Brainscape's Knowledge GenomeTM

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


See full index

FINALS > Resp > Flashcards

Resp Flashcards

1
Q

More common type of lung cancer

A
  • Non small cell lung cancer = 80%
  • SCLC = 20%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

types of non small cell lung cancer

A
  • adenocarcinoma
  • squamous cell carcinoma
  • large cell carcinoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

S+S lung cacner

A
  • Cough
  • Haemoptysis
  • SOB
  • Weight loss
  • Supraclavicular LN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Extrapulmonary manifestations

A
  • Recurrent laryngeal nerve palsy = hoarse voice
  • Phrenic nerve palsy = SOB
  • SVC obstruction = face swell, distended neck and upper chest veins = pembertons sign
  • Horners = ptosis, anhidrosis, miosis, pancoast
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Paraneoplastic syndromes

A
  • SIADH = SCLC
  • Cushings = SCLC
  • Hypercalcaemia = squamous cell
  • Lambert eaton = SCLC = antibodies against SCLC cells and calcium channels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

guidelines for lung cancer 2ww

A

> 40 with
- clubbing
- lymphadenopathy
- recurrent chest infections
- thrombocytosis (increased plt)
- chest signs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

CXR for patients over 40 who have

A
  • 2+ unexplained sx in pt who never smoked
  • 1+ unexplained sx in pt that have ever smoked or had asbestos
    UE
  • cough, sob, chest pain, fatigue, weight loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

CXR in lung cancer

A
  • hilar enlargement
  • peripheral opacity (visible lesion)
  • pleural effusion (unilateral)
  • collapse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

lung ca ix

A
  • CXR
  • Staging CT (contrast)
  • PET CT (for mets)
  • Bronchoscopy with endobrachial USS
  • histology = bronchoscopy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

1st line tx NSCLC

A

surgery
- radiotherapy can also be curative

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

Tx SCLC

A
  • chemo and radio
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

CURB65

A
  • Confusion
  • urea >7
  • RR >30
  • BP <90 s or <60 d
  • > 65
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Atypical pneumonia treatment

A
  • Macrolides (clarithromycin)
  • fluoroquinolones (levofloxacin)
  • tetracyclines (doxy)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Legionella S+S

A
  • can cause SIADH = hyponatraemia
  • urine antigen test to screen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Mycoplasma pneumoniae

A
  • rash = erythema multiforme
  • target lesions
  • neuro sx in young
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

PCP

A
  • Fungal pneumonia
  • Immunocompromised patients = steroids
  • Dry cough, SOB, night sweats
  • Prophylactic co-trimoxazole
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Spirometry results for obstructive disease

A
  • FEV1 <70%
  • Obstruction is slowing air passage out the lungs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Sprirometry results for restrictive

A
  • FEV1 and FVC are equally reduced
  • FEV1:FVC ratio >70%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Asthma exam finding

A
  • Polyphonic expiratory wheeze
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

drugs that can worsen asthma

A
  • BB
  • NSAIDs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Asthma Ix

A
  • Spirometry
  • Reversibility testing >12% increase on testing
  • FeNO >40
  • Peak flow variabulity >20%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Asthma Mx

A

1 = SABA
2 = Inhaled corticosteroid (beclametasone)
3 = Leukotrine receptor antagonist
4 = LABA (salmeterol)
5 = MART regime
6 = increase ICS dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

ABG in acute asthma

A
  • initially = respiratory alkalosis as a raised RR caused drop in CO2
  • Normal PCo2 or low O2 = SCARY = getting tired
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

moderate exacerbation features asthma

A
  • peak flow 50-75%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

severe exacerbation features asthma

A
  • peak flow 33-50%
  • RR >25
  • HR >110
  • Can’t complete sentences
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

life threatening features asthma

A
  • Peak flow <33%
  • sats <92%
  • PaO2 <8
  • tiredness
  • confusion
  • Silent chest
  • shock
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

asthma exacerbation mx

A

OSHITME
- Oxygen
- Salbutamol 5mg nebs 20-30mins
- Hydrocortisone=pred 40-50mg oral or 100mg H IV
- Ipratropium = 500mcg nebs
- T
- Magnesium = IV 1.2-2g

