resp Flashcards
Ongoing dyspnoea post needle aspiration in context of pneumothorax?
Chest drain
PIMS or PIZZ for genotype associated with AATD?
PIZZ
Chronic sinusitis + nephritic syndrome?
Granulomatosis with polyangiitis
Management of high altitude cerebral edema (HACE)?
Descent and dexamethasone
Male subfertility, sinusitis, dextrocardia, bronchiectasis?
Kartagener’s syndrome
Indications for corticosteroids in sarcoidosis?
Hypercalcaemia, uveitis, cardiac or neuro involvement, parenchymal lung disease
Mechanism of Bupropion?
Norepinephrine-dopamine reuptake inhibitor and nicotinic antagonist
Most useful marker for monitoring the progression of patients with chronic obstructive pulmonary disease (COPD)?
Forced expiratory volume in one second (FEV1)
Good prognostic factors in sarcoidosis?
HLA B8 and Lofgren’s syndrome (bilateral hilar lymphadenopathy, erythema nodosum, polyarthritis and fever)
First line investigation for asthma?
FBC
Bronchiectasis - most common organism?
H Influenzae
Benefit of steroids in COPD?
Reduces exacerbations
Bilateral pulmonary infiltrates, raised eosinophils, asthmatic?
Allergic bronchopulmonary aspergillosis - Oral glucocorticoids
Upper airway compression investigation?
Flow volume loop
Varenicline mechanism?
Nicotinic receptor partial agonist
Large right-sided pneumothorax measuring 4.4 cm? Patient is asymptomatic.
Minimally symptomatic pneumothorax, regardless of size, can be treated with conservative treatment / regular follow-up
Coal, asbestos, arsenic, radon - which one is not a risk for developing lung ca?
Coal
Cannot complete sentences in asthma - severe or life threatening?
Peak flow <30% best or predicted - severe or life threatening?
Severe and life threatening
More wheezy and breathless than usual having stopped montelukast therapy 3 months ago?
Churg-Strauss syndrome
Management of high altitude pulmonary oedema (HAPE)?
Descent and nifedipine
Serial peak flow measurements at work and at home for which dx?
Occupational asthma
Normal function of the cystic fibrosis transmembrane regulator? Which type of channel does this act on?
Chloride
Risk of developing lung ca with asbestos and smoking exposure?
50 times - 10 (smoking) 5 (asbestos)
Which one of the following is the main criteria for determining whether a patient with chronic obstructive pulmonary disease (COPD) should be offered long-term oxygen therapy?
LTOT if 2 measurements of pO2 < 7.3 kPa
Settings on bi-level pressure support in COPD?
IPAP - 10
EPAP - 5
Most common cause of occupational asthma?
Isocyanates
Acute severe asthma attack first and second line?
IV MgSO4, aminophylline
Presentation of dyspnoea and hypoxaemia 72 hours post operatively?
Basal atelectasis
Patient presented with shortness of breath, cough, chest pain, and brown sputum on a background of recently brittle asthma? Raised IgE and eosinophils?
Allergic bronchopulmonary aspergillosis
Cherry red lesion seen on bronchoscopy?
Lung carcinoid
Before starting azithromycin what tests to be done and why?
ECG + baseline LFTs - rule out prolonged QT
Sarcoidosis grading on CXR?
Sarcoidosis CXR
1 = BHL
2 = BHL + infiltrates
3 = infiltrates
4 = fibrosis
Normal CO2 in asthma attack grading?
Life threatening
Bronchiolitis obliterans associated with which chronic condition?
RA
Light’s criteria (25-35)
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
Contraindications to lung ca surgery?
Malignant effusion, FEV < 1.5, SVC obstruction, vocal cord paralysis
Vital capacity in males and females?
4,500ml in males, 3,500 mls in females
ARDS criteria?
Berlin criteria: acute onset of hypoxaemia (pO2/FiO2 ratio less than 300 mmHg), bilateral infiltrates on chest X-ray (CXR), and non-cardiogenic origin of pulmonary oedema
Cavitating lung lesion - infection?
Staph aureus, Klebsiella and Pseudomonas
Pneumonia commonest in alcohol xs?
Klebsiella pneumonia
COPD - still breathless despite using SABA/SAMA and no asthma/steroid responsive features?
LABA LAMA
Reticular changes on CT imaging - worse at bases?
IPF
Parotid swelling, fever and anterior uveitis?
Heerfordt syndrome
Polycythaemia increases risk of?
Stroke
Caution for Varenicline and Bupropion?
Self harm, epilepsy
Eosinophils and fractional exhaled nitric oxide testing come back as normal? Next step in testing for asthma?
Measure peak expiratory flow (PEF) twice daily for 2 weeks/spirometry
Asthma diagnosis?
FeNO > 40
Presentation of chronic sinusitis unresponsive to antibiotics, nasal congestion, epistaxis, and a swollen nasal bridge, which strongly suggests involvement of the upper respiratory tract?
Gran with polyangiitis
PFTs in obesity?
Reduced FEV1 and FVC with a normal FEV1/FVC ratio, and reduced expiratory reserve volume
