Resp Flashcards
Positive Ziehl-Neelsen stain for acid fast bacilli
TB
Caseous Necrosis
TB
Apical disease is most likely:
(Secondary) TB
Miliary Tuberculosus
Spread of organisms into the bloodstream
If miliary tuberculous organisms spread by pulmonary artery…
Miliary dissemination into the lung occurs
If Miliary tuberculosis organisms spread via pulmonary vein…
Systemic dissemination to the liver, spleen and kidneys
Positive anti-glomerular basement membrane antibodies
Goodpastures syndrome
Chest infection with a parrot/pigeon as a pet
Chlamydophila psittaci
Dry cough + diarrhoea after holiday abroad (Spain), some indication of water spread
Legionella Pneumopila
How to test for Legionella Pneumophila
Test urine for antigens
Tall thin young man (marijuana)
Probably pneumothorax (Marfan’s)
Bilateral hilar lymphadenopathy, erythema nodosum, granulomas, fatigue, uveitis and weight loss
Sarcoidosis
Bronchiole wider than neighbouring arteriole (on CT)
Bronchiectasis
Signet ring sign
Bronchiectasis
D sign on x-ray
Empyema
“Steeple” sign on x-ray
Laryngotrachebronchitis/croup
Child with barking cough
Croup
Pneumocystis pneumonia
HIV (treat with co-tramoxazole [+prednisalone if severe]
Asthma + nasal polyps + salicylate sensitivity
Samters triad
Alcoholic (danger of aspiration pneumonia)
Klesbiella pneumoniae
Red jelly sputum
Klebsiella Pneumoniae
Mucous sputum
Chlamydia psittaci
Rusty Sputum
Pneumococcal pneumonia
Cannonball metastases (also weight loss and haematuria)
Classically from primary renal cell carcinoma
Morning headache
Hypercapnia or side effects of organic nitrates
ACTH secreting lung tumour
Small cell carcinoma of lung
PTH secreting lung tumour
Squamous cell carcinoma of lung
Increasing serum ACE and Ca2+
Sarcoid
Egg shell calcification at hilar region
Silicosis
Heart failure cells seen in alveolar spaces
(Macrophages that have absorbed haemosiderin)
Found in;
-chronic pulmonary oedema
-associated (severe) left-ventricular heart failure
-long-standing pulmonary hypertension
Ghon Focus
Area of infection and caseous necrosis at the periphery of the lung, beneath the pleura - found in TB infection
Ghon Focus rupture
(Rare)
Rupture through the visceral pleura into the pleural cavity will produce tuberculous pleurisy
Assman focus
Apical lesions of secondary tuberculosis infection
‘Coin lesion’ found on chest radiographs
Rounded solitary lesion
Common lesions are;
-primary bronchial or lung carcinoma
-carcinoid tumour
-metastatic tumour
-bronchial hamartoma
-granulomatous inflammation
-lung abscess
When does horners syndrome occur?
When there is a local spread of cancer to the intrathoracic nodes or a Pancoasts tumour
Signs of Horners syndrome
-ptosis (drooping of the eyelid)
-enophthalmos (sunken eye)
-Miosis (small pupil)
-lack of sweating on the ipsilateral side of the face
Why do the signs of Horners syndrome occur
Due to invasion of the cervical sympathetic chain
Thumbprint sign on head x-ray
Epiglottitis
Inspiratory whoop/barking cough
Pertussis
Snow storm appearance on x ray
Baritosis / silicosis
Non-smoker + lung cancer
(Peripheral) adenocarcinoma
Where are squamous + small cell lung cancers located
Central
High d-dimers
Suspect (but not diagnose) pulmonary embolism
Action to take if high d-dimers found
Send for CTPA or V/Q scan
Low d-dimers
Exclude pulmonary embolism
Large PE
Thrombolysis
Small PE
DOAC
Respiratory alkalosis
Panic attack
Frank pus on aspiration
Empyema
Raised eosinophils on obstructive lung disease
Asthma
Raised neutrophils in obstructive lung disease
COPD
Pickwickian disease
(Obesity hypoventilation syndrome)
Obese people whose body fat prevents air getting in
-causes sleep apnoea and hypercapnia
Guillian-Barre disease
Causes paralysis
Normally preceded by a strep. Throat / infection of respiratory or GI tract.
A.K.A polyneuritis (meaning rapidly progressive, ascending motor neurone paralysis, beginning in the feet and ascending to the other muscles)
Types of coal workers pneumoconiosis
Simple (early form)
Progressive massive fibrosis (later form)
Where are problems found in coal workers pneumoconiosis?
Apex of lung
When does adult respiratory distress syndrome occur?
When non-cardiogenic pulmonary oedema leads to acute respiratory failure
What does CXR show in adult respiratory distress syndrome?
Bilateral alveolar shadowing
TLCO
How well oxygen can diffuse into the blood
Asbestosis problems are found…
At the base of the lung
Treatment of PE if not immediately life threatening
Anticoagulation therapy
(Apixaban / rivaroxaban)
Type 1 diabetic presents with vomiting and not taking her insulin. Dehydrated and deep laboured breathing
Metabolic acidosis (diabetic ketoacidosis)
22 year old woman, weight loss, sputum, night sweats, tender well defined nodules on shins bilaterally
Erythema nodosum
Hypercalcemia
Moans - GI conditions (constipation/nausea/decreased appetite/ abdominal pain/ peptic ulcer disease
Bones - (bone aches/ fractures/ loss of height)
Stones - kidney conditions (kidney stones/ frequent urination)
Groans - psychological conditions (confusion, dementia, memory loss, depression)
Brachial plexus lesion
Finger tingling, arm pain
Farmers lung antigen
Saccharopolyspora rectivirgula
