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MSRA > Resp > Flashcards

Resp Flashcards

1
Q

what does granulomatous condition mean

A

nodules of inflammation full of macrophages

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2
Q

Pulmonary manifestations of sarcoid

A

mediastinal lymphadenop
pulm fibrosis
pulm nodules

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3
Q

What is Lofgren’s syndrome

A

triad of a specific sarcoid presentation

erythema nodosum
bilat hilar lymphad
polyarthralgia

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4
Q

What does raised serum ACE indicate

A

sarcoid

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5
Q

sarcoid can cause what electrolyte imbalance

A

Hypercalcaemia

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6
Q

Gold standard for sarcoid dx

A

histology from biopsy- shows non-caseating granulomas with epithelioid cells

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7
Q

mx sarcoid

A

if asymptomatic - nil, often self resolves in 6m

Oral steroids for 6-24m and bisphosphonates

2nd line- mtx/azathioprine

rarely needs a lung transplant

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8
Q

Is most bronchial carcinoma small cell or non small cell

A

non small cell

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9
Q

Most common cause of CAP

A

Streptococcus pneumoniae

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10
Q

CAP pathogen COPD

A

Haemophilus influenzae

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11
Q

CAP pathogen post influenza, or HAP, or IVDU

A

Staphylococcus aureus

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12
Q

CAP in alcoholics / impaired swallow/ diabetic

A

Klebsiella pneumoniae

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13
Q

CF/immunocomp CAP pathogen

A

Pseudomonas aeruginosa

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14
Q

atypical pneumonia affecting young adults with diffuse infiltrates

A

Mycoplasma pneumoniae

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15
Q

Milder atypical pneumonia

A

Chlamydophila pneumoniae

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16
Q

Most common viral pneumonia

A

influenza

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17
Q

most common viral influenza in infants or elderly

A

RSV

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18
Q

CURB criteria

A

Confusion (abbreviated mental test score <= 8/10)

(urea >7)

R Respiration rate >= 30/min

B Blood pressure: systolic <= 90 mmHg and/or diastolic <= 60 mmHg

65 Aged >= 65 years

> 2 = hospital

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19
Q

tension ptx management

A

large bore cannula 2nd IC space MCL (then chest drain)

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20
Q

Drugs causing interstitial lung disease

A

‘MAN B messing up my lungs’

mtx
amiodarone
nitrofurantoin

bleomycin

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21
Q

Novel drug for ILD

A

pirfenidone

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22
Q

klebsiella pneumonia is often which lobe and what might complication be

A

upper

abscess and empyema

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23
Q

mycoplasma pneumonia complications

A

erythema multiforme
haemolytic anaemia

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24
Q

blood results in legionella

A

hyponatraemia
lymphopenia

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25
Q

type of pneumonia with bi-basal consolidation

A

legionella

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26
Q

fungal pneumonia pathogen in HIV - desat on exertion

A

pneumocytis jiroveci

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27
Q

HAP is after how long in hosp

A

48h

28
Q

PE mx if Wells >4

A

CTPA, if delay start DOAC

28
Q

If you have low suspicion of PE anyway what can you do

A

PERC- if negative then probability <2%

28
Q

PE Mx if Well’s <4

A

D dimer

29
Q

Length of treatment for provoked PE

A

3 months then reassess

30
Q

Length of treatment for PE with malignancy

A

6m or until cure of cancer

31
Q

Length of treatment for PE with pregnancy

A

until end of pregnancy, nb should have LMWH i think

32
Q

first-line treatment for massive PE where there is circulatory failure

A

thrombolysis

33
Q

COPD sx in a young person - consider

A

alpha 1 antitrypsin defic

34
Q

bronchiectasis affects which airways

A

medium sized

35
Q

genetic causes of bronchiectasis

A

CF
PCD/kartageners syndrome

36
Q

Other causes of bronchiectasis

A

post infective
aspiration or lung ca obstructing
Allergic bronchopulmonary aspergillosis
COPD

37
Q

Imaging signs for bronchiectasis

A

signet ring sign on CT

XR- tram lines and ring shadows

38
Q

How to diagnose PCD

A

nasal biopsy

39
Q

pleural aspirate pH <7.2 suggests

A

pus- needs chest drain

40
Q

pleural fluid protein <30g/L

A

transudate

41
Q

pleural fluid protein >30g/L

A

exudate

42
Q

XR findings in silicosis

A

upper zone fibrosis

‘egg-shell’ calcification of the hilar lymph nodes

43
Q

If pleural fluid protein level is between 25-35 g/L what do you do to determine if trans or exudative

A

Lights criteria

44
Q

Lights criteria

A

To be considered an exudate at least one of:

pleural fluid protein divided by serum protein >0.5

pleural fluid LDH divided by serum LDH >0.6

pleural fluid LDH more than two-thirds the upper limits of normal serum LDH

45
Q

when do you definitely put in a chest drain after a pleural tap is done

A

if the fluid is purulent or turbid/cloudy

if the fluid is clear but the pH is less than 7.2

46
Q

What is the main therapeutic benefit of inhaled corticosteroids in patients with COPD

A

reduces exacerbations

47
Q

what are ‘asthmatic features’ of COPD

A

prev dx asthma/atopy

eosinophils

diurnal variation in PEFR

variation in FEV1 over time

48
Q

COPD first line

A

SABA/SAMA

49
Q

COPD second line in no asthmatic features

A

LABA and LAMA

50
Q

COPD second line in asthmatic features

A

LABA and ICS

51
Q

Ipatropium type of drug

A

SAMA (note tiotripium is LAMA)

52
Q

FEV1:FVC in COPD

A

<0.7

53
Q

when do you give prophylactic abx in COPD patient

A

non smoker, have optimised standard treatments and continue to have exacerbations

need to exclude bronchiectasis (CT) and atypical cultures

Check LFT and QTc first

54
Q

Pulm fibrosis picture on spirometry and TLCO

A

restrictive spirometry picture (FEV1:FVC >70%, decreased FVC) and impaired gas exchange (reduced TLCO)

55
Q

Are pleural plaques themselves pre-malignant?

A

No, and they are not associated with an increased risk of lung cancer or mesothelioma.

56
Q

Difference between asbestosis and mesothelioma

A

asbestosis- lower lobe fibrosis (not cancerous)

mesothelioma- pleural disease

57
Q

Is mesothelioma or lung cancer more common in asbestosis exposure?

A

lung ca

58
Q

COPD severity scale

A

FEV1

> 80% mild (stage 1)

> 50% mod (2)

> 30% severe (3)

<30% very severe (4)

59
Q

Does coal dust increase risk of cancer

A

no, more coal workers pneumoconiosis or COPD

60
Q

rounded opacity in the right upper zone surrounded by a rim of air, b/g of TB

A

Aspergilloma

61
Q

What valve issue can cause haemoptysis

A

mitral stenosis

62
Q

pulmonary haemorrhage (haemoptysis), renal impairment (rapidly progressive glomerulonephritis) and flat or saddle nose (due to a collapse of the nasal septum) is characteristic of

A

granulomatosis with polyangiitis.

63
Q

Haemoptysis
Systemically unwell: fever, nausea
Glomerulonephritis

A

Goodpastures

64
Q

commonest causes of an anterior mediastinum mass

A

can be remembered by the 4 T’s:

teratoma,
terrible lymphadenopathy,
thymic mass
thyroid mass

MSRA (21 decks)

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