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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
Management of tension pneumothorax?
26
Where can chest drains be safely inserted?
27
1st line treatment for Goodpasture's syndrome?
IV methylprednisolone
28
Inheritance pattern of CF?
29
Incubation period for influenza?
1-4 days
30
Give three signs of COPD on an X-ray
bulla = an air-filled space >1 cm (due to emphysematous destruction)
31
what's the difference between full and partial respiratory compensation?
full compensation = pH restored to normal range partial = pH not restored to normal range
32
Exposure to what results in bird-fancier's lung?
avian proteins (from bird droppings)
33
What type of pleural effusion is most likely in cor pulmonale?
transudate
34
What protein in the blood protects lung cells against neutrophil elastase? where is it made? (neutrophil elastase destroys alveolar walls)
alpha-1 antitrypsin made in liver
35
alpha-1 antitrypsin deficiency is caused by a mutation on which chromosome?
36
What's a key side effect of ethambutol?
37
What's a key side effect of pyrazinamide?
38
Where does lung cancer not usually metastasise to?
Pancreas
39
Most common lung cancer in smokers?
40
Most common lung cancer in non-smokers?
41
Name a test for latent TB diagnosis
42
Organism that most commonly causes HAP?
Pseudomonas aeruginosa
43
Organism that most commonly causes CAP?
Strep pneumoniae
44
Give three organisms that cause atypical pneumonia
(name first three)
45
What's the treatment for a score of 0-1 in CURB65?
46
What's the treatment for a score of 2 in CURB65?
47
What's the treatment for a score of 3 or more in CURB65?
48
Which antibiotics inhibit the 50s subunit?
49
Give two examples of macrolides
50
First line investigation for suspected PE due to DVT?
CT pulmonary angiography
51
What would a lung biopsy show in a patient with sarcoidosis?
52
What treatment would be given for stage 1 sarcoidosis?
53
Give three extra pulmonary manifestations of sarcoidosis other than erythema nodosum and lymphadenopathy.
- Polyarthritis - Uveitis - Arrythmias
54
What conc. of protein do you find in transudates vs exudates? (give value)
trans = <30 g/L ex = >30 g/L
55
Two main causes of clubbing?
Chronically low O2 levels Malabsorption
56
Two classes of drugs contraindicated in asthma?
- Beta blockers - NSAIDs
57
Common side effect associated with regular nebulised salbutamol?
58
What test can be done to differentiate between nephrogenic and cranial diabetes insipidus?
59
Two main side effects of isoniazid?
60
4 X-ray signs in TB?
- Ghon complexes (caseating granulomas) - Dense homogenous opacity - Hilar lymphadenopathy - Pleural effusion
61
Give an alternative test to the heel prick test for CF.
- Sweat test (conc. of chloride in sweat of CF patients is higher)
62
What investigation can be used to help confirm a diagnosis of asthma.
- Spirometry - Usually 1% increase in FEV1 after SABA administration (FEV1/FVC reduced, increased residual volume)
63
Give two examples of SABAs.
64
Give two examples of LABAs
65
Give an example of a SAMA and a LAMA
66
Give two examples of ICS
67
Pathophysiology of chronic asthma?
Narrowing of the airway due to: - smooth muscle contraction - thickening of airway wall due to inflammation - presence of secretions
68
What three hormones do SCLCs sometimes secrete?
69
Give three cancers that lung cancer is most likely to metastasise from.
- Bladder - Prostate - Colorectal (Wilm's tumor, sarcoma, breast cancer etc)
70
Give three differentials for bilateral lymphadenopathy other than TB and sarcoidosis.
- Silicosis - Lymphoma - HF
71
1st and 2nd line antibiotics for H. influenzae?
1st line: Doxycycline 2nd line: Co-amoxiclav
72
Give two differentials for a COPD exacerbation
- Pneumonia - CHF (+pneumothorax, pleural effusion etc)
73
MC form of lung cancer?
Squamous cell carcinoma (about 40% of total lung cancers)
74
What does a signet ring sign on CT indicate?
Bronchiectasis
75
What does bronchus sign on CT indicate?
Bronchogenic cancer
76
What does a polo mint sign on CT indicate?
PE
77
What does a split pleura sign on CT suggest?
Empyema or malignant effusion
78
Most at risk group of spontaneous pneumothorax?
Male 20-40 Low BMI
79
First line antibiotics for group A strep pharyngitis?
Penicillin or amoxicillin
80
First line antibiotics for otitis media?
Amoxicillin (otitis media usually self resolves within a week)
81
What nasal spray can be given for sinusitis?
82
What delayed antibiotic can be given for sinusitis?
83
What is croup and what's effective in treating it?
84
What bacteria causes whooping cough and what's special about it? What antibiotic is general successful?
85
What two drugs can be given for idiopathic pulmonary fibrosis?
86
Sign of pleural effusion on X-ray?
Bilateral costophrenic blunting
87
Five levels of the MRC dyspnoea scale?
88
After salbutamol, what is next line management for COPD exacerbations in asthmatic patients.

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