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

MRC dyspnoea scale for COPD

A

1 = SOB on strenuous
2 = SOB uphill
3 = SOB on flat
4 = SOB <100m
5 = cant leave house

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

spirometry in COPD

A
  • FEV1:FVC <70%
  • no response to reversibility testing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

FEV1 staging for COPD

A

1 (mild) = FEV1 >80% predicted
2 (moderate) 50-79%
3 (severe) 30-49%
4 (V severe) <30%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Initial COPD tx

A
  • SABA = salbutamol
  • SAMA = Ip bromide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

COPD Mx if no asthma/steroid response

A
  • LABA = formoterol and LAMA = tiotropium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

COPD Mx if are asthma/steroid response

A

LABA and ICS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Chronic bronchitis COPD

A
  • Mucus hypersecretion and airway obstruction
    Blue bloaters
  • Alveolar and renal hypoxia
  • Increased EPO secretion = polycythaemia
  • Increased renin = fluid retention
  • cyanosed and bloated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Emphysema COPD

A
  • Alveolar trapping
    Pink puffers
  • Airway collapse on exhalation = obstruction
  • Exhale slowly through pursed lips
  • Increased airway pressure to prevent airway collapse
  • Flushing and puffing
  • Well perfused, barrel chest
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

final inhaler step for COPD

A

LABA, LAMA and ICS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

when LTOT needed

A
  • Chronic hypoxia <92%
  • polycythaemia
  • cyanosis
  • cor pulmonale
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

what is cor pulmonale

A
  • Right sided HF
  • Pulmonary HTN limits RV pumping blood into pulmonary arteries
  • Causes back pressure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

S+S cor pulmonale

A
  • SOB
  • Oedema
  • Syncope
  • CHest pain
  • Hypoxia and cyanosis
  • Raised JVP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

ABG in acute exacerbation COPD

A

Resp acidosis
- Low pH
- Hypoxia
- Hypercapnia
- Riased bicarb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

COPD exacerbation mx

A
  • inhalers and nebs
  • steroids = pred 30mg for 5d
  • abx if needed
  • physio
    Severe
  • IV aminophylline
  • NIV
  • ITU
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

when is NIV considered

A
  • Persistent resp acidosis despite tx
  • potential to recover
  • acceptable to patient
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

what is bronchiectasis

A
  • permanent dilation of the bronchi
  • chronic cough
  • continuous soutum production
  • recurrent infections
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Ix bronchiectasis

A
  • culture = HI and Psued aeruginosa
  • CXR - tram track opacities, ring shadows
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Best ix for bronchiectasis

A
  • High resolution CT
46
Q

Mx bronchiectasis

A
  • vaccines
  • physio
  • rehab
  • long term abx
  • colistin
  • bronchodilatoers
  • surgery
47
Q

infective bronchiectasis mx

A
  • cultures
  • abx extended course
  • ciprofloxaxin if pseud aer
48
Q

S+S interstitial lung disease

A
  • SOB
  • Dry cough
  • fatige
  • bibasal fine end inspiratory crackles
  • finger clubbing
49
Q

Ix ILD

A
  • clinical features
  • HRCT = ground glass
  • spirometry
50
Q

spirometry for ILD

A
  • restrictive
  • FEV and FVC equally reduced
  • FEV1:FVC ration >70% (normal/increased)
51
Q

IDP signs and Mx

A
  • SOB and cough >3 months
  • > 50years old
  • Pirfenidone reduces fibrosis and imflam
  • Nintedanib inhibits tyrosine kinase
52
Q

drugs that can cause pulmonary fibrosis

A
  • amiodarone
  • cyclophosphamide
  • methotrexate
  • nitrofurantoin
53
Q

patho hypersensitivity pneumonitis

A
  • also called extrinsic allergic alveolitis
  • type 2 and 4 hypersensitivity reaction to an environmental allergen
54
Q

