Resp Flashcards

1
Q

What are small cell lung cancer associated hormones?

A

ADH, ACTH, Lambert Eaton

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2
Q

What are squamous lung cancer associated conditions?

A

PTH, Clubbing, HPOA, Ectopic TSH

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3
Q

What are adenocarcinoma associated conditions?

A

Gynaecomastia, HPOA

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4
Q

What are the stages of sarcoidosis?

A

1 BHL, 2 BHL and infiltrates, 3 infiltrates without BHL, 4 fibrosis

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5
Q

What indicates a good prognosis in sarcoidosis?

A

HLA B8, Erythema Nodosum, polyarthritis, fever

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6
Q

What is the first line investigation for asthma in adults?

A

FBC for eosinophilia or fractional nitric oxide. Bronchodilator reversibility with spirometry is diagnostic.

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7
Q

What does respiratory alkalosis + normal PaO2 indicate?

A

Anxiety

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8
Q

What does respiratory alkalosis + reduced PaO2 indicate?

A

Pulmonary Embolism (PE)

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9
Q

What is the target oxygen saturation for COPD once CO2 is normal?

A

94-98%

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10
Q

What is the treatment for allergic bronchopulmonary aspergillosis?

A

Prednisolone

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11
Q

What are the stages of idiopathic pulmonary fibrosis (IPF)?

A

Small peripheral changes in lower zones -> ground glass -> honeycombing

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12
Q

What do ground glass changes indicate?

A

Organising pneumonia

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13
Q

What is CURB65 criteria?

A

RR >30, DBP <60

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14
Q

When is a chest tube indicated?

A

Purulent fluid, culture or pH <7.2

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15
Q

What causes a left shift in the oxygen dissociation curve?

A

Lower acidity, temperature, 2-3 DPG, HbF, carboxy/methyhaemoglobin

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16
Q

What causes a right shift in the oxygen dissociation curve?

A

Raised acidity, temperature, 2-3 DPG

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17
Q

What conditions are associated with bronchiectasis?

A

CF, Measles, Hypogammaglobulinaemia, Aspergillosis

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18
Q

What happens if you have high EPO due to altitude or marathon running?

A

Secondary polycythaemia increases stroke risk

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19
Q

What is the cut-off for pulmonary arterial pressure?

A

> 20

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20
Q

When is NIV indicated in COPD?

A

In T2RF that does not improve with medical therapy

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21
Q

What happens to TLCO in asbestosis?

A

It is reduced

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22
Q

What is the treatment for Chlamydia psittaci?

A

Doxycycline

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23
Q

What is EAA?

A

Hypersensitivity pneumonitis with a primarily granulomatous inflammatory response

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24
Q

What does normal PCO2 in acute severe asthma indicate?

A

Life threatening condition

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25
Q

What is the treatment for High Altitude Pulmonary Edema (HAPE)?

A

Descent, oxygen, nifedipine

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26
Q

What indicates bronchiolitis obliterans in a patient with rheumatoid arthritis?

A

Dyspnoea and obstructive pattern on spirometry

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27
Q

How much does smoking increase lung cancer risk?

A

x10, asbestos x5, both x50

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28
Q

What is the association of bronchiectasis with eosinophilia and fungal hyphae?

A

Allergic bronchopulmonary aspergillosis treated with oral prednisolone

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29
Q

What can oral itraconazole be used for?

A

As a steroid sparer

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30
Q

What are Light’s Criteria for exudative effusion?

A

Requires one of the following: Pleural fluid protein / Serum protein >0.5, Pleural fluid LDH / Serum LDH >0.6, Pleural fluid LDH > 2/3 * Serum LDH upper limit of normal

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31
Q

Is glucose used in Light’s Criteria?

