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1
Q

Chlamydiophila

A

Sinusitis, pharyngitis, laryngitis

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2
Q

Staph aureus

A

IVDU, recurrent influenza infection, abscesses

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3
Q

Mycoplasma

A

Pericarditis, erythema nodosum, epidemics

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4
Q

Legionnaire’s

A

Air conditioning, decreased sodium, decreased albumin

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5
Q

Pneumocystis jiroveci

A

Fungus, opportunistic, Kaposi’s sarcoma

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6
Q

Klebsiella

A

Purulent dark sputum

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7
Q

Chlamydia Psittaci

A

Contact with birds, hepatosplenomegaly

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8
Q

Strep pneumoniae

A

Rusty coloured sputum

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9
Q

Brochiectasis organisms

A

H influenza
Strep pneumoniae
Staph Aureus
Pseudomonas aeruginosa

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10
Q

Rifampin side effects (5)

A 
Orange tears and urine 
Flu like symptoms 
Hepatitis 
GI disturbance 
Rash
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11
Q

Isoniazid (5)

A 
Peripheral neuropathy
CNS effects 
Deranged LFTs 
Rash 
Sideroblastic anaemia
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12
Q

Pyraminazide (6)

A 
Hepatitis 
GI disturbance 
Arthalgia
Gout 
Puritis
Spideroblastic anaemia
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13
Q

Ethambutol (3)

A

Blurred vision
Colour blindness
Peripheral neuropathy

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14
Q

Drug to prevent peripheral neuropathy

A

Pyridoxine

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15
Q

Tram line shadows

A

Bronchiectasis

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16
Q

DVT Ix:

A

Doppler US

Gold standard: contrast venography

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17
Q

Past history of infection

Foul smelling sputum

A

Bronchiectasis

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18
Q

Causes UTI and pneumonia

A

Pseudomonas Aergiunosa

Needs third gen cephalosporin

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19
Q

Strawberry tongue

A

Sign of scarlet fever : Kawasaki disease

Strep pyonges

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20
Q

Leistopirosis

A

Contact of urine with infected animals

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21
Q

A history of poor asthma

control suggests …

A

..that patient is on long-term steroid therapy, which is the

main cause of her Cushing’s syndrome

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22
Q

Diagnosis of Asthma

A
  1. FEV1 ≥15% (and 200 ml) increase following administration of a
    bronchodilator/trial of corticosteroids
  2. > 20% diurnal variation on ≥ 3 days in a week for 2 weeks on PEF diary
  3. FEV1 ≥15% decrease after 6 minutes of exercise.

British Guideline of the Management of Asthma.
London: The British Thoracic Society 2008

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23
Q

BTS guidelines for asthma management

A
  1. SABA
  2. SABA and inhaled corticosteroid
  3. SABA and inhaled corticosteroid and LABA
  4. increase steroid dose or add leukotrine receptor antagonist or theophylline
  5. Oral steroids and refer
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24
Q

