusion

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15
Q

What changes may be seen in a CXR in someone with pleural effusion

A

Blunting of the costophrenic angle
Fluid in lung fissure
Tracheal and mediastinal deviation if big effusion
Large effusions will have meniscus

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16
Q

Gs investigation for pleural effusion

A

Pleural ultrasound- more sensitive and specific compared to CXR

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17
Q

What lung cancer is strongly associated with smoking

A

Squamous cell carcinoma

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18
Q

Cancer can spread to the lungs from what areas

A 
Kidney 
Prostate 
Breast 
Bowel 
Bladder
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19
Q

Lung cancer can metastasise to which sites

A

Brain
Adrenals
Bone
Liver

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20
Q

What ECG Changes may you see in COPD

A

Prominent P wave in inferior leads (II,III, aVF)
Right axis deviation
Low voltage QRS
RBBB

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21
Q

What would you hear on auscultation in patient with idiopathic pulmonary fibrosis

A

Fine bi-basal end inspiratory crackles

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22
Q

What is croup

A

Laryngotracheobronchitis- URTI characterised by a seal like barky cough, voice horseness, stridor and resp distress

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23
Q

What is the tx for empyema

A

Broad spectrum abx- ceftriaxone and metronidazole
Chest tube drainage
Supportive care
Fluid resuscitation

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24
Q

What is the characteristics of empyema fluid

A

Yellow, turbid
Ph less than 7.2
Low glucose
High ldh

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25
Q

Gold standard investigation for mesothelioma

A

Video assisted thorascopic surgery (VATS)

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26
Q

What paraneoplastic syndromes are associated with small cell lung cancers

A

ACTH- Cushings
SIADH
Lambert Eaton myasthenia syndrome

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27
Q

What paraneoplastic syndromes is associated with non small cell lung cancer

A

Hyperparthyroidism

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28
Q

List 5 causes of respiratory alkalosis

A 
Panic attack
PE
CNS Infection
Anaemia
Aspirin overdose
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29
Q

List 3 causes of respiratory acidosis

A

Airway obstruction
Opiate overdose- decreased ventilatory drive
Ventilatory muscle inadequacy- neuromuscular disorders, exhaustion

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30
Q

List 5 causes of metabolic acidosis

A 
DKA
Lactic acidosis
Renal tubular acidosis
Sepsis 
Metformin poisoning
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31
Q

List 5 causes of metabolic alkalosis

A 
Vomiting 
Diarrhoea
Milk alkali syndrome 
Liquorice 
Conns syndrome
32
Q

What would be seen on histology of an asthmatic

A

Charcot Leyden crystals and crushmann spirals

33
Q

which pathology would psommoma bodies be indicative of

A

Mesothelioma

34
Q

A Reid index of >50% is an indicator in which disease

A

Chronic bronchitis

35
Q

What drug should be given for prophylaxis against the se of isoniazid

A

Pyridoxine hydrochloride

36
Q

What is meigs syndrome

A

A triad of

  • benign ovarian tumour
  • Ascites
  • pleural effusion
37
Q

What stain can be used to diagnose pneumocystis jivorecii

A

Silver stain

38
Q

What are the signs of TB on CXR

A 
Ghon focus
Dense homogenous opacity 
Hilar lymphadenopathy
Pleural effusions 
Tree in a bud sign- nodules w/ poorly defined margins
39
Q

Differentials for bi-hilar lymphadenopathy

A 
Sarcoidosis 
Silicosis 
Hodgkin lymphoma 
Mycoplasma 
TB
40
Q

What tumour causes horners syndrome

A

Pancost tumour in the apex of the lung

41
Q

Signs of bronchiectasis

A

Clubbing
Coarse inspiratory crepitations

42
Q

Complications of COPD

A

Respiratory infections
Lung cancer
Pneumothorax
ARDS

43
Q

Differentials of COPD

A

Asthma
Bronchiectasis
TB
Congestive HF

44
Q

What is haemophilius influenzae

A

A gram negative coccobacillus

45
Q

Antibiotics used to treat h.influenzae

A

Co-amoxiclav

Doxycycline

46
Q

Signs of interstitial pulmonary fibrosis

A

Cyanosis
Clubbing
Fine end inspiratory crackles

47
Q

Signs of pleural effusion

A

Stony dull on percussion
Chest expansion reduced on affected side
Decreased vocal resonance/tactile fremitus on affected Side