Ix for Hypersensitivity Pneumonitis

A
  • brobcheolar lavage = raised lymphocytes
55
Q

causes of Hypersensitivity Pneumonitis

A
  • bird fanciers lung
  • farmers lung
  • mushroom worker
  • malt workers
56
Q

Mx Hypersensitivity Pneumonitis

A
  • remove allergen
  • Oxygen
  • Steroids
57
Q

Asbestos causes

A
  • fibrosis
  • pleural thickening
  • adenocarcinoma
  • mesothelioma
58
Q

exudative pleural effusion

A
  • protein >30g/l
59
Q

Transudative effusion

A
  • protein <30g/l
60
Q

Exudative causes

A
  • inflamation
  • cancer
  • infeciton
  • rheumatoid
61
Q

transudative causes

A
  • congestive cardiac failure
  • hypoalbuminaemia
  • hypothyroidism
  • meigs syndrome
62
Q

meigs syndrome

A
  • benign ovarian tumour
  • pleural effusion
  • ascites
63
Q

S+S effusion

A
  • SOB
  • dull percussion
  • decreased breath sounds
  • trachea away in large effusions
64
Q

CXR effusion

A
  • blunt CP angle
  • fluid in fissures
  • meniscus
  • tracheal deviation away
65
Q

Mx effusions

A
  • Conservative
  • pleural aspiration
  • chest drain
66
Q

empyema

A
  • infected pleural effusion
  • pus, low oh, low glucose, high ldh
  • drain and abx
67
Q

lights criteria for exudative

A
  • Exudate = protein >30g/l if between 25-35 use lights criteria
  • pleural fluid protein/serum protein >0.5
  • pleural fluid LDH/serum LDH >0.6
  • pleural fluid LDH >2/3 upper limits normal serum LDH
68
Q

Mx pneumothorax

A
  • No SOB and <2cm air rim = no tx, follow up
  • SOB and >2cm = aspiration, if fails 2 then drain
69
Q

where is drain in pneumothorax

A
  • 5th IC space
  • mid axillary line
  • anterior axillary line
70
Q

when surgery in pneumothorax

A
  • chest drain fails to correct
  • persistent air leak in drain
  • recurrent pneumothorax
71
Q

tension pneumothorax

A
  • trauma
  • ## one way valve that lets air in and not out
72
Q

signs tension pneumothorax

A
  • deviation away
  • reduced ae
  • increased resonance
  • tachy
  • hypo
73
Q

mx tension pneumothorax

A
  • large bore cannula into 2nd IC in MC line
74
Q

definition of pulmonary htn

A

mean pulmonary arterial pressure >20 mmHg

75
Q

5 causes pulmonary htn

A

1 = idiopathic
2 = left heart failure
3 = chronic lung disease
4 = pulmonary vascular disease
5 = miscellaneous

76
Q

ECG in pul htn

A
  • p pulmonale = peaked p waves
  • RV hypertrophy
  • right axis devation
  • RBBB
77
Q

CXR in PHTN

A
  • dilated pulmonary arteries
  • rv hypertrophy
78
Q

mx idiopathic PHTN

A
  • CCB
  • IV prostaglandins
  • Endothelin receptor antagonists
  • phosphodiesterae 5 inhibitors
79
Q

epi of sarcoidosis

A
  • 20-39 or 60
  • women
  • black
80
Q

skin features sarcoidosis

A
  • erythema nodosum on shins
  • lupus pernio = purple lesions on cheeks and nose
81
Q

lungs in sarcoidosis

A
  • mediastinal lymphadenopathy
  • pulmonary fibrosis
  • pulmonary nodules
82
Q