A

No

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32
Q

Eosinophilic Granulomatosis - Churg Strauss

A

Nasal polyps, unmasked by montelukast

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33
Q

Granulomatosis with Polyangitis

A

Sinus pain and nephrotic syndrome

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34
Q

Occupational asthma causes

A

Flour, Isocyanates, Cadmium, Platinum Salts

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35
Q

Acute mountain sickness prevention

A

Acetazolamide

36
Q

HACE treatment

A

Descent, Dexamethasone

37
Q

HAPE treatment

A

Descent, Nifedipine, Dexamethasone, Acetazolamide

38
Q

Transfer factor raised conditions

A

Asthma, haemorrhage, left to right shunts, polycythaemia

39
Q

Transfer factor low conditions

A

Everything else

40
Q

Most common organism in bronchiectasis

A

Haemophilus influenza

41
Q

Spirometry pattern in rheumatoid dyspnoea

A

Obstructive pattern, bronchiolitis obliterans

42
Q

Sarcoidosis inheritance

A

AR such as CF = 50% chance of carrier, 25% chance of having

43
Q

Alpha 1 antitrypsin genotypes

A

PiZZ = Emphysema, PiMM = Normal, PiMZ = Carrier

44
Q

Malt workers lung causative agent

A

Aspergillus clavatus

45
Q

NIV in bronchiectasis

A

NIV won’t work due to too many secretions

46
Q

Kartagener’s syndrome symptoms

A

Primary ciliary dyskinesia, male subfertility, recurrent sinusitis, malabsorption, dextrocardia

47
Q

Post smoking intervention improving COPD survival

48
Q

LTOT criteria

A

Po2 of <7.4 or above with secondary polycythaemia, nocturnal hypoxaemia, peripheral oedema or pulmonary hypertension

49
Q

Contraindications to lung cancer surgery

A

SVC obstruction, FEV <1.5, malignant pleural effusion, vocal cord paralysis

50
Q

Treatment for alpha-1-antitrypsin deficiency

A

Lung volume reduction surgery

51
Q

Obesity effect on lung function

A

Raised KCO and restrictive picture

52
Q

EAA causative agent

A

Hypersensitivity pneumonitis, thermophilic actinomycetes (saccharopolyspora rectivirgula)

53
Q

Bupropion mechanism

A

Inhibition of norepinephrine-dopamine reuptake and antagonism of nicotinic acetylcholine receptors

54
Q

Recurrent chest infections and subfertility

A

Primary ciliary dyskinesia (Kartagener’s syndrome)

55
Q

BiPAP pressures

A

E comes before I. E=5, I=10

56
Q

Diagnostic test for OSA

A

Polysomnography (PSG)

57
Q

Granulomatosis with polyangitis affected systems

A

ENT, respiratory and kidney

58
Q

COPD stages

A

> 80% mild stage 1, 50-79 moderate stage 2, 30-49 severe stage 3, <30 very severe stage 4

59
Q

Sarcoidosis treatment necessity

A

Most improve without treatment

60
Q

Urea in pneumonia prognosis

A

Linked with poor prognosis

61
Q

Squamous cell lung cancer markers

A

PTHrp, clubbing, HPOA

62
Q

Small cell lung cancer markers

A

ADH, ACTH, Lambert Eaton

63
Q

Azithromycin precautions

A

Requires LFTs and baseline ECG as can cause long QT

64
Q

Occupational asthma monitoring

A

Serial peak flows at home and work

65
Q

ARDS characteristics

A

Non-cardiogenic sudden onset pulmonary oedema with hypoxaemia and Po2/fio2 <300

66
Q

Varenicline usage

A

Partial nicotine agonist, started 1 week before stop date and continued for 12 weeks. Not to be used in depression. Most common SE is nausea

67
Q

Asthma treatment based on features

A

No asthmatic features - LAMA; Asthmatic features - ICS

68
Q

Indications for steroids in sarcoidosis

A

Hypercalcaemia, cardio or neuro involvement, uveitis or parenchymal lung disease

69
Q

Common infection in alcoholics

A

Klebsiella

70
Q

Lung metastases calcification

A

Only osteosarcoma or chondrosarcoma undergo calcification

71
Q

Peak flow utility in COPD

72
Q

Most common cause of occupational asthma

A

Isocyanates

73
Q

Non-CF bronchiectasis treatment

A

Inspiratory muscle training and postural drainage

74
Q

Scuba diving and pneumothorax

A

Avoid for life following pneumothorax; flying for 1 week post XR or 2 weeks if no XR

75
Q

OSA management

A

Weight loss then CPAP

76
Q

Coal dust cancer risk

A

Does not cause cancer

77
Q

Chlamydia psittaci infection source

A

Bird keepers

78
Q

Catamenial pneumothorax definition

A

Endometrial tissue in the lungs

79
Q

Asthma eosinophil count

A

Raised eosinophil count of 0.6 x 10^9/l or feNO >= 50

80
Q

Silicosis characteristics

A

Foundry, multiple and small well-rounded nodules, particularly in the upper zone

81
Q

Amyloidosis and bronchiectasis

A

Does not cause bronchiectasis

82
Q

Asymptomatic secondary haemothorax management

A

Always conservative management

83
Q

LTOT effect on COPD survival

A

Does improve survival

84
Q

ICD implications

A

Loss of HGV licence, 1 year off driving for normal drivers

85
Q

Hyponatraemia association