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Finals passmed > Resp > Flashcards

Resp Flashcards

1
Q

When stepping down asthma treatment what should you do?

A

Reduce the ICS by 25-50%

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2
Q

What are the common features of a lung abscess presentation?

A

Symptoms develop over weeks, systemic symptoms, productive cough with foul-smelling sputum, some haemoptysis, chest pain, dyspnoea

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3
Q

What are the X-Ray signs of a lung abscess?

A

fluid-filled space within an area of consolidation, air-fluid level

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4
Q

What is the management of a lung abscess?

A

IV Abx
percutaneous drainage if not resolving

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5
Q

What is FEV1?

A

The total volume of air someone is able to exhale in the first second of forced expiration

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6
Q

What is FVC?

A

The total volume of air that can be exhaled by the person in one breath

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7
Q

What is the FEV1/FVC ratio like in obstructive diseases?

A

Low (FEV1 is low but the total volume of air the lungs can hold is the same, they just have issues getting it out)

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8
Q

What is alpha-1-antitrypsin deficiency?

A

A genetic condition that classically causes emphysema

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9
Q

What are the causes of upper zone lung fibrosis?

A

CHARTS
- coal workers pneumoconiosis, hypersensitivity pneumonitis, ankylosing spondylitis, radiation, tuberculosis, silicosis/sarcoidosis

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10
Q

What is the most common type of lung cancer in non-smokers?

A

Adenocarcinoma

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11
Q

What are the most common types of lung cancer in smokers?

A

adenocarcinoma, small cell and squamous cell

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12
Q

Which type of lung cancer is associated with gynaecomastia?

A

Adenocarcinoma

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13
Q

Which type of lung cancer is most associated with finger clubbing?

A

squamous cell

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14
Q

What is a pancoast tumour?

A

A tumour at the apex of the lung

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15
Q

What are the features of a pancoast tumour?

A

Persistent hoarse voice, smoking history, malaise, weight loss

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16
Q

What score is used to decide if a PE can be managed in outpatients?

A

Pulmonary embolism severity index (PESI)

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17
Q

What is a common complication of steroid inhaler use?

A

Oral/oesophageal candidiasis (painful swallowing)

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18
Q

What is the management of extrinsic alveolitis?

A

e.g. farmers lung/pigeon fanciers lung
Avoid triggers,
oral glucocorticoids

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19
Q

What is the most common cause of resp infections in COPD patients?

A

Haem flu (most common), step pneumonia

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20
Q

What are the features of idiopathic pulmonary fibrosis?

A
  • exertional dyspnoea
  • bibasal fine end creps
  • dry cough
  • clubbing
  • ground- glass
21
Q

What X Ray finding is indicative of bronchiectasis?

A

tram-line - parallel line shadows

22
Q

What is the PEFR gradings of asthma attacks?

A

<33% = life-threatening
33-50% = severe
50-70% = moderate

23
Q

What does a pneumonectomy look like on an X-Ray?

A

White space where the lung is - fills with fluid after a while that is why it is white

24
Q

What is the management of an acute exacerbation of COPD?

A

Oral prednisolone for 5 days

25
Q

When do you give antibiotics in a COPD exacerbation?

A

When the sputum is purulent or there are clinical signs of pneumonia

26
Q

What are the features of autoimmune hepatitis?

A

Jaundice, amenorrhoea, signs of chronic liver disease

27
Q

What may be seen on bloods in autoimmune hepatitis?

A

Deranged lfts, raised WCC, raised IgG, ANA/SMA/LKMI antibodies

28
Q

What is the management of autoimmune hepatitis?

A

Steroids, immunosuppressants - azathioprine, liver transplantation

29
Q

What is good inhaler technique?

A
  • shake
  • breathe out gently
  • breathe in slow and deep, press down and keep breathing in
  • hold breath for 10 seconds
  • wait 30 seconds before second dose
30
Q

What is a common endocrine complication of small cell lung cancer?

A

SIADH

31
Q

which conditions have a raised transfer coefficient?

A

asthma, pulmonary haemorrhage, left to right cardiac shunts, polycythaemia

32
Q

Which conditions cause a lower transfer coefficient?

A

pulmonary fibrosis, pneumonia, pulmonary emboli, pulmonary oedema, emphysema, anaemia, low cardiac output

33
Q

What are the features of a pneumothorax?

A

Sudden onset dyspnoea, chest pain, hyper-resonant on percussion, reduced

34
Q

What is the criteria for discharging a patient following an acute asthma attack?

A
  • stable on their discharge medication for 12-24hrs
  • inhaler technique
  • PEF > 75% of predicted
35
Q

What is the most common organism in a COPD exacerbation?

A

haemophilus influenzae

36
Q

What is the most common organism that causes a bronchiectasis exacerbation?

A

haemophilus influenzae

37
Q

Which conditions cause upper zone fibrosis?

A

C - coal workers pneumoconiosis
H - hypersensitivity pneumonitis
A - ankylosing spondylitis
R - Radiation
T - tuberculosis

38
Q

What is the fluid from if it is exudate? (fluid protein/serum protein ratio >0.5)

A

TB, lung cancer, meigs syndrome

39
Q

What would cause a transudate pleural effusion?

A

non-resp causes like nephrotic syndrome, heart failure

40
Q

What can you give in type 2 respiratory failure if medical interventions didn’t work?

A

BiPAP

41
Q

Which chest signs on auscultation do you hear in pulmonary fibrosis?

A

fine end-inspiratory crepitations

42
Q

What would you give in a viral COPD exacerbation?

A

5 day course of oral prednisolone

43
Q

What condition has a ground glass appearance on CXR?

A

IPF

44
Q

What type of lung cancer is associated with Cushing’s syndrome?

A

small cell lung cancer

45
Q

What is the management of allergic aspergilliosis?

A

Oral prednisolone

46
Q

What are the features of sarcoidosis?

A

erythema nodosum, bilateral hilar lymphadenopathy, fever, polyarthralgia, lupus pernio, cough, hypercalcaemia

47
Q

What is the management of life-threatening asthma in those who do not respond to treatment?

A

intubation and ventilation

48
Q

How do you calculate pack years?

A

1 pack year is 20 cigarettes per day for 1 year

Finals passmed (23 decks)

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