Brainscape's Knowledge GenomeTM

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


See full index

Respiratory > Pulmonary vasculitides, eosinophilia > Flashcards

Pulmonary vasculitides, eosinophilia Flashcards

1
Q

What are cardiac causes of clubbing

A

Cyanotic HD
IE
Atrial myxoma

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

What are respiratory causes of clubbing

A

Lung cancer
TB
Asbestos
Fibrosing alveolitis
CF
Bronchiectasi
Abscess
Empyema

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

What are other causes of clubbing

A

Chron’s
Cirrhosis
Grave’s
Whipples

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

What causes respiratory acidosis

A 
COPD
Asthma 
Pulmonary oedema
Neuromuscular
Obesity
HYpoventilation 
Benzo / opiate overdose
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What causes respiratory alkalosis

A 
Anxiety
Hyperventilation
PE
Salciclyte
SAH
Encephalitis
Stroke
Altitude
Pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is granulomatous polyangiitis

formerly known as Wegener’s granulomatosis.

A

Necrotizing granulomatous vasculitis affecting upper and lower respiratory tract + kidney
Features
* upper respiratory tract: epistaxis, sinusitis, nasal crusting
* lower respiratory tract: dyspnoea, haemoptysis
* rapidly progressive glomerulonephritis (‘pauci-immune’, 80% of patients)
* saddle-shape nose deformity
* also: vasculitic rash, eye involvement (e.g. proptosis), cranial nerve lesions

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

Granulomatosis with polyangiitis

How do you investigate

A
  • cANCA positive in > 90%, pANCA positive in 25%
  • chest x-ray: cavitating nodules or lesions > CT-PET showing increased uptake > CT guided bx: fibroinoid necrosis
  • renal biopsy: epithelial crescents in Bowman’s capsule
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Management of Granulomatosis with polyangiitis [4]

A
  • CCS - high-dose methyl- prednisolone
  • pulsed IV cyclophosphamide
  • Plasma exchange- used for renal disease but its role in pulmonary disease is less clear.
  • Remission can be sustained with less aggressive agents, such as azathioprine. Methotrexate can be used as an alternative in less severe renal disease.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is Churg Straus

A

Eosinophilic vasculitis

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

3 stages

A

Stage 1 =. allergy
Asthma
Sinusitis / rhinitis
Polyps

Stage 2 = eosinophilia

Stage 3 = vasculitis
Heart, lung, GI, kidney

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

What is Kartamenger syndrome

A

Primary ciliary dyskinesia

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

What is suggestive of Katmenger syndrome

A

Sinusitis
Bronchiectasis
Dextrocardia
Subfertility

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

What causes altitude sickness

A

Chronic hyperbaric hypoxia at high altitude

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

Altitude sickness

How do you prevent and treat

A

No >500m per day
Acetazolamide
Descent

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

What can altitude sickness progress too

A

Pulmonary oedema

Cerebral oedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Altitude sickness

What does cerebral oedema present with

A

Headache
Ataxia
Papilloedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Altitude sickness

How do you treat

A

Descent

Dexamethasone

19
Q

Goodpasture’s syndrome

Features, investigation finding

A

Causes alveolar haemorrhage resulting from anti-glomerular basement membrane (GBM) antibodies that can also cause crescentic glomerulonephritis. Features: pulmonary haemmorrhage
Investigation: renal biopsy shows linear IgG deposits along basement membrane

20
Q

Pulmonary eosinophilia are a heterogenous group of diseases

Pulmonary eosinophilia causes

associated with eosinophilic alveolar infiltrates and peripheral eosinop

A
  • Parasitaemia, e.g. helminthic infections.
  • Resolving pneumonia.
  • Hydatid disease.
  • Sarcoidosis.
  • Polyarteritis nodosa.
  • ABPA.
  • EGPA.
  • Acute and chronic eosinophilic pneumonia.
21
Q

How would pulmonary eosinophilia typically present?

A
  • Severe haemoptysis is recognized, but is often absent.
  • Cough, dyspnoea, pleuritic pain.
  • Clinical examination may reveal evidence of underlying extra thoracic and thoracic disease, e.g. purpuric rash, joint pain/inflammation.
  • Pulmonary vasculitis should be considered in any persistent, aggressive or unusual presentation of pneumonia.
22
Q

Contents [4]

A

Coal Workers Pneumoconiosis (CWP)
Asbestosis
Silicosis
Mesothelioma

23
Q

CWP
Ep
Ax [2]
Pathophysiology [3]

A 
Ep: countries w/ underground coal mines 
Ax: inhalation of coal dust particles, over 15-20y
Px: 
- dust particles of 1 to 3 micrometres 
- ingested by macrophages which die
- releasing enzymes and causing fibrosis
24
Q

CWP
Presentation [2]
Investigations

A

Asymptomatic
Can co-exist with chronic bronchitis

Ix:
CXR, PFT

25
Q

CWP
Describe CXR
Describe PFT

A

CXR:

  • Multiple upper zone round opacities
  • 5-10mm

PFT: restrictive pattern

26
Q

CWP Mx [3]

