Resp Flashcards

1
Q

How would you estimate the severity of pneumonia (risk of mortality)?

A

CURB65

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2
Q

What urea level scores a point on the CURB65 score?

A

-

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3
Q

What resp rate scores a point on there CURB65 score?

A

.

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4
Q

What scores points on the CURB65 score?

A

Confusion
Urea (>7mmol/L)
Resp rate (>30)
BP (SBP<90 or DBP<60)
65 (age>65)

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5
Q

What blood pressure levels score a point on CURB65?

A
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6
Q

What four drugs are used to treat active TB?

A

RIPE -
Rifampicin (6 months)
Isoniazid (6 months)
Pyrazinamide (2 months)
Ethambutol (2 months)

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7
Q

What’s the main side effect of rifampicin?

A

discolouration of bodily fluids (e.g red urine, yellowy sweat/saliva)

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8
Q

Give four examples of obstructive lung diseases.

A
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9
Q

What spirometry measurements are affected in obstructive lung disease?

A
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10
Q

What’s the diagnostic FEV1/FVC ratio for COPD?

A
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11
Q

What spirometry measurements are affected in restrictive lung disease?

A
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12
Q

What gene is mutated in CF and on what chromosome?

A
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13
Q

What size is a small vs large pneumothorax?

A
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14
Q

What imaging technique is used in diagnosing interstitial lung disease?

A

High resolution CT thorax

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15
Q

What type of hypersensitivity reaction is hypersensitivity pneumonitis?

A

Type III

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16
Q

In which type of respiratory failure would you see raised HCO3-?

A

chronic type II

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17
Q

Give two conditions that cause type I respiratory failure.

A
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18
Q

Give two conditions that cause type II respiratory failure.

A
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19
Q

What ventilation support can be used to treat type I respiratory failure? what about type II?

A

CPAP and BiPAP (Bi = 2)

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20
Q

In which type of respiratory failure do you see raised CO2?

A

Type II

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21
Q

What is the mode of action of tiotropium bromide?

A
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22
Q

Give two signs of a life-threatening asthma attack

A
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23
Q

HRCT findings in pulmonary fibrosis?

A
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24
Q

What’s the treatment pathway for treating ASTHMA?

A
  • SABA
  • ICS
  • ICS + LABA (=MART)
  • LTRA / increase dose of ICS

(LTRA = leukotriene receptor antagonist)

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25
Q

Management of tension pneumothorax?

A
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26
Q

Where can chest drains be safely inserted?

A
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27
Q

1st line treatment for Goodpasture’s syndrome?

A

IV methylprednisolone

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28
Q

Inheritance pattern of CF?

A
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29
Q

Incubation period for influenza?

A

1-4 days

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30
Q

Give three signs of COPD on an X-ray

A

bulla = an air-filled space >1 cm (due to emphysematous destruction)

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31
Q

what’s the difference between full and partial respiratory compensation?

A

full compensation = pH restored to normal range
partial = pH not restored to normal range

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32
Q

Exposure to what results in bird-fancier’s lung?

A

avian proteins (from bird droppings)

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33
Q

What type of pleural effusion is most likely in cor pulmonale?

A

transudate

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34
Q

What protein in the blood protects lung cells against neutrophil elastase? where is it made?
(neutrophil elastase destroys alveolar walls)

A

alpha-1 antitrypsin
made in liver

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35
Q

alpha-1 antitrypsin deficiency is caused by a mutation on which chromosome?

A
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36
Q

What’s a key side effect of ethambutol?

A
37
Q

What’s a key side effect of pyrazinamide?

A
38
Q

Where does lung cancer not usually metastasise to?

A

Pancreas

39
Q

Most common lung cancer in smokers?

A
40
Q

Most common lung cancer in non-smokers?

A
41
Q

Name a test for latent TB diagnosis

A
42
Q

Organism that most commonly causes HAP?

A

Pseudomonas aeruginosa

43
Q

Organism that most commonly causes CAP?

A

Strep pneumoniae

44
Q

Give three organisms that cause atypical pneumonia

A

(name first three)

45
Q

What’s the treatment for a score of 0-1 in CURB65?

A
46
Q

What’s the treatment for a score of 2 in CURB65?

