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Zero to finals > Resp 2 > Flashcards

Resp 2 Flashcards

1
Q

causes of exudate

A

pnuemonia/ infections
PE
dresslers
malignancy
connective tissue disease
pancreatitis

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2
Q

lupus pernio is seen in

A

sarcoidosis

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3
Q

how to differentiate LEMS from myasthenia gravis

A

LEMS symptoms get slightly better with use

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4
Q

what structural change occurs in bronchiectasis

A

permanent dilation of the bronchi

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5
Q

what do you hear on auscultation in bronchiectasis

A

scattered crackles, wheeze and squeaks

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6
Q

ix for diagnosing bronchiectasis and what you might see

A

high resolution CT chest
tram track opacities and ring shadows

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7
Q

bronchiectasis pseudomonas aerunginosa exacerbation abx choice

A

cipro

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8
Q

ix for diagnosing interstitial lung disease and what is seen

A

high resolution CT thorax
ground glass opacities

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9
Q

ground glass opacities on CT chest indicate what

A

ILD

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10
Q

medications for slowing idiopathic pulmonary fibrosis progression

A

pirfenidone
nintedanib

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11
Q

drugs causing pulmonary fibrosis

A

amiodarone
cyclophosphamide
methotrexate
nitrofurantoin

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12
Q

extrinsic allergic alveolitis involves what kind of hypersensitivity reactions

A

III and IV

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13
Q

how is extrinsic allergic alveolitis diagnosed

A

bronchoalveolar lavage
shows lymphocytosis

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14
Q

what is cryptogenic organising pneumonia

A

bronchiolitis obliterans previously

a focal area of inflammation

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15
Q

transudate vs exudate protein content

A

transudate <30g/L
exudate >30g/L

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16
Q

lights criteria

A

pleural fluid protein:serum protein >0.5
pleural fluid LDH: serum LDH >0.6
pleural fluid LDH greater than 2/3 normal upper limit of LDH

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17
Q

causes of exudate

A

malignancy
pneumonia
PE
rheumatoid

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18
Q

causes of transudate

A

congestive HF
hypoalbuminaemia
hypothyroidism
meigs syndrome

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19
Q

what side does the trachea deviate in pleural effusion

A

away from effusion

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20
Q

x ray signs of pleural effusion

A

blunting of costophrenic angles
fluid in lung fissures
meniscus level
tracheal deviation away from effusion
mediastinal shift

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21
Q

what is an empyema

A

an infected pleural effusion

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22
Q

pleural aspiration analysis for an empyema

A

low pH
low glucose
high LDH
pus

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23
Q

what mx of pleural effusion prevents recurrence

A

chest drain

24
Q

what is a pneumothorax

A

when air enters the pleural space and separates the lung from the chest wall

25
Q

what size pneumothorax can be manage conservatively

A

<2cm

26
Q

safe triangle boundaries

A

5th intercostal space
mid axillary line
anterior axillary line

27
Q

mid axillary line corresponds to

A

the lateral edge of the latissimus dorsi

28
Q

anterior axillary line corresponds to

A

the lateral edge of the pectoralis major

29
Q

what will you see in the chest drain that indicates the pneumothorax has resolved

A

no bubbling in the water
reduced swinging of water

30
Q

complications of chest drain

A

air leak around drain site
surgical emphysema

31
Q

what surgery can be used in refractory pneumothorax and what is done

A

VATS
pleurodesis- the lining of the pleura is irritated so it sticks to the lung

32
Q

what happens in a tension pneumothorax

A

trauma to the chest wall breaks the pleura

this occurs in more air entering the pleural space with every breath but no air being able to escape, creating constant additional pressure on the lung

33
Q

tension pneumothorax mx

A

insert a wide bore cannula into the 2nd ICS mid clavicular line or 4th/5th ICS anterior midaxillary line

chest drain after decompression

34
Q

contraindications to LMWH for VTE prophylaxis

A

current bleeding
warfarin
DOAC

35
Q

wells score <4

A

d dimer

36
Q

wells score >4

A

CTPA

37
Q

when may CTPA be unsuitable for a patient

A

renal impairment
contrast allergy

38
Q

resp alkosis with low po2 vs high po2 indicates

A

low= PE
high= hyperventilation

39
Q

riavroxaban dosing for PE

A

25mg BD for 21 days
then 20mg OD

40
Q

1st and 2nd line anticoagulation for PE

A

1st=DOAC
2nd= LMWH

41
Q

DOAC contraindications in PE mx

A

severe renal impariment
antiphospholipid syndrome
pregnancy

42
Q

1st line anticoagulation for PE in pregnancy

A

LMWH

43
Q

1st line anticoagulation for PE in pts with antiphospholipid syndrome

A

warfarin

44
Q

what side of the heart does pulmonary htn strain

A

right

45
Q

MAP pulmonary hypertension

A

20 mmHg

46
Q

ECG changes due to right heart strain

A

P pulmonale (peaked p waves)
RVH
right axis deviation
right bundle branch block

47
Q

RVH signs on ECG

A

tall r waves in V1 and V2
deep S waves in V5 and V6

48
Q

causes of pulmonary hypertension

A

idiopathic
left heart failure
chronic lung disease
PE

49
Q

what is lofgrens syndrome

A

a type of sarcoidosis with a triad of:

erythema nodosum
bilateral hilar lymphadenopathy
polyarthralgia

50
Q

what is seen on bloods for sarcoidosis

A

raised ACE
hypercalcaemia

51
Q

histology in sarcoidosis

A

non caseating granulomas
epitheloid cells

52
Q

sarcoidosis mx

A

nothing if not needed

steroids with bisphosphonates for 6-24 months if needed

methotrexate second line

53
Q

sarcoidosis prognosis

A

usually spontaneously resolves within 2 yrs in most patients

54
Q

what is used to assess symptoms of OSA

A

epworth sleepiness scale

55
Q

OSA mx

A

lifestyle= reduce weight, alcohol and smoking

CPAP

surgery if refractory- uvulopalatopharyngoplasty

Zero to finals (21 decks)

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