COPD management

A
  1. SABA or SAMA
  2. Replace with LAMA or (LABA+/-ICS)
  3. Combo of 2
  4. Combo of 3
  5. Nebulizer or oral theophyline
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25
COPD Classification
FEV1% predicted - mild: >80 - moderate: 50-80 - severe: 30-49 - v severe: <30
26
Acute asthma severity
``` BTS Guideline 2016 -Moderate Acute PEF>50-75 -Acute Severe PEF= 33-50 -Life threatening PEF<33 clinical signs but note CO2 is normal -Near Fatal raised CO2/mechanical ventilation/raised inflation pressures ```
27
Symbicort
Steroid and long acting beta agonist
28
Tirotropium
antimuscarinic
29
fluffy airspace shadowing
pus or fluid
30
Non cardio resp cause of breathlessness (days/weeks)
malignancy neuromuscular anaemia/thyrotoxicosis
31
Pneumothorax management
Primary (young fit person) <2cm - wait >2cm - aspiration Secondary <2cm - aspiration >2cm - chest drain
32
LMWH examples
enoxaparin, tinziparin, dalteparin
33
Restrictive CXR DDx
Fibrosis: - idiopathic fibrosing alverolitis - connective tissue disease, RhA - Drugs: methotrexate, nitrernitoin - Asbestosis
34
Sarcoidosis - restrictive or obstructive?
restrictive
35
Diagnostic for sarcoidosis
bronchoscopy and biposy | NON caseating granulomas (gram -ve)
36
Bloods in fibrosis
Lymphocytes are normal Increased neutrophils and esinophils Increases ESR, ANA
37
Honeycombing on CXR
Fibrosis
38
Tx for fibrosis
Supportive and prednisolone/immuno-suppressant
39
Drugs contraindicated in asthma
BBs and NSAIDS
40
Reticulonodular shadowing Upper Zones Lower Zones
Upper Zones: extrinsic allergic alveolitis | Lower Zones: cryptogenic fibrosing alveolitis
41
Aspiration pneumonia Tx
Cef and Met
42
Pneumocystis Pneumonia
Co trimoxazole
43
Bronchiectasis gold standard Ix
High Resolution CT
44
Bronchiestasis Tx
1. Excercise and improved nutrition 2. Airway clearance therapy 3. Inhaled bronchodilator and hyperosmolar agent 4. Abxs 5. Surgery
45
COPD CXR
- hyperinflation >6 ribs - flattened diaphragm - LARGE CENTRAL PULMONARY ARTERIES - DECREASED PERIPHERAL VASCULAR MARKINGS - bullae
46
wedge shaped infarct
PE
47
respiratory causes of clubbing
- interstitial lung disease - malignancy: mesothelioma, bronchiogenic carcinoma - supprative lung diseases: CF, brinchiectasis, abcess
48
Atypical pneumonia Abx
-FAM fluroquinilones: ciprofloxacin macrolides; clarythromycin or azithromycin
49
Staph Aureus - typical or aytipcal? | Blood film and Tx
Atypical gram +ve cocci clusters Flcoxacillin and rifampicin (vancomycin for MRSA)
50
Aspergillus: cresent shape sign on CXR
Aspergillioma - TB or sarcoidosis
51
Aspergillus: esinophilia and increased IgE
ABPA
52
Aspergillus: prolonged and persistent neutropenia with rapid deterioration and septic picture
Invasive aspergilliosus - halo sign - positive galactomannan or beta D glucan assay
53
Pickwican Syndrome
Obstructive Sleep Apnoea RF: weight gain, smoking, alcohol, sedative use, englarged tonsils, macroglossia, marfans, downs, --> sleep studies and polysommonography
54
Acid Fast Bacilli on Lowenstein-Jensen medium
TB
55
Risk factor for TB
HIV
56
Gold standard for TB diagnosis
Acid fast bacilli on Lowenstein-Jensen medium
57
PCP Tx | PCP is caused by Pneumocystis jirovecii, previously called Pneumocystis carinii
co-trimoxazol
58
cold AIHA
mycoplasma
59
warm-type AIH
CLL
60
Which paraneoplastic syndrome is associated with lung cancer?
Lambert-Eaton | small cell carcinoma
61
clubbing is associated with which lung cancer
non small cell
62
CXR with a cavitation with an air-fluid level in it.
lung abcess
63
optochin sensitive
streptococcus
64
chains
steptococcus
65
pruritic vesicular rash
varicella zoster The rash typically occurs on the patient’s torso and face and pneumonia is a complication occuring more commonly in those with immunosuppression. The lesions are often crusted over by 7-10 days. The diagnosis is based on clinical findings.
66
post-influenza pneumonia
staphylococcus Treatment of staphyloccocal infection is with flucoxacillin or vancomycin if MRSA.
67
HIV positive patients with TB
HIV positive patients tend to have a more atypical CXR including effusion, lower zone involvement and a miliary pattern.
68
rusty coloured phlem
pneumococcal pneumonia

Resp (13 decks)

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