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Year 6 Written > Resp > Flashcards

Resp Flashcards

1
Q

Pulmonary oedema mx

A
  1. Sit pt up, 2. Iv furosemide, 3.nitrate infusion OR morphine infusion if SOB+++
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2
Q

Asthma acute Mx

A
  • High flow 02
  • salbutamol nebulisers
    - ipratroprium bromide nebulisers
  • iv mgSo4
    – ICU ref/specialist
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3
Q

COPD mx (chronic)

A
  1. SABA or SAMA (e.g. ipratroprium)
    2.
    If steroid responsive: corticosteroid + LABA (fluticasone/salmeterol)
    If steroid unresponsive: LAMA + LABA (tioptoprium/salmeterol)
  2. LABA + LAMA _ ICS
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4
Q

When is BIPAP used?

A

T2 RF to facilitate CO2 exhalation
(IPAP > EPAP)

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5
Q

Which resp disease is this?

A

Reticulo-nodular shadowing as in interstitial lung disease

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6
Q

Interstitial lung disease causative drugs

A
  • Nitrofurantoin
  • MTX
  • Amiodarone
  • Chemo drugs
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7
Q

What does this CXR show?

A

Bilateral hilar lymphadenopathy as in sarcoidosis

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8
Q

Features of sarcoidosis

A
  • Dry cough
  • Malaise
  • Hyperca features
  • Erythema nodosum
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9
Q

Biopsy results for sarcoidosis

A

Granulomas (clusters of macrophages, lymphocytes, etc.)

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10
Q

Myasthenic crisis and features

A

Acute resp failure where forced vital capacity (FVC) <1L + need for ventilators support
- Use of accessory muscles
- Weak cough

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11
Q

Severe pneumonia + multi focal consolidation initial Mx

A

IV Co-Amox and clarithro

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12
Q

What do for airway of an alert pt with respiratory acidosis

A

Non-invasive ventilation

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13
Q

Idiopathic pulmonary fibrosis features

A
  • Dry cough
  • Increasing SOBOE
  • Finger clubbing
  • On ausc, bibasal creps
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14
Q

Bronchiectasis features

A
  • Younger pt usually
  • SOB worsening
  • Productive cough
  • Recurrent chest infx during childhood
  • Bilat scattered wheeze
  • Coarse inspiratory crackles
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15
Q

Empyema
1) What that
2) Features
3) Ix
4) Mx

A

1) collection of pus in the pleural space
2) SOB, pleural effusion
3) Pleural effusion: purulent aspirate and microscopy shows growth
4) Chest tube (catheter thoracotomy) drainage

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16
Q

Obstructive sleep apnoea
1) Features
2) Mx

A

1)
- Heavy snoring
- Day time sleepiness ++ (Epworth sleepiness score)
- Often plus weight
2) - CPAP
- +/- weight loss & diabetes mx

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17
Q

TB
1) Features
2) CXR finding
3) Next diagnostic ix?

A

1) - Malaise
- Weight loss
- Haemoptysis
2) Consolidation with cavitation
3) Sputum microscopy

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18
Q

Pneumothorax v lobar collapse

A
  • Pneumothorax is more rapid onset with severe syx ++
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19
Q

Which gram negative bacteria is likely to be causing pneumonia in CF patient?

A

Pseudomonas aeruginosa

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20
Q

Lung ca w keratin pearls

A

SCC

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21
Q

Bronchiectasis and features

A

Abnormal widening bronchi -> excess mucous & damaged cilia
Productive cough + dull percussion

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22
Q

Abx for legionella

A

Clarithromcyin

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23
Q

Abx for klebsiella

A

Ceftriaxone/cefotaxime

24
Q

COPD acute mx

A
  1. ±O2
  2. Neb salbutamol + neb ipratropium bromide
  3. IV hydrocortisone + PO pred (5 days)
  4. Amox/co-amox
  5. Further support: aminophylline/ITU/NIV)
25
Q

Asbestos plaques v mesothelioma

A

both conditions caused by asbestos
- Mesothelioma is a Ca

26
Q

What spirometry result represents a restrictive picture?

A
  • FEV1/FVC normal or incr
  • FEV1 and FVC both proportionally reduced
27
Q

What spirometry results represents an obstructive picture?

A
  • FEV1/FVC<0.7
  • FEV1 reduced
28
Q

pneumothorax + (haemodynamically nstable OR bilat)

A

Chest drain

29
Q

Primary pneumothorax <= 2cm

A

D/c and r/v in OPD

30
Q

Primary pneumothorax >2cm

A

Needle aspiration

31
Q

Done needle aspiration for pneumothorax, but not successful

A

Chest drain

32
Q

Secondary pneumothorax >2cm

A

Chest drain + admit

33
Q

Secondary pneumothorax 1-2cm

A

Needle aspiration + admit

34
Q

Secondary pneumothorax <1cm

A

Admit (+observe 24h)

35
Q

Tension pneumothorax cxr

A

airway deviate away from side of pneumothoraz

36
Q

Tension pneumothorax mx

A

Needle decompreession
- gret cannula
-2nd ICS, MCL

37
Q

Increased compliance of lung

A

emphysema (underlying COPD)

38
Q

Where is needle aspiration done?

A

Triangle of safety
Borders:
- Front: pec major
- Back: lat dorsi
- Top: axilla
- Bottom: 5th ICS

39
Q

Where is chest drain inserted?

A

4th-5th ICS, MAL

40
Q

Cor pulmonale features and ix

A

Features: peripheral oedema, raised JVP, loud P2
Ix: echo

41
Q

How is pulmonary HTN defined?

A

Pulmonary artery pa >= 20mmHg

42
Q

SCC of lung -> why hyperCa?

A

PTHrP release

43
Q

Small cell lung Ca + muscle cell improving on repetitive movement

A

Lambert Eaton syndrome

44
Q

Which Ab associated w Lambert eaton syndrome?

A

anti-voltage gated calcium channel

45
Q

Breast ca or small cell lung ca + progressive muscle stiffness

A

Stiff man syndrome

46
Q

Stiff man syndrome associated ab

A

Anti-amphiphysin

47
Q

Symptomatic asthma

A
  • Using SABA >=3/week
  • Cough/wheeze >= 3/weel
  • Nocturnal syx
48
Q

Chronic asthma mx

A
  1. SABA
  2. SABA + low dose ICS
  3. LTRA (montelukast) + low dose ICS
    1. Good resp to LTRA: LTRA + low dose ICS + LABA
    1. Min resp to LTRA: Low dose ICS + LABA
    1. LTRA + med dose ICS + LABA
    1. Med dose ICS + LABA
49
Q

Severe asthma feature

A
  • peak flow 33-50%
  • Inability to complete sentences
50
Q

Life threatening asthma

A
  • peak flow <33%
  • PaCO2 normal
  • silent chest
51
Q

Near-fatal asthma feature

A
  • Raised PaCO2
52
Q

Ix for active and latent TB

A

Active
- CXR & sputum

Latent
- Mantoux or interferon gamma assay

53
Q

Alternative name for extrinsic allergic alveolitis

A

Hypersensitivity pneumonitis

54
Q

Allergic bronchopulmonary aspergillosis features

A
  • episodic syx of infx
  • elevated IgE
  • Flitting consolidation on XR
  • Bronchiectasis pic on xr (dilated central airways)
55
Q

development of multiple round pulmonary nodules in patients with
Rheumatoid Arthritis and a background of Coal workers pneumoconiosis

A

Caplan’s syndrome

Year 6 Written (26 decks)

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