Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 3 OSCE > Miscellaneous Respiratory > Flashcards

Miscellaneous Respiratory Flashcards

1
Q

What is hypersensitivity pneumonitis/extrinsic allergic alevolitis?

A

Hypersensitivity induced lung damage due to inhaled organic particles (bird fanciers lung, farmers lung, mushroom workers lung)

NB- not coal miners lung (that’s different)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Features of hypersensitivity pneumonitis

A

Lethargy, dyspnoea, productive cough, anorexia and weight loss

NB- weeks-months after exposure (may have dyspnoea, fever, dry cough a few hours after the exposure)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Investigations for hypersensitivity pneumonitis

A

Imaging- fibrosis
Lavage- lymphocytosis
Blood- no eosinophilia
Specific IgG antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Management of hypersensitivity pneumonitis

A

Avoid precipitating factor
Oral glucocorticoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Kartageners syndrome (primary ciliary dyskinesia)

A

Dectrocardia or complete situs invertus (quiet heart sounds or small volume complexes in lateral leads), inverted p wave lead I
Bronchiectasis
Recurrent sinusitis
Subfertility (male and female)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Causes of upper zone fibrosis

A

CHARTS

Coal workers pneumoconiosis
Histiocytosis/hypersensitivity pneumonitis
AS (think that there is an AS in charts, and AS affects spine which is an “upper” problem)
Radiation
TB
Silicosis/sarcoidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Causes of lower zone fibrosis

A

MAID

Most connective tissues diseases (eg. SLE, alpha 1 antitrypsin, except ankylosing spondylitis)
Asbestosis
IPF
Drug induced eg. Amiodarone, bleomycin, methotrexate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Obstructive sleep apnoea predisposing features

A

Obesity
Macroglossia- acromegaly, hypothyroidism, amyloidosis
Large tonsils
Marfan’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Consequences of obstructive sleep apnoea

A

Daytime somnolence
Compensated respiratory alkalosis
Hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Assessment of OSA

A

Epworth sleepiness scale
Sleep studies (polysomnography)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Management of OSA

A

Weight loss
CPAP
Intraoral device
Tell DVLA if causing daytime sleepiness
Surgery last resort

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Respiratory manifestations of RA

A

Pulmonary fibrosis
Pleural effusion
Pulmonary nodules
Bronchiolitis obliterans
Drug SE’s- methotrexate pneumonitis
Caplans syndrome- fibrotic nodules with coal dust exposure
Infection secondary to immunosuppression
Pleurisy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Features of sarcoidosis

A

Acute- erythema nodosum, bilateral hilar lymphadenopathy, swinging fever, polyarthralgia
Insidious- dyspnoea, non productive cough, malaise, weight loss, night sweats
Skin- lupus pernio
Hypercalcaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Lofgrens syndrome

A

Acute disease. Bilateral hilar lymphadenopathy, erythema nodosum, fever and poly arthralgia secondary to sarcoidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Heerfortds syndrome

A

Parotid enlargement, fever, uveitis secondary to sarcoidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Staging sarcoidosis

A

0- normal
1- BHL
2- BHL + interstitial infiltrates
3- diffuse interstitial infiltrates
4- diffuse fibrosis

17
Q

Management of sarcoidosis

A

Conservative- lifestyle measures

Medical- Steroid indications;
-CXR stage 2/3 with symptoms
-hypercalcaemia
-eye heart or neuro involvement

If steroids unsuccessful, try methotrexate or azathioprine

Surgical- transplant for end-stage fibrosis

18
Q

Features of silicosis

A

Fibrosis lung disease
Egg shell calcification of hilar lymph nodes

19
Q

Lupus pernio

A

Raised purple plaque that appears on face is associated with sarcoidosis

20
Q

Kartageners syndrome

A

Dextrocardia or complete situs invertus (quiet heart sounds, small volume complexes in lateral leads)
Bronchiectasis
Recurrent sinusitis
Subfertility

21
Q

Causes of white shadows in CXR

A

consolidation
pleural effusion
collapse
pneumonectomy
specific lesions e.g. tumours
fluid e.g. pulmonary oedema

22
Q

Causes of a white out with a central trachea

A

Consolidation
Pulmonary oedema (usually bilateral)
Mesothelioma

23
Q

Relative contraindications of a chest drain

A

INR >1.3
Platelet count <75
Pulmonary bullae
Pleural adhesions

24
Q

Yellow nail syndrome

A

Nail discolouration and dystrophy
Lymphoedema
Chronic respiratory disorder

25
Q

Bilateral hilar lymphadenopathy

A

Sarcoidosis
TB
Malignancy (lymphoma)
Pneumoconiosis
Fungi

26
Q

Investigations for sarcoidosis

A

Clinical diagnosis, but tests to perform on anyone who is presenting with breathlessness;

Bedside- observations, cardiorespiratory examination, ECG, urine dipstick (kidney involvement), ophthalmoscopy (eye involvement)
Bloods- FBC UE LFT ESR CRP bone profile (hypercalcaemia in 10%)
Imaging- CXR, bronchoscopy with ultrasound guided biopsy of mediastinal lymph nodes (gold standard), USS of abdomen for other organ involvement, TTE (cardiac involvement)

27
Q

Empyema CXR

A

lenticular crescentic opacity

28
Q

Simple manoeuvres that can open airway

A

head tilt / chin lift
jaw thrust: preferred if concern about cervical spine injury

29
Q

Oropharyngeal airway

A

Easy to insert and use
No paralysis required
Ideal for very short procedures
Most often used as bridge to more definitive airway

30
Q

Laryngeal mask

A

Widely used
Very easy to insert
Device sits in pharynx and aligns to cover the airway
Poor control against reflux of gastric contents
Paralysis not usually required
Commonly used for wide range of anaesthetic uses, especially in day surgery
Not suitable for high pressure ventilation (small amount of PEEP often possible)

31
Q

Tracheostomy

A

Reduces the work of breathing (and dead space)
May be useful in slow weaning
Percutaneous tracheostomy widely used in ITU
Dries secretions, humidified air usually required

32
Q

Endotracheal tube

A

Provides optimal control of the airway once cuff inflated
May be used for long or short term ventilation
Errors in insertion may result in oesophageal intubation (therefore end tidal CO2 usually measured)
Paralysis often required
Higher ventilation pressures can be used

Year 3 OSCE (61 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions