Resp Flashcards
Most common cause of occupational asthma
isocyanates (spray paint)
upper lobe fibrosis
CHARTS
C - Coal worker’s pneumoconiosis
H - Histiocytosis/ hypersensitivity pneumonitis
A - Ankylosing spondylitis
R - Radiation
T - Tuberculosis
S - Silicosis/sarcoidosis
causes of exudative pleural effusion
- Malignany
- Emphyema (low pleural glucose conc + pleural fluid <7.3)
what can cause a false negative manatoux test
sarcoidosis
upper zone fibrosis, egg-shell calcification of hilar nodes
silicosis
klebsiella symptoms
red current jelly sputum
alcoholics
Lead to pleural emphyema
contraindication to lung cancer surgery
superior vena cava obstruction
vocal cord paralysis
what drug class is ipatropium bromide
SAMA
Example of a LABA
salmetrolol
Example of a LAMA
Tiotropium
cause of coarse crackers
fluid in lungs
idiopathic pulmonary fibrosis what is heard
fine end inspiratory crepitations
cavitating lesions what cancer
squamous cell
what is used to guide antibiotic treatment in acute bronchitis
CRP >100 immediate
(doxycycline/amoxicillin)
pleural fluid protein >30
exudative
COPD prophylaxis
azithromycin
Diagnosis of mesothelioma
thoracoscopy and histology
high risk pneumothorax treatment
straight to chest drain
What is meigs syndrome
fibroma
ascites
pleural effusion
What is the triangle of safety
base of the axilla, lateral edge pectoralis major, 5th intercostal space and the anterior border of latissimus dorsi
When do you have to do abg
oxygen sats <92%
what is lupus pernio associated with
sarcoidosis
what is sued to prevent recurrence of pneumothorax
Video assisted thoracoscopic surgery (VATS) pleurodesis
61%
Over rapid aspiration/drainage of pneumothorax can result in
pulmonary oedema
what must be done before starting TNF-inhibitors?
chest x ray to look for TB
indication for thrombolysis in PE
massive PE + hypotension
most common cause of IE with strep viridians
poor dental hygience
why do you get hypercalcaemia in sarcoidosis
increased conversion of vitamin D to its active form
treatment of Allergic bronchopulmonary aspergillosis
pred and itraconazole
what does A1TP do
protect against neutrophil elastase which causes breakdown of alveoli
lights criteria for exudative
pleural fluid protein divided by serum protein >0.5
pleural fluid LDH divided by serum LDH >0.6
CAP treatment
amoxicillin TDS 500mg
Adult acute asthma management
- Oxygen
- Oxygen driven nebulised salbutamol 5mg
- Steroids: pred 40mg or IV hydrocortisone 20mg
- Neb ipratropium bromide
What immediate investigations would you do in an asthma attack
Current Peak Flow: Expected - *>75% mild, 50-75% moderate, <33% life threatening
SpO2 - hypoxia
ABG - hypoxia, normo/hyper capnia & uncomplicated acidosis
CXR - ?infection
Important investigations following pleural tap
- LDH and Protein in Pleural Fluid/Serum → determine whether effusion is exudate or transudate
- Effusion Cytology → to investigate possible concerns of malignancy
- Glucose or pH of Effusion → investigate possible malignancy (both should
be low)
What is seen on chest x-ray with pleural effusion
Blunting of costophrenic angles
Opaque consolidation in right hemithorax & concave meniscus sign
In considering the patient for a chest drain insertion, you wish to avoid the costal blood vessels. Where are these located and how can they be avoided?
Location → costal grooves on the inferior surface of the ribs
How to Avoid → insert the chest drain directly above the rib (4-6th on mid-axillary line) aiming inferiorly
what will CTPA show with PE
occlusion of pulmonary vasculature +/- distally threadlike vessels
cause of pneumonia in bird owners
Chlamydia psittaci
what eye condition does ethambutol cause
optic neuritis
criteria for discharge following asthma attack
been stable on their discharge medication (i.e. no nebulisers or oxygen) for 12-24 hours
inhaler technique checked and recorded
PEF >75% of best or predicted
A 33-year-old man who is known to be HIV positive presents with cough and dyspnoea. Auscultation of his chest is unremarkable but he is noted to desaturate on exertion.
pneumocytosis jiroveci
which TB drug causes INR to go up vs down
down: rifampicin (inducers)
Up: isoniazid (inhibitors)
which pneumonia organism cause positive cold agglutination test → peripheral blood smear may show red blood cell agglutination
mycoplasma
common complication of PJP
pneumothorax
LTOT requirements
Offer LTOT to patients with a pO2 of < 7.3 kPa or to those with a pO2 of 7.3 - 8 kPa and one of the following:
secondary polycythaemia
peripheral oedema
pulmonary hypertension
A small (1-2cm) calcified nodule is visible in the lateral area of the right mid zone
ghon focus - latent TB
malignancy associated with asbestos
bronchogenic carcinoma.
which side is aspiration pneumonia more common in
right
how many lobes does right lung have
3
