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resp Flashcards

1
Q

Normal FEv1

A

> 80%

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2
Q

risk factors for endometrial cancer

A

excess oestrogen eg nulliparity
PCOS
Tamoxifen
obesity
diabetes
HNPCC

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3
Q

what cancer are psammoma bodies seen in and what are they

A

collections of calclium
seen in serous cystadenocarcinoma

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4
Q

what conditions would cause a decrease in TLCO

A

pneumonia
pulmonary fibrosis
PE
Pulmonary oedema
emphysema
Anaemia

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5
Q

prognostic indicator is melanoma

A

breslow thickness

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6
Q

what O2 sats in asthma warrant an ABG

A

<92%

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7
Q

what level of FEV1 would show bronchodilator reversibiltiy

A

12%

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8
Q

treatment of hyponatraemia based on fluid status

A

hypovol - norm saline
euvol - fluid restrict
hypervol - fluid restrict 500-1L daily

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9
Q

an FEv1/FVC ratio of what indicates obstructive lung disease

A

<0.7

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10
Q

what antibiotics are given prophylactically in COPD and what tests need to be done ?

A

Azithromycin, LFT due to heaptic cholestatisi and U+E due to long QT

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11
Q

What non pharmalogical management is offered to COPD patients

A

pulmonary rehab
smoking cessation
Annual flu
one of pneumococcal vaccine

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12
Q

what is second line treatment for COPD

A

steroid if asthmatic features
SABA+ LABA+ICS
IF NOT
SABA+ LABA + LAMA

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13
Q

what features suggest steroid responsiveness in COPD

A

prev diagnosis of asthma or atopy
eosionophilia
FEV1 variation >400ml
20% diurnial variation in peak flow

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14
Q

first line antibiotics for infective exacerbation of COPD

A

Amox, clarithromycin or doxycyclin

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15
Q

what does capnography monitor

A

end tidal co2

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16
Q

what anaestheic agent doesnt casue a drop in Bp so good in trauma

A

Ketamine

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17
Q

mangement of acute heart failure and hypotension

A

inotropic agents- dobutamin
noreadrenaline - if inotropes not work
mechanical assisstance - intra-aortic balloon

STOP BB

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18
Q

what could cause an transudative thoracentesis

A

HF, , hypoalbineumia, atelectasis, hypo thyroid, meigs peritoneal dialysis

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19
Q

what could cause an exudative thoracentesisi

A

malignancy, Infection, Infarct adn asbestos
pancreatitis, PE, connective tissue

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20
Q

if lymphocytes are seen on cytology of pleural effusion what should be suspected

A

TB or malignancy

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21
Q

first line treatment of acute bronchitis if requiring antibiotics

A

oral doxycyclin

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22
Q

in a secondary pneumothorax <1cm how should it be mananged

A

admit and O2

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23
Q

is alpha 1 antiprypsin obstructive or restrictive

A

obstructive

24
Q

Does ACEI cause hypo or hyperkalaemia
and how

A

hyper
block aldosterone - aldosterone casues reabsorptions of Na and water adn secretion of K

25
Q

in non smokers what type of lung cancer is most likely seen

A

adencarcinoma

26
Q

what antibiotics are used fro atypical pneumonias

A

macrolides and tetracycline eg doxy

27
Q

pleural effusion with low glucose is characteristic of

A

rheumatoid or Tb

28
Q

when is lights criteria used and what is it

A

used in Pleural Effusion to distinguish between exudate and transudate

  1. pleural fluid protein divided by serum protein >0.5
  2. pleural fluid LDH divided by serum LDH >0.6
  3. pleural fluid LDH more than two-thirds the upper limits of normal serum LDH
29
Q

what is meigs syndrome and what type of pleural effusion woud it cause

A

transudative
ovarian tumour causes ascites and pleural effusion

30
Q

what pH of pleural effusion would warrant chest tube

A

<7.2

31
Q

most common casue od exudative pleural effusion

A

pneumonia

32
Q

the pill:

what cancer does it casue
what cancer does it protect against

A

increased risk of breast and cervical cancer
protective against ovarian and endometrial cance

33
Q

most common septci arthritis organism in young adults

A

neuserria gonorrhoea

34
Q

treatment of a 0-2 CURB65 score CAP

A

Amoxicillin 1g tds IV/PO (5 days)

35
Q

treatment of a 3-5 CURB65 score CAP

A

Co-amoxiclav IV 1.2g tds + Doxycycline PO 100mg bd

36
Q

up to what age can asthma be diagnosed without FeNO

A

up to 5 yrs then must get FeNO test

37
Q

diagnosis of asthma in 5-16 years

A

BDR test
FeNO if norm spirometry or obstructive spiromtry with no BDR

38
Q

positive FeNO test results in children and adutls

A

adult - 40 parts per billion
children 35 parts per billion

39
Q

what is used to measure COPD severity and what are the levels

A

FEV1

> 80% = mild should have symps
50% = mod
30% - severe
<30% - v severe

40
Q

if a COPD patient has severe COPD and >2 exacerbations in the last year and alreasy on triple therapy what shoudl be added

A

PDE-4 inhib roflumilast

41
Q

factors that improve survivial in COPS

A

smoking cessation
long term o2 therapy
lung redution surgery

42
Q

when is chest xray repeated in pneumonia

A

6 weeks

43
Q

paraneoplastic syndrome of small cell

A

ADH
ACTH
lambert eaton

44
Q

what blood abnormality may be seen in lung cancer

A

thrombocytosis (high platelets)

45
Q

features of legionella pneumonia and mycoplasma pneumoni

A

legionella - hyponatraemia and lymphopenia
mycoplasma - dry cough AIHA+ erythema multiforme

46
Q

hypoxia and SOB post surgery diagnosis and treatment

A

atelectasis - sit upright and breathing exercises

47
Q

mangement of HAP and aspiration pneumonia compare to CAP

A

HAP = amox+gent for gram -ve cover
Asp - amoz+met for anaerobe cover

48
Q

investigations for Goodpasteurs

A

renal biopsy - linear IgG
Increase TCLO due to po haemorrhages

49
Q

mangement of goodpasteurs

A

plamaphoresis
steroids
cyclophosphamide

50
Q

type og collagen inolevd in anti-GMB

A

type 4

51
Q

investigation of PE in individual with renal impairement

A

V/Q scan

52
Q

what is dabigatran

A

direct thrombin inhibitor

53
Q

treatment of PE:
- normally
-severe renal impaire <15
- anti- phospholipid

A

norma - DOAC eg apixaban
REnal -LMWH
anti- LMWH followed by warfarin

54
Q

PE with hypotension treatment

A

thrombolyse

55
Q

treatent of antiphospholipid sydnrome

A

primary thromboprophylacis - aspirin
secondary thromboprophylaxis - warfarin

56
Q

treatment for viraly induced episodic wheeze in kids

A

salbutamol first
ntermittent leukotriene receptor antagonist(montelukast ) 2nd line

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