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MRCP > Resp > Flashcards

Resp Flashcards

1
Q

How does acute mountain sickness present and how is it managed

A

at 2500-3000m
headache, nausea, fatigue over 6-12hrs
Mx descent
prophylaxis acetazolamide

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2
Q

Pathophysiology HAPE

A

> 4000m
hypoxia -> uneven pulm vasoconstriction & blood flow -> areas with increased blood have increased cap pressure and leak causing oedema

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3
Q

HAPE management

A

descent
nifiedipine, dex, acetazolamide

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4
Q

HACE pathophysiology

A

hypoxia causes cerebral vasodilation increases cerebral blood flow causing oedema

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5
Q

HACE presentation and management

A

headache, ataxia, papilloedema
Mx: descent, dex

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6
Q

acute Mx asthma

A

SABA
Pred
SAMA
IV MG
IV amiophylline
I&V
ECMO

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7
Q

Diagnosis of asthma <5

A

clinical

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8
Q

Diagnosis asthma 5-16

A

spirometry and BDR test
FeNO if normal spiro or obstructive spiro with -ve BDR test

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9
Q

Diagnosis asthma >17

A

spiro and BDR test
FeNO
?occupational

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10
Q

Causes of acute exercabtion of COPD

A

h. influenza
strep pneumoniae
moraxella catarrhalis
rhinovirus

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11
Q

NIV starting settings

A

pH <7.35
EPAP 4-5cm h20
IPAP 10-15cm H20

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12
Q

How is COPD diagnosed

A

post bronchodilator spiro
FEV1/FVC <70%
FEV1 >80%: mild
FEV1 50-80%: mod
FEV1 30-50%: severe
FEV1 <30%: very severe

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13
Q

CXR findings in COPD

A

hyperinflation
bullae
flat hemidiaphragm

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14
Q

signs of asthma/steroid responsiveness in COPD

A

asthma/atopy hx
increased eosinophils
FEV1 variation
diurnal variation PEF

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15
Q

When to consider LTOT

A

2 ABG more than 3 weeks apart
pO2 <7.3 or 7.3-8.0 +
polycythaemia, peripheral oedema or pulmonary hypertension

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16
Q

What causes lung mets & appearance on CXR

A

Breast
bladder
prostate
renal
colorectal

  • cannonball
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17
Q

Carcinoid ca

A

40-50
long Hx
cherry red ball on broncoscopy
Mx: surgical

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18
Q

Small cell lung CA

A

ectopic ADH: low Na
ACTH: Cushings
Lambert Eaton Syndrome
Mx: chemo/radio

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19
Q

Non small cell lung Ca

A

Radiotherapy
Mediastinoscopy prior to surgery ?lymph node involement

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20
Q

CI to non small cell lung Ca surgery

A

SCV obstruction
Vocal cord paralysis
FEV1 <1.5
Malignant effusion

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21
Q

Squamous cell Ca

A

PTH related protein: High Ca
Clubbing
HPOA
TSH: hyperthyroid

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22
Q

Adenocarcinoma

A

gynaecomastia
HPOA

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23
Q

Cystic fibrosis gene and inheritance type

A

chromosome 7
autosomal recessive

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24
Q

Cystic fibrosis defect

A

defect in CFTR which codes cAMP regulated chloride channel

25
Q

Organises that colonise in CF pts

A

s. aureus
p. aeruginsosa
burkholderia cepacia CI to transplant
aspergillus

26
Q

Mx CF

A

chest physio
high cal high fat diet, pancreatic enzyme sups, vit sups
lung transplant b cepecia CI
Orkambi - homozygous

27
Q

Causes of transudate pleural effusion

A

protein <30
HF, low albumin, hypothyroid

28
Q

Causes of exudate pleural effusion

A

protein>30
infection, CTD, Ca, pancreatitis, PE

29
Q

When do you use lights criteria

A

When protein 25-35

30
Q

What could low glucose in pleural effusion indicate

A

RA, TB

31
Q

What would high amylase in pleural effusion indicate

A

pancreatitis, oesophageal perforation

32
Q

what would blood in pleural effusion indicate

A

mesothelioma, PE, TB

33
Q

When would you insert a chest drain if pleural effusion likely from infection

A

if aspirate is cloudy/purulent or pH <7.2

34
Q

What is sarcoidosis

A

non caseating granulomas, unknown cause

35
Q

Sarcoidosis presentation

A

young adult, african
erythema nodusum
BHL
swinging fever
polyarthralgia

SOB, cough, malaise, weight loss, hypercalcaemia

36
Q

Management of sarcoidosis

A

2/3rds self limiting
steroids if
- symptomatic + CXR S2-S3
- hypercalcaemia
-eye, heart, neuro involvement

37
Q

Poor prognostic factors of Sarcoidosis

A

insidious
no erythema nodosum
extra pulm
CXR S3-4
Black or afro/Caribbean

38
Q

CXR stages of sarcoidosis

A

1- BHL
2- BHL + interstitial infiltrates
3- diffuse interstitial infiltrates only
4- diffuse fibrosis

39
Q

What is ARDS

A

increased permeability of alveolar capillaries leading to fluid in alveoli

40
Q

Causes of ARDS

A

infection
trauma
transfusion

41
Q

Mx ARDS

A

Itu for organ support
treat cause

42
Q

What is alpha 1 antitrypsin deficincy genetic and inheritance pattern

A

autosomal recessive
chromosome 14

43
Q

How does A1AT deficiency present

A

PiZZ
panacinar emphysema, cirrhosis, hepatocellular ca

44
Q

Management A1AT def

A

no smoking, bronchodilators
IV A1AT
lung volume reduction surgery, lung transplant

45
Q

types of pneumothorax

A

primary: young, tall, no lung disease
secondary: lung disease
traumatic
iatogenic
tension: displacement of mediastinal structures

46
Q

management primary pneumothorax

A

<2cm and not SOB : discharge
otherwise aspirate, chest drain if fails

47
Q

management secondary pneumothorax

A

<1cm: 02 and observe 24h
1-2cm: aspirate, chest drain if fails
>2cm/>50/SOB: chest drain

48
Q

Management recurrent pneumothorax

A

VATS for pleurodesis +/- bullectomy

49
Q

Discharge advice post pneumothorax

A

stop smoking
no flying 2 weeks
no diving

50
Q

What is eosinophilic granulomatosis with polyangiitis

A

ANCA associated vasculitis
asthma, sinusitis, SOB
high eosinophils
pANCA +ve

51
Q

What is granulomatosis with polyangiitis

A

ANCA associated vasculitis
upper and lower resp tract
glomerulonephritis
cANCA +ve
renal bisopy: epithelial cresents in Bowmans capsule

52
Q

Management of granulomatosis with polyangiitis

A

steroids
cyclophosphamide
plasma exchange

53
Q

Symptoms of ABPA

A

wheeze, cough SOB
eosinophilia
+ve RAST for aspergillus
raised IgE

54
Q

Management of ABPA

A

1st line glucocorticoids
2nd line itraconazole

55
Q

Causes of EAA

A

bird: avain proteins from poo
farmers: saccharopolyspora retivirgula
Malt: asp claratus

55
Q

What kind of hypersensitity reaction is EAA

A

type III /IV

56
Q

Presentation of EAA

A

acute: SOB, cough fever
chronic: SOB, cough, lethargy, weight loss

57
Q

Ix EAA

A

upper/mid fibrosis
bronchoalvealor lavage: lymphocytosis
IgG AntibodiesMan

58
Q

management EAA

A

avoidance
glucocorticoids

MRCP (19 decks)

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