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Respiratory > passmed qs > Flashcards

passmed qs Flashcards

1
Q

What is transfer factor

A

describes the rate at which a gas will diffuse from alveoli into blood

Carbon monoxide is used to test the rate of diffusion.

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2
Q

causes of raised transfer factor

A

asthma
pulmonary haemorrhage (Wegener’s, Goodpasture’s)
left-to-right cardiac shunts
polycythaemia
hyperkinetic states
male gender, exercise

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3
Q

what causes a lower tlco

A

pulmonary fibrosis
pneumonia
pulmonary emboli
pulmonary oedema
emphysema
anaemia
low cardiac output

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4
Q

what would cor pulmonale show on ecg

A

peaked p waves

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5
Q

allergy related asthma would lead to an increase in what type of immune cell

A

eosinophills

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6
Q

typical spirometry results for asthma

A

FEV1 - significantly reduced
FVC - normal
FEV1% (FEV1/FVC) < 70%

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7
Q

life threatening feature of an asthma attack

A

silent chest

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8
Q

what does IL 4 5 13 do in asthma

A

IL-4: Facilitates class switching to IgE
IL-5: Facilitates release of eosinophils
IL-13: Stimulates mucus production

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9
Q

type 2 resp failure ?

A

low PaO2 and high PaCO2)

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10
Q

feautures of a severe asthma attack

A

oxygen saturations <90%, peak expiratory flow rate <33% of best, silent chest, bradycardia, hypotension, exhaustion

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11
Q

what can be seen on histology for asthma

A

Curschmann spirals can be seen on histology, which are where shed epithelium becomes whorled mucous plugs

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12
Q

a wedge shaped opacification on cxr would indicate

A

Pulmonary embolism

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13
Q

meigs syndrome is characterised by

A

benign ovarian tumor
pleural effusion
ascites

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14
Q

How can marfans cause a spontaneous pneumothorax

A
  • increases rf
  • increased stress on the lungs from being tall
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15
Q

most common organisms isolated from patients with bronchiectasis

A

haemophilus influenzae - mc
p aeruginosa
klebs
s pneumoniae

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16
Q

patient with recurrent bronchiectasis should be treated with ?

A

prophylactic abx

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17
Q

common finding on auscultation for pneumonia

A

increased tactile vocal fremitus and dull percussion note

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18
Q

flu like illness, dry cough, erythema multiforme and evidence of anaemia would suggest

A

lower resp tract infection with mycoplasma pneumonia

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19
Q

most likely causative organism for patients with pneumonia returning from holiday

A

Legionella pneumophilia

  • inhalation or aspiration of unsanitary water such as in showers supplied by poorly maintained water tanks
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20
Q

patients who are allergic to penicillin cant also have ?

A

co - amixoclav

21
Q

best investigation for atypical pneumonia

A

polymerase chain reaction

22
Q

infective resp symptoms + alcohol=

A

klebsiella
upper lobe

23
Q

what stain would you use for pneumocystitis jiroveci

A

silver stain

24
Q

mechanism of rifampic

A

inhibits bacterial DNA dependent RNA polymerase preventing transcription of DNA into mRNA

25
Q

Reactivation of tuberculosis is/are most characteristically caused by:

A

corticosteroids
infliximab
etanercept

26
Q

Isoniazid mechanism and SE

A

inhibits mycolic acid synthesis

peripheral neuropathy

27
Q

quadruple therapy drugs for tb

A

ethambutol, isoniazid, pyrazinamide, rifampicin

28
Q

what tb drug can cause visual acuity and color vision difficulties

A

ethambutamol

29
Q

cavitating lesions are common in what type of lung cancer

A

squamous cell carcinoma

30
Q

svc obstruction due to small cell lung cancer treatment ?

A

iv dexamethasone

31
Q

patients with sclc and LEMS would present with

A
  • limb weakness normally lower limbs
  • dry mouth
  • impotence
  • difficulty urinating
32
Q

PTHrp and hypercalcaemia are associated with lung cancer

A

Squamous cell carcinoma

33
Q

Small cell lung cancer can cause what paraneoplastic syndrome

A

Cushings
Addisons

34
Q

Where does adenocarcinoma arise from

A

Bronchial glands

35
Q

fine end inspiratory crackles on auscultation and clubbing?

A

pulmonary fibrosis

36
Q

right sided pleuritic chest pain

A

pneumonia

37
Q

normal fev1/ fvc ratio

A

70%

38
Q

does sarcoidosis feature caesating or non caseating granuloma

A

non caseatign

39
Q

typocal px of sarcoidosis

A

Black female 20-40 , dry dough, erthema nodosum, worsening dyspnoea

40
Q

raised ACE levels think ?

A

sarcoidosis

41
Q

Which ECG feature would be most consistent with a diagnosis of pulmonary hypertension?

A

p pulmonaelae

42
Q

what is bosentan and what should be monitored alongside

A

endothelin -a receptor agonist
liver function tests

43
Q

What bacteria is most likely to cause Otis media

A

Streptococcus pneumonias
Haemophilia influenzas

44
Q

A patient as ptosis, anhydrosis and miosis ?

A

Horner syndrome
Pancoast tumor that affects the apex
Ipsilateral

45
Q

Thick and dark green sputum would make you think ?

A

Bronchiectasis

46
Q

tb on cxr would show

A

Bilateral hilar lymphadenopahty
ghon focus
ranke complex

47
Q

what conditions cause finger clubbing

A

bronchiectasis
mesotheliona
idopathic pulmonary fibrosis
lung abscess

48
Q

tumor marker for liver cancer

A

ca-19-9

Respiratory (21 decks)

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