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Year 3 difficult topics > resp > Flashcards

resp Flashcards

1
Q

asthma management drug order?
reliever?

1st line
2nd line

A

SABA- reliever, ICS - 3x use of SABA

second line add on drug is Leukotriene receptor antagonist - ORAL

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2
Q

if a pt is on ICS and LRT what is the complication?

A

might not adhere as LTRA is oral and to be taken at night

might want to offer LABA

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3
Q

what to do if

If asthma is uncontrolled on a low dose of ICS and a LTRA?

A

offer a long acting beta 2 agonist

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4
Q

children asthma 5-16

what is added onto SABA ICS?

A

LTRA- review 4-8 weeks

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5
Q

what skin involvement - eryhtema nodosum has a resp condition associated?

investiagtion findings for this?

A

sarcoidosis

raised ESR and calcium

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6
Q

Hx of sarcoidosis

A

dry cough, skin involvement, dyspnoea

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7
Q

COPD management acute on chronic attack?

drug choices

A

amoxicillin
doxycycline
clarithromycin

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8
Q

gallstone investigation of choice?

A

ultrasound

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9
Q

what is the spirometry result findings for asthma

A

FEV1/FVC <70%

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10
Q

‘the FEV1 is normally normal in asthmatic patients’

True / false

A

false

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11
Q

what is FEV1

A

forced expiratory volume - volume that has been exhaled at the end of the first second of forced expiratio

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12
Q

what causes a resp alkalosis

A

PE
anxiety / hyperventilate
altitude
paracetamol poisoning

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13
Q

what causes a resp acidosis

A 
copd
asthma 
benzos
opiates
nmd
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14
Q

stable management of copd

A

smoke cessation
influenza vaccination
pneumococcal vaccination

saba/sama - first line

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15
Q

is there an oral prophylactic abx therapy that can be offered to copd sufferers with recuurent infective exarcebations?

what side effect can this drug bring?

A

yes
azithromycin

prolongation of QT interval

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16
Q

moderate asthma
RR
pulse

A

<25

<110

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17
Q

severe asthma features

A

pefr 33-50%

RR>25
pulse >110

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18
Q

life threateneing asthma features

A

silent chest / cyanosis
oxygen sats <92%
pefr 33%

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19
Q

what does curb 65 stand for

A

confusion

urea
resp rate

blood pressure
aged 65

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20
Q

this pneumonia presents with

Hyponatraemia and lymphopenia common
Classically seen secondary to infected air conditioning units

A

legionella pneumophillia

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21
Q

if you suspect pneumocystis jiroveci
how would the patient present
what test must you do?

A

dry cough , exercise induced , absence of wheeze / chest signs

test for HIV

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22
Q

lung fibrosis that affects upper zone?

A 
hypersensitivity pneumonitis 
coal workers pneumoconiosis 
silicosis 
sarcoidosis 
ankylosing spondylitis 
tb
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23
Q

lower zone lung fibrosis

A

drug induced ; amiodarone , methrotrexate
asbestosis
sle

24
Q

CHARTs - acronym for what resp condition?

A 
coal worjers 
hisiocystosis 
ankylosing 
radiation 
tuberculosis 
silicosis
25
Q

what is sarcoidosis characterised by ?

what xray findings?

A

non-caseating graulomas

bilateral lymphadenopathy

26
Q

stereotypical ~HX
an 80-year-old man who used to work in ship building presents with progressive shortness-of-breath. A chest x-ray shows multiple pleural plaques and bilateral lower zone interstitial shadowing

A

asbestosis

27
Q

what are pleural plaques in the lung caused by?

A

asbestosis related lung disease - 20/40 years later

28
Q

mid zone fibrosis
dyspnoea
cough
fever

A

extrinsic allergic alveolitis

29
Q

in a respiratory acidosis is the pCO2 high or low?

how is a resp acidosis compensated?

A

the pC)2 is high whihc is why there is a resp acidosis

the compensation would be a high hco3-

30
Q

in aptient with copd

what does a really high bicarb show?

A

chronic resp acidosis

31
Q

PaCO2 >_______ suggests a respiratory acidosis (or respiratory compensation for a metabolic alkalosis)

A

6.0kpa

32
Q

ROME

abg

A

Resp = Opposite

ph is low and pCO2 is high
ph is high and pCO2 is low

metabolic= equal
low ph+ low base excess
high ph +high bicarb/ be

33
Q

what skin rash do you get with sarcoidosis

A

painless/ not itchy raised purple plaque of induarted skin

34
Q

predisposing factors for OSA?

what conditions

A

hypothyroidism
amyloidosis
marfans syndrome

35
Q

assessment of OSA

A

epworth sleepiness scale

MSLT

36
Q

management for osa >?

A

weigth loss

cpap

37
Q

curb65

what is a normal u?

A

confused
urea
resp rate
blood pressure

65?

38
Q

lenticular crescentic opacity is diagnostic of what?

A

empyema

39
Q

where is aspiration pneumonia more likely to occur

A

RIGHT

40
Q

TB

skin involvement?

A

lupus vulgaris

41
Q

TB investigations
what stain?
CXR findings?

A

ziehl-neelson stain
upper lobe shadowing , streaky fibrosis , cavitation
hilar lymphadenopathy

42
Q

what are the main complications of primary TB

post primary TB

A

lobar collapse
bronchiectasis
pleural effusion

empyema
pleural effusion
adenocarcinoma

43
Q

protein/ serum protein ratio of 0.25 - pleural effusion aspirate

is this a transudate or an exudate?

A

transudate

congestive heart failure

44
Q

what is the quadruple therapy for pulmonary tuberculosis ?

A

rifampicin
isoniazid
ethambutol
pyrizinamide

45
Q

visual acuity needs to be tested as part of management of TB

what other tests need to be done?
why??

A

ethambutol causes loss in visual acquity

LFTs as the drugs used are hepatotoxic

46
Q

latent tb treatment?

A

3 months of isoniazid w pyridoxine and rifampicin

isoniazid w pyridoxine for 6 months

47
Q

HAP

A

staph aureus
pseudomonas aeruginosa
klebsiella pneumonia

48
Q

cavitating lesions which pneumonia?

A

klebsiella

staph aureus

49
Q

pneumonia
cavitating lesion
abscess

A

staph aureus

50
Q

parrot fever, associated with birds pneumonia?

A

chlamydia psittaci

51
Q

coxiella burnetti

A

causes q fever

farm animals

52
Q

causes of a cavitating lung lesion?

A

cancer- squamous cell lung cancer

autoimmune :RA, granulomatosis with polyangitis
TB
staph
klebseilla

53
Q

which pneumonia is +

A

strep pneumonia - cocci

staph aureus - clusters

54
Q

bacillus? - pneumonia

A

haemophjillus
klebsiella
pseudomnas aeruginoas

55
Q

pleurtic chest pain

A

pneumothorax
pulmonary embolism

pericarditis
pneumonia
pleural effusion

56
Q

pneumonia examination sign

A 
assymetry 
reduced chest expansion 
coarse crackles
bronchial breathing 
increased vocal resonance
decreased percussion note

Year 3 difficult topics (22 decks)

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