48
Q

Signs of pneumothorax

A

Hyper-resonant percussion on affected side
Decreased or absent breath sounds on affected side
Decreased vocal resonance/tactile fremitus on affected side

49
Q

Signs of pneumoniae

A

Dull percussion
Increased vocal resonance/ tactile fremitus
Pleural rub
Bronchial breathing

50
Q

Signs of COPD

A

Hyperinflation
Hyper-resonance on percussion
Reduced chest expansion
Decreased/quiet breath sounds

51
Q

Most likely HAP organisms

A

Pseudomonas aureginosa

Staph aureus

52
Q

Where is the most appropriate site for a needle thoracostamy to treat tension pneumothorax

A

2nd intercostal space, midclavicular line, same side as pneumothorax

OR

5th intercostal space, anterior axillary line, same side as pneumothorax

53
Q

Abx to five according to CURB-65

A

0-1= amoxicillin po
2- amoxicillin and clarithromycin/doxycycline
3-5= iv co-amoxiclav and clarithromycin

54
Q

What criteria is used to classify cause of Pleural effusion

A

Lights criteria

55
Q

What drugs can cause pulmonary fibrosis

A

Nitrofurnatoin
Amiadorone
Methotrexate
Bleomycin

56
Q

If PE score is less than 4 what is next line management

A

D dimer

57
Q

If PE score is more than or equal to 4 what’s the next step

A

CTPA and start on DOAC

58
Q

What is the worst prognosis bases infection that can be acquired by someone with bronchiectasis

A

Pseudomonas aureginosa

59
Q

List 5 causes of finger clubbing

A 
Bronchiectasis 
Cystic fibrosis 
VSD 
IPF
Lung cancer
60
Q

What abx is used to treat legionella pneumoniae

A

Clarithromycin

61
Q

What is lofgrens triad

A

Erythema nodusum
Arthralgia
Bilateral hilar lymphadenopathy

62
Q

What may tests may be high in sarcoidosis

A

Serum ACE

Hypercalcaemia

63
Q

List 5 differentials for dry cough

A 
Asthma 
Gord
Pulmonary fibrosis 
Ramipril induced
Sleep apnoea
64
Q

List t differentials for sputum/wet cough

A

COPD
Bronchiectasis
Acute bronchitis
HF
Cystic fibrosis

65
Q

Gs Ix for IPF

A

HRCT

66
Q

What prophylaxis abx is given in COPD

A

Azithromycin

67
Q

How many cigarettes is 1 pack year equal to

A

20

68
Q

A- What is the key tell tale sign of acute apiglottis

B- gs Ix

C- tx

A

A- Pts lean forward in tripod position and extend their neck

B- laryngscopy

C- secure airway, I’ve antibiotics, supplemental o2 and corticosteroids

69
Q

What is the most common cause of croup

A

Parainfluenza virus

70
Q

What is the key tell tale sign of croup

A

Seal like barky cough

71
Q

Tx for croup

A

Dexamethasone and supportive care

72
Q

Most common cause of bronchiolitis

A

RSV

73
Q

List 5 causes of bronchiectasis

A 
Congenital- primary ciliary dyskinesia, CF
Bacterial infection 
COPD
CT disease 
RA
Idiopathic
74
Q

List 4 causes of hypersensitivity pneumonitis

A

Malt workers lung
Pigeon fanciers lung
Farmers lung
Cheese workers lung

Associated with jobs and hobbies

75
Q

What kind of hypersensitivity reaction is hypersensitivity pneumonitis

A

TYPE 3

76
Q

2hat paraneoplastic syndromes is small cell lung cancer associated with-

A

SIADH
CUSHINGS/ADDISON
LEMS
CEREBELLAR DEGENERATION

77
Q

Give 2 medications that can be used to treat pulmonary hypertension

A

Phosphodiesterase inhibitors- sildenafil
Calcium channel blocker- amlodipine
Endothelial receptor antagonist
IV prostanoids

Phase 2A (HV) (13 decks)

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