phase 2 resp Flashcards
which gene is mutated in CF
Cystic fibrosis transmembrane conductance regulator on chromosome 7
What is the mode of action of tiotropium bromide?
Causes bronchodilation by blocking muscarinic acetylcholine receptors
where to put needle for pneumothorax
Right 2nd intercostal space, midclavicular line
incubation period for influenza?
1-4 days
what causes Pigeon fancier’s lung?
Avian proteins
where does mesothelioma metastasize
locally - rarely metastasizes to local sites
extra pulmonary signs of tb
Persistently swollen glands, Abdominal pain, Dysuria, Haematuria, Pain and loss of movement in an affected bone or joint, Confusion, Persistent headache, Seizures
PE first line investigation
CT pulmonary angiogram
differential diagnosis for influenz
Common cold
URTI
Pharyngitis
Meningitis
Bacterial / lower RTI
Malaria / dengue fever
x ray for tb
Ghon complex / Ghon focus / dense homogenous opacity / hilar lymphadenopathy / pleural
effusion
name of the syndrome that is causing his eyelid to be droopy, pupil constricted and lack of sweat
on the left side of his face?
Horner’s syndrome
what causes horners syndrome
Pancoast tumour of the apex of the left lung
what kind of nerve is involved in horners syndrome
Sympathetic
pathophysiology of pancoast tumour
Pancoast tumour invades the apical chest wall, and as it becomes larger, it can affect other nearby
structures, including intercostal nerves, the brachial plexus (causing his shoulder pain and arm
weakness), and the sympathetic chain
3 sites which lung cancer is most likely to metastasise from
Breast cancer, colon cancer, prostate cancer, sarcoma, bladder cancer, neuroblastoma, and Wilm’s
tumor.
extrapulmonary signs of sarcoidosis
Erythema nodosum, polyarthritis, lupus pernio, uveitis, arrhythmias, granulomatous hepatitis
differentials manifesting with bilateral hilar lymphadenopathy on x-ray.
tb, lymphoma, silicosis
potential causes of bronchiectasis.
cystic fibrosis
TB
AIDS
airway obstruction
signs on examination of that patient for bronchiectasis
Coarse crackles heard in early inspiration and often in the lower zones, large airway rhonchi (lowpitched snore-like sounds), wheeze, clubbing is found infrequently.
complications of bronchiectasis
Repeated infection and deteriorating lung function, empyema, lung abscess, pneumothorax from
repeated coughing, life-threatening haemoptysis, respiratory failure.
most appropriate antibiotic for h influenzae
Co-amoxiclav, doxycycline
differential diagnoses for a COPD exacerbation. (
Pneumonia, pneumothorax, congestive heart failure, pulmonary oedema, pleural effusion
pneumothorax symptoms
Two thirds of patients will have both pain and dyspnoea, However, a significant number may be
asymptomatic and therefore a high index of suspicion is needed
is D dimer sensitive or specific for PE
High sensitivity, low specificity
pleural effusion vs pneumothorax
Pleural effusion – dullness on percussion,
Pneumothorax – hyper-resonant on percussion,
what is fev1 in obstructve
FEV1<0.8
Most common organism in COPD exacerbation
haemophilus influenzae.
Others = strep pneumoniae, Moraxella catarrhalis
what kind of effusion would MI cause
Transudative effusion – bilateral effusions are more likely to be due to cardiac failure.
what can develop after pleural effusion is aspirated and ph is low
empyema
questioons to ask for asthma histoey
Family history, other atopic diseases, diurnal variation, cough at night, better/worse at home/school/work/in holidays, any allergies, drug history
what signs indicate poor asthma control
Nocturnal cough, multiple exacerbations, wheeze, recessions, hyperinflated chest
what is FVC in obstructiv
normal
asthma patient currently on Salbutamol and a corticosteroid inhaler. What must you do before adding in more pharmacological interventions?
check inhaler techniqye
