more respiratory diseases

Question 1

risk factors for pulmonary embolism

Answer 1

thrombosis
malignancy
surgery
immobility

Question 2

definition of embolism

Answer 2

a mass of material in the vascular system lodged in a vessel blocking its lumen

Question 3

most common cause of pulmonary embolism

Answer 3

DVT

Question 4

signs of first class pulmonary embolism

Answer 4

idiopathic pulmonary hypertension

small level pulmonary deficiency

Question 5

signs of second class pulmonary embolism

Answer 5

acute respiratory and cardiac problems
chest pain
shortness of breath
right heart strain

Question 6

ECG signs of second class pulmonary embolism

Answer 6

deep S waves in lead I

presence of Q waves and inverted T waves in lead 3

Question 7

sign of third class pulmonary embolism

Answer 7

sudden death

Question 8

treatment of pulmonary embolism

Answer 8

anticoagulants (heparin and warfarin)

thrombolysis

Question 9

risk factors for sarcoidosis

Answer 9

age 20-29
women >40
coeliac disease
Black people (increased genetic tendency)

Question 10

pathology of sarcoidosis

Answer 10

non-caseating granulomas

Question 11

signs of sarcoidosis

Answer 11

wheezing
coughing
chest pain

Question 12

diagnostic tests for sarcoidosis

Answer 12

CT
PET
biopsy
test tissues to rule out other causes
bloods - increased ESR

Question 13

treatment of sarcoidosis

Answer 13

anti-inflammatories

give corticosteroids if patient has parenchymal lung disease, uveitis, hypercalcaemia, or neurological or cardiac involvement

Question 14

pathology of idiopathic pulmonary fibrosis

Answer 14

active lung epithelium produces mediators –> differentiation in myofibroblasts –> produce excess extracellular matrix –> remodelling of lung architecture and deposition of collagen

Question 15

signs of idiopathic pulmonary fibrosis

Answer 15

dry cough
malaise
weight loss
cyanosis
finger clubbing

Question 16

complications of idiopathic pulmonary fibrosis

Answer 16

respiratory failure

increased risk of lung cancer

Question 17

diagnostic tests for idiopathic pulmonary fibrosis

Answer 17

ABG - decreased Pao2 and increased PaCO2
CXR/CT - decreased lung volume and honeycomb lung (essential for diagnosis)
spirometry - restrictive
biopsy

Question 18

treatment for idiopathic pulmonary fibrosis

Answer 18

corticosteroids
antifibrinitic drugs (pirfenidone)
tyrosine kinase inhibitors (nintedanib)
transplant

Question 19

how do tyrosine kinase inhibitors work against idiopathic pulmonary fibrosis?

Answer 19

reduce fibroblast proliferation
reduce production of collagen and fibrogenic mediators
inhibit other growth factor receptors

Question 20

risk factors for pleural effusion

Answer 20

heart failure
TB
cirrhosis

Question 21

pathology of pleural effusion

Answer 21

damage to pleura leads to secretion of fluid which is in greater volume than can be absorbed by the lymphatic system

Question 22

signs of pleural effusion

Answer 22

bronchial breathing
decreased expansion
decreased percussion (stony dull)
decreased vocal resonance

Question 23

complications of pleural effusion

Answer 23

constricts breathing

constricts cardiac contractions

Question 24

diagnosis of pleural effusion

Answer 24

CXR

fluid biopsy

Question 25

treatment of pleural effusion

Answer 25

treat underlying cause pleural tap if large effusion pleuroperitoneal shunt if chronic

Question 26

treatment of pneumothorax

Answer 26

treat primary condition | chest drain

Question 27

signs of tension pneumothorax

Answer 27

respiratory distress hypotension tachycardia tracheal deviation from side with pneumothorax

Question 28

what is a pneumothorax?

Answer 28

gas in the cavity between the lung and the chest wall, causing the lung to collapse

Question 29

pathology of pulmonary hypertension

Answer 29

high pulmonary artery blood pressure due to arterial swelling

Question 30

risk factors for pulmonary hypertension

Answer 30

``` family history prior clots in the lungs HIV mitral valve disease sickle cell LV dysfunction ```

Question 31

signs of pulmonary hypertension

Answer 31

syncope | tachycardia

Question 32

symptoms of pulmonary hypertension

Answer 32

``` shortness of breath feeling faint or dizzy chest pain palpitations oedema ```

Question 33

diagnosis of pulmonary hypertension

Answer 33

echocardiogram ECG pulmonary function tests exclude other causes

Question 34

treatment of pulmonary hypertension

Answer 34

oxygen therapy diuretics prostaglandins clotting inhibitors

Question 35

risk factors for hypersensitivity pneumonitis

Answer 35

exposure to an inhaled allergen e.g. Farmer's lung, Pigeon fancier's lung

Question 36

pathology of hypersensitivity pneumonitis

Answer 36

either type 3 or type 4 hypersensitivity

Question 37

treatment of hypersensitivity pneumonitis

Answer 37

depends on causes - e.g. antibiotics or corticosteroids

Question 38

blood test results for hypersensitivity pneumonitis

Answer 38

``` raised neutrophilia lymphocytosis eosinophilia raised ESR and CRP blood gases - hyperaemia serum antibodies ```

Question 39

signs on CT scan of hypersensitivity pneumonitis

Answer 39

patchy ground glass attenuation small, poorly defined centrilobular nodules patchy areas of air trapping evidence of pulmonary fibrosis and honeycombing if advanced

Question 40

what percentage of adult asthma is occupational?

Answer 40

15%

Question 41

what is pneumoconiosis caused by?

Answer 41

inhalation of mineral dust - e.g. asbestos, silicates, coal dust

Question 42

how many people with occupational asthma end up unemployed?

Answer 42

1/3

Question 43

what does asbestos exposure cause?

Answer 43

pleural plaques diffuse pleural thickening asbestosis mesothelioma

Question 44

diagnosis of occupational asthma

Answer 44

OASYS peak flow diary - measure every few hours - a positive work effect index is suggestive of occupational asthma

Question 45

causes of Goodpasture's syndrome

Answer 45

viral respiratory infection | breathing in hydrocarbon solvents

Question 46

how much more likely are men to develop Goodpasture's syndrome than women?

Answer 46

8x

Question 47

pathology of Goodpasture's syndrome

Answer 47

anti-glomerular basement membrane antibodies attack collagen

Question 48

signs of Goodpasture's syndrome

Answer 48

``` coughing up blood dry cough shortness of breath bloody urine burning sensation when urinating nausea and vomiting pale skin oedema ```

Question 49

treatment of Goodpasture's syndrome

Answer 49

plasmapheresis corticosteroids bp correcting medication kidney transplant

Question 50

risk factors for Wegener's granulomatosis (granulomatosis with polyangiitis)

Answer 50

genetic

Question 51

which blood vessels are inflamed in Wegener's granulomatosis

Answer 51

sinuses lungs kidneys

Question 52

pathology of Wegener's granulomatosis

Answer 52

a form of vasculitis | widespread anti-neutrophil cytoplasmic antibodies

Question 53

first sign of Wegener's granulomatosis

Answer 53

rhinitis | then goes on to cause many other problems

Question 54

diagnosis of Wegener's granulomatosis

Answer 54

test for cytoplasmic c-ANCA autoantibodies (90% cases)

Question 55

treatment of Wegener's granulomatosis

Answer 55

corticosteroids cyclophosphamide rituximab