Music Soc Revision Flashcards
Common causes of ARDS
urosepsis
covid
Symptoms of ARDS
Sudden onset
Dyspnoea
Respiratory distress
Sx of underlying cause
Define ARDS
Inflammatory mediator release causing increased capillary permeability causing oedema, impaired gas exchange and reduced lung compliance
CXR for ARDS
Ground glass appearance
Atopic triad in asthma
Eczema
Rhinitis
Asthma
FH of atopy incl. hayfever
Asthma symptoms + exacerbation symptoms
Cough worse in the morning or wakes someone up at night
Asthma signs
FEV1/PVC ratio under 70% is diagnostic
Peak flow - varies by at least 20 percent for three days a week or increase
CXR
Bloods - neutrophilia or eosinophilia
Types of pneumothorax
Spontaneous
Secondary to COPD/asthma
Traumatic
Signs of acute asthma
Decreased chest expansion
Absent breath sounds
Decreased vocal resonance
Primary pneumothorax mx
< 2 cm - Discharge and repeat CXR
> 2 cm - Aspiration
If that fails, insert a chest drain
Secondary pneumothorax mx
If greater than 2cm - aspirate
If less than 1cm after aspiration - high flow oxygen
> 2 cm
Chest drain
Primary pneumothorax mx
If lower than 2cm - oxygen and discharge
If above 2cm - aspirate via intercostal drain in safe triangle
Secondary pneumothorax mx
If greater than 2cm - aspirate
If less than 1cm after aspiration - high flow oxygen
if more than 2cm, drain
Define bronchiectasis
Dilation of bronchi after inflammation or vaccination
CXR for bronchiectasisi
Tram track sign
CT bronchiectasis
Signet ring sign
Causes of bronchiectasis
Post infection - measles, influenza, pertussis, mycobacterium
Immunodeficiency
Genetic - CF
Symptoms of bronchiectasis
Massive sputum production
Worse when lying down or when waking up
Signs of bronchiectasis on auscultation
High pitched inspiratory squeaks, pops
Inv for bronchiectasisi
FBC
Sputum culture
CXR or tram track sign
CXR sign for bronchiectasis
Tram track sign
Iv for COPD
Vital signs
Reduced FEV1/FVC ratio
Sputum culture in acute exacerbation
FBC, U+E, ABG for hypoxia
COPD mx
Step 1: SABA/SAMA
Step 2: LAMA+LABA or Step 3: LABA+ICS
LABA+LAMA+ICS
Stop smoking
Pneumococcal vaccines
Pulmonary rehab
Types of lung cancer
Small cell
Non small cell
Mesothelioma
Mets
Subdivision of non small cell lung cancer
Adenocarcinoma
SCC
Large cell carcinoma
Risk factors for lung cancer
Smoking
Age
Asbestos
Signs and symptoms - lung cancer
Haeoptysis Chest pain Cough Increased fractures Bone pain - PTHrP Supraclavicular lymphadenopathy
Lung cancer inv
Obs, bloods CXR, CT for staging Sputum culture Bronchoscopy Biopsy
Biopsy buzzword for small cell carcinoma
Oat cells on biopsy
Define extrinisic allergic alveolitis
Hypersensitivity pneumonitis due to inhalation of organic dusts such as from mushrooms, air conditioner, birds etc
Symptoms and signs of EAA
Acute - 4-12hr dry cough, dysnpoea, malaise and fever
Chronic - breathlessness, reduced exercise tolerance, hx of acute episodes
Fine inspiratory creps on auscultation
Extrinsic allergic alveolitis investigations and findings
Bloods - neutrophilia, lymphopenia, ABG showing low oxygen and co2
Serology - IgG
CXR - ground glass, honeycombing, reticulonodular shadowing
Ground glass apperance on high res CT
Restrictive pulmonary funciton tests
Define pulmonary fibrosis
Idiopathic inflammation of lungs causing alveolar and interstitial fibrosis
RF for pUl fib
Smoking
Animal/veg exposure
Medications
Signs on invx???
Ground glass appearnce
Define pneumoconiosis
Fibrosis due to mineral dusts, incl asbestosis and silicosis
Signs of pneumoconiosis
Melanoptysis - coal workers
Pleuritic CP - asbestosis
Clubbing
Decreased breath sounds
Signs on investigation for pneumoconiosis
CXR - micronodular mottling Bilateral lower reticulonodular shadowing CT - fibrotic Restrictive lung funciton pattersn Bronchoscopy and BAL
CURB 65
Confusion urea over 7 RR over 30 BP less than 90 over 60 over 65
Pul fibrosis signs
Gradual onset
Progressive dyspnoea on exertion
Dry cough without wheeze
CAP
Strep pneumoniae
Haemophilus influenza
HAP
Pseudomonas aeruginosa
Klebsiella
Inv and cxr findings for pneumonia
BP HR RR Temp Sats Sputum cutlure CXR - lobar/diffuse consolidation
Mx for pneumonia
A to E
Oxygen if sats below 92, consider CPAP,BiPAP
Abx
Pneumonccal / HiB vacine
Cause of pneumonia in IVDU
Staph aureus -
causes abscess in lungs that look like cysts
Atypical
Cold aglutinin test - mycoplasma infectino
hyponatremia - legionella
Xocillea - caused by cattle
Pneumocystitis jivorecci (PCP - HIV, diffuse consolidation
Living in closed quarters, low grade fever
Mycoplasma pneumoniae
Mx
Erythromycin/calri
Water, spas, plumbing
Dry cough
Legionella pneumophilia
HIV patients
Worse with exercise
Pneumocystitis jivorecii
IVDU h
Homelessness
Staph aureas
CXR - abscess
Fluxo
Recurrent chest infections
Bronchiectasis
CF
Recurrent chest infections
Pseudo aureo
Piptazobactam
Sputum culture
Living in closed quarters, low grade fever
Mycoplasma pneumoniae
Mycoplasma pneumoniae inx
Cold agglutinins on histology
Mycoplasma pneumoniae Mx
Erythromycin/calri
Water, spas, plumbing
Dry cough
Legionella pneumophilia
Legionella pneumophilia ivx and mx
Urine Ag test
IV cipro
Chlamydia psitacci ivx and mx
Sputum culture
Doxcycline
HIV patients
Worse with exercise
Pneumocystitis jivorecii
Pneumocystitis jivorecii inv and mx
High dose trimox
HIV test
Rash + breathlessness
Sarcoidosis
Define sarcoidosis
Multisystem inflammatory disorder causing non-caseating granulomas
RF: Scandinavian and afro carrbiean
Sarcoidosis symptoms and signs
General consitituional sytmepoms
Sob, dry cough
Lupus pernio
Erythema nodosum, arrythmias, uveitis, arthraliga
Sarcoidosis signs on blood
Raised serum ACE, Ca, ESR, ALP, GGT
Sarcoidosis signs / invx
Hypercalciuria in urine
bilateral hilar lymphadenopathy
Biopsy and lavage
TB RF
Recent travel
Immunosuppression
alcoholism
malnutrition
Signs of TB
Dry cough that becomes productive cough
Fever
Drenching night sweats
Miliary TB (TB that’s spread):
Meningitis
Bone lesions
Confusion
Invx/mx
Obs
Sputum smear - acid fast bacilli
using Ziehl-neelson stain on lowensteinjensen agar
CXR- cavitation lesion of upper lobes
Invx/mx for tb
Obs
Sputum smear - acid fast bacilli
using Ziehl-neelson stain on lowensteinjensen agar
CXR- cavitation lesion of upper lobes