other s+s sarcoidosis

A
  • fever, wl, fatigue
  • liver nodules, cirrhosis, cholestasis
  • uveitis, conjuncitivitis
  • optic neuritis
  • BBB
  • Kidney stones, neprhitis
  • DI
  • nerve palsy
  • arthralgia
83
Q

lofgrens syndrome

A
  • erythema nodosum
  • bilateral hilar lymphadenopathy
  • polyarthralgia
84
Q

blood tests in sarcoidosis

A
  • raised ACE
  • hypercalcaemia
85
Q

sarcoidosis histology

A

non caseating granulomas with epithelioid cells

86
Q

mx sarcoidosis

A
  • conservative
  • oral steroids
  • bisphosphonates
  • methotrexate 2nd line
87
Q

TB micro cause

A
  • Mycobacterium tuberculosis
  • Bacillus
  • acid fast bacilli
88
Q

staining for TB

A

Zeihl Neelsen stain
- turns them bright red against blue background

89
Q

testing pre TB vacciantion

A
  • mantoux test
  • only given vaccine if negative
90
Q

S+S TB

A
  • cough
  • haemoptysis
  • lethargy
  • night sweats
  • weight loss
  • erythema nodosum
91
Q

TB Ix

A
  • mantoux test
  • interferon gamma release assay
  • CSR
  • cultures
92
Q

what is mantoux

A
  • inject tuberculin into intradermal space on forearm
  • after 72 hrs, induration 5mm or more = +ve
93
Q

TB CXR

A
  • Primary = patchy consolidation, pleural effusion, hilar lymphadenopathy
  • reactivated = patchy/nodular consolidation with cavitation
  • Disseminated = millet seeds
94
Q

when is NAAT used

A
  • diagnosing TB in HIV or <16
  • RF for multi drug resistance
95
Q

Latent TB Tx

A
  • Isoniazid and rifampicin for 3 months
  • Or isoniazid for 5 m
96
Q

RIPE

A
  • Rifampicin 6m
  • Isonizaid 6m
  • Pyrazinamide 2m
  • Ethambutol 2m
97
Q

RIPE and SE

A
  • R = red tears and urine, reduced COCP
  • I = peripheral neuropathy
  • P = hyperuricaemia = gout and stones
  • E = colour blindness and reduced acuity
98
Q

mx if wells score likely

A
  • CTPA
99
Q

mx if wells unlikely

A
  • d dimer
  • if +ve then CTPA
100
Q

ABG in PE

A
  • resp alkalosis
    = blow off CO2 therefore alkalotic blood
101
Q

mx PE

A
  • 1st line = rivaroxaban
  • 2nd = LMWH = enoxaparin
102
Q

how long to anticoagulate for in PE

A
  • 3m if reversible cause
  • over 3m if unprovoked or irreversible cause
  • 3-6m active cancer
103
Q

T1RD

A
  • normal CO2
  • low O2
104
Q

T2RF

A
  • high CO2
  • Low O2
105
Q

does co2 make blood acidic or alkalotic

A

acidic = breaks down into carbonic acid

106
Q

what causes obstructive sleep apnoea

A
  • collapse of pharyngeal airway
107
Q

S+S apnoea

A
  • apnoea during sleep
  • snoring
  • morning headache
  • unrefreshed
  • daytime sleepiness
  • concentration problems
  • reduced oxygen sats
108
Q

asthma diagnostic testing >17 years

A
  • all pt should have spirometry with bronchodialtor reversibility
  • all should have FeNO
109
Q

asthma testing 5-16 yrs

A
  • spirometry with BDR
  • FeNo if normal spirometry or obstructive spirometry with negative BDR
110
Q

what is polysomnography

A

sleep studies

111
Q

common causes resp alkalosis

A
  • anxiety
  • PE
  • CNS disorders
  • altitude
  • pregnancy
112
Q

how does SABA work

A
  • stimulates b2 receptors of resp tract
  • increases sympathetic activity
    relaxes bronchial smooth muscle

FINALS (31 decks)

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