Complication

A
  • Avoid coal dust
  • Treat co-existent chronic bronchitis
  • Claim compensation

Complication: Progressive massive fibrosis

27
Q

Progressive massive fibrosis [5]

A

Progressive SOB
Worsening fibrosis
Eventually developing cor pulmonale
CXR showing upper AND middle zone fibrotic masses
- start from periphery extending to hilum

28
Q

Silicosis
Epidemiology [4]
Ax
Presentation [2]

A

Ep:

  • Metal mining
  • Quarrying
  • Sand blasting
  • Pottery/ceramic manufacture

Ax: inhalation of silica dust particles

Presentation

  • Progressive SOB
  • Increased TB incidence in these patients
29
Q 
Silicosis
CXR [3]
PFT [1]
Mx [2]
Complication [1]
A

CXR

  • Diffuse miliary or nodular pattern
  • In upper and mid zones
  • Egg shell calcification of hilar nodes

PFT: restrictive

Mx: avoid silica, claim compensation

CX: PMF

30
Q

Asbestosis
Epidemiology
Aetiology
What are the different types of asbestos fibers [4]

A

Ep: building trade (fire proofing, pipe lagging, electrical wire insulation, roofing felt)

Ax:

  • inhalation of asbestos fibres:
  • crocidolite (blue) = most fibrogenic
  • chrysotile (white) = least fibrogenic
  • amosite = intermediate fibrogenicity (least common)
31
Q 
Asbestosis
Onset [1]
Symptoms [1]
Signs [2]
Pathophysiology [2]
Incidence
A 
Symptoms
- onset >10y post exposure
- progressive SOB
Signs
- finger clubbing
- fine ended crackles

Pathophys:

  • Particles deposited at alveolar duct bifurcations
  • Cause alveolar macrophage alveolitis

Inc: 90% patients have asbestos exposure but only 20% have had asbestosis

32
Q

Asbestosis
Investigation [2]
Mx [4]
Cx [2]

A

Ix:

  • CXR or HRCT thorax
  • PFT

Mx (symptomatic):

  • Antibiotics (if infection)
  • Bronchodilators if obstructive
  • Smoking cessation
  • Claim compensation

Cx: cor pulmonale, malignancy

33
Q

What are the cancers related to general asbestos exposure? [4]

What are benign asbestos related diseases [3]

A 
Malignant:
lung cancer
mesothelioma
colon cancer
laryngeal cancer

Benign:
Pleural plaques
Diffuse pleural thickening
Benign asbestos related pleural diffusion

34
Q

Asbestosis - what can you see on CXR or HRCT? [3]

What can you see on PFT [2]

A
  • Lower zone linear interstitial fibrosis
  • Progressively involving entire lung
  • Pleural thickening

PFT:

  • Restrictive
  • But can be obstructive esp if smoker
35
Q

Mesothelioma
Ax
Px [2]
Presentation [4]

A 
Ax: inhalation of asbestos fibres
Px: 
- tumour of mesothelial cells of pleura 
- or more rarely peritoneum
Presentation:
- Chest pain, SOB
- Weight loss, fever
- Clubbing
- Recurrent pleural effusions
36
Q

Mesothelioma: presentation of metastases [4]

A
  • Lymphadenopathy
  • Hepatomegaly
  • Abdo pain
  • GI obstruction
37
Q

Mesothelioma investigations
initial [2]
dx [2]

A

Initial:

  • CXR/CT (pleural thickening)
  • Pleural aspiration (blood)

Diagnostic:

  • USS or CT guided percutaneous pleural biopsy
  • Thoracoscopy under LA
38
Q

Why is thoracoscopy both therapeutic and diagnostic

A

Can obtain pleural biopsy

  • Pleural fluid drainage
  • Pleurodesis
39
Q

Mesothelioma staging [3]

A

CT thorax
Mediastinoscopy
Video-assisted thoracoscopy

40
Q

TMN staging mesothelioma: stage 1 [2]

A

T1N0M0
T1a - limited to ipsilateral parietal pleura
T1b - ipsilateral parietal pleura + visceral pleura

41
Q

TMN staging mesothelioma: stage 2 [4]

A 
T2N0M0
-1a or 1b 
\+ confluent diaphragm or
\+ visceral pleura or
\+ lung involvement
42
Q

TMN staging mesothelioma: stage 3
T3M0
T1-3N1M0
T1-3N2M0

A

T3M0
- locally advanced tumour

T1-3N1M0
- ipsilateral, pulmonary or hilar LN

T1-3N2M0
- Sub carinal or ipsilateral mediastinal LN

43
Q

Stage 4 mesothelioma

A

Any T4:
- Locally advanced technically irresectable tumour

Any N3

  • Contralateral mediastinal, LN or
  • internal mammary and ipsilateral/contralat supraclavicular LN

Any M1 (distant mets)

44
Q

Mesothelioma management [2]

Prognosis

A

Chemotherapy - pemitrexed and cisplatin

Pleurodesis and in-dwelling pleural drain

Prog: <2y

Respiratory (14 decks)

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