A
47
Q

What’s the treatment for a score of 3 or more in CURB65?

A
48
Q

Which antibiotics inhibit the 50s subunit?

A
49
Q

Give two examples of macrolides

A
50
Q

First line investigation for suspected PE due to DVT?

A

CT pulmonary angiography

51
Q

What would a lung biopsy show in a patient with sarcoidosis?

A
52
Q

What treatment would be given for stage 1 sarcoidosis?

A
53
Q

Give three extra pulmonary manifestations of sarcoidosis other than erythema nodosum and lymphadenopathy.

A
  • Polyarthritis
  • Uveitis
  • Arrythmias
54
Q

What conc. of protein do you find in transudates vs exudates? (give value)

A

trans = <30 g/L
ex = >30 g/L

55
Q

Two main causes of clubbing?

A

Chronically low O2 levels
Malabsorption

56
Q

Two classes of drugs contraindicated in asthma?

A
  • Beta blockers
  • NSAIDs
57
Q

Common side effect associated with regular nebulised salbutamol?

A
58
Q

What test can be done to differentiate between nephrogenic and cranial diabetes insipidus?

A
59
Q

Two main side effects of isoniazid?

A
60
Q

4 X-ray signs in TB?

A
  • Ghon complexes (caseating granulomas)
  • Dense homogenous opacity
  • Hilar lymphadenopathy
  • Pleural effusion
61
Q

Give an alternative test to the heel prick test for CF.

A
  • Sweat test
    (conc. of chloride in sweat of CF patients is higher)
62
Q

What investigation can be used to help confirm a diagnosis of asthma.

A
  • Spirometry
  • Usually 1% increase in FEV1 after SABA administration
    (FEV1/FVC reduced, increased residual volume)
63
Q

Give two examples of SABAs.

A
64
Q

Give two examples of LABAs

A
65
Q

Give an example of a SAMA and a LAMA

A
66
Q

Give two examples of ICS

A
67
Q

Pathophysiology of chronic asthma?

A

Narrowing of the airway due to:
- smooth muscle contraction
- thickening of airway wall due to inflammation
- presence of secretions

68
Q

What three hormones do SCLCs sometimes secrete?

A
69
Q

Give three cancers that lung cancer is most likely to metastasise from.

A
  • Bladder
  • Prostate
  • Colorectal
    (Wilm’s tumor, sarcoma, breast cancer etc)
70
Q

Give three differentials for bilateral lymphadenopathy other than TB and sarcoidosis.

A
  • Silicosis
  • Lymphoma
  • HF
71
Q

1st and 2nd line antibiotics for H. influenzae?

A

1st line: Doxycycline
2nd line: Co-amoxiclav

72
Q

Give two differentials for a COPD exacerbation

A
  • Pneumonia
  • CHF
    (+pneumothorax, pleural effusion etc)
73
Q

MC form of lung cancer?

A

Squamous cell carcinoma (about 40% of total lung cancers)

74
Q

What does a signet ring sign on CT indicate?

A

Bronchiectasis

75
Q

What does bronchus sign on CT indicate?

A

Bronchogenic cancer

76
Q

What does a polo mint sign on CT indicate?

A

PE

77
Q

What does a split pleura sign on CT suggest?

A

Empyema or malignant effusion

78
Q

Most at risk group of spontaneous pneumothorax?

A

Male
20-40
Low BMI

79
Q

First line antibiotics for group A strep pharyngitis?

A

Penicillin or amoxicillin

80
Q

First line antibiotics for otitis media?

A

Amoxicillin
(otitis media usually self resolves within a week)

81
Q

What nasal spray can be given for sinusitis?

A
82
Q

What delayed antibiotic can be given for sinusitis?

A
83
Q

What is croup and what’s effective in treating it?

A
84
Q

What bacteria causes whooping cough and what’s special about it? What antibiotic is general successful?

A
85
Q

What two drugs can be given for idiopathic pulmonary fibrosis?

A
86
Q

Sign of pleural effusion on X-ray?

A

Bilateral costophrenic blunting

87
Q

Five levels of the MRC dyspnoea scale?

A
88
Q

After salbutamol, what is next line management for COPD exacerbations in asthmatic patients.

A