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Resp Flashcards

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
Q

COPD Classification

A

FEV1% predicted

  • mild: >80
  • moderate: 50-80
  • severe: 30-49
  • v severe: <30
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26
Q

Acute asthma severity

A 
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
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27
Q

Symbicort

A

Steroid and long acting beta agonist

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28
Q

Tirotropium

A

antimuscarinic

29
Q

fluffy airspace shadowing

A

pus or fluid

30
Q

Non cardio resp cause of breathlessness (days/weeks)

A

malignancy
neuromuscular
anaemia/thyrotoxicosis

31
Q

Pneumothorax management

A

Primary (young fit person)
<2cm - wait
>2cm - aspiration

Secondary
<2cm - aspiration
>2cm - chest drain

32
Q

LMWH examples

A

enoxaparin, tinziparin, dalteparin

33
Q

Restrictive CXR DDx

A

Fibrosis:

  • idiopathic fibrosing alverolitis
  • connective tissue disease, RhA
  • Drugs: methotrexate, nitrernitoin
  • Asbestosis
34
Q

Sarcoidosis - restrictive or obstructive?

A

restrictive

35
Q

Diagnostic for sarcoidosis

A

bronchoscopy and biposy

NON caseating granulomas (gram -ve)

36
Q

Bloods in fibrosis

A

Lymphocytes are normal
Increased neutrophils and esinophils
Increases ESR, ANA

37
Q

Honeycombing on CXR

A

Fibrosis

38
Q

Tx for fibrosis

A

Supportive and prednisolone/immuno-suppressant

39
Q

Drugs contraindicated in asthma

A

BBs and NSAIDS

40
Q

Reticulonodular shadowing
Upper Zones
Lower Zones

A

Upper Zones: extrinsic allergic alveolitis

Lower Zones: cryptogenic fibrosing alveolitis

41
Q

Aspiration pneumonia Tx

A

Cef and Met

42
Q

Pneumocystis Pneumonia

A

Co trimoxazole

43
Q

Bronchiectasis gold standard Ix

A

High Resolution CT

44
Q

Bronchiestasis Tx

A
  1. Excercise and improved nutrition
  2. Airway clearance therapy
  3. Inhaled bronchodilator and hyperosmolar agent
  4. Abxs
  5. Surgery
45
Q

COPD CXR

A
  • hyperinflation >6 ribs
  • flattened diaphragm
  • LARGE CENTRAL PULMONARY ARTERIES
  • DECREASED PERIPHERAL VASCULAR MARKINGS
  • bullae
46
Q

wedge shaped infarct

A

PE

47
Q

respiratory causes of clubbing

A
  • interstitial lung disease
  • malignancy: mesothelioma, bronchiogenic carcinoma
  • supprative lung diseases: CF, brinchiectasis, abcess
48
Q

Atypical pneumonia Abx

A

-FAM
fluroquinilones: ciprofloxacin
macrolides; clarythromycin or azithromycin

49
Q

Staph Aureus - typical or aytipcal?

Blood film and Tx

A

Atypical
gram +ve cocci clusters
Flcoxacillin and rifampicin
(vancomycin for MRSA)

50
Q

Aspergillus: cresent shape sign on CXR

A

Aspergillioma - TB or sarcoidosis

51
Q

Aspergillus: esinophilia and increased IgE

A

ABPA

52
Q

Aspergillus: prolonged and persistent neutropenia with rapid deterioration and septic picture

A

Invasive aspergilliosus

  • halo sign
  • positive galactomannan or beta D glucan assay
53
Q

Pickwican Syndrome

A

Obstructive Sleep Apnoea
RF: weight gain, smoking, alcohol, sedative use,
englarged tonsils, macroglossia, marfans, downs,

–> sleep studies and polysommonography

54
Q

Acid Fast Bacilli on Lowenstein-Jensen medium

A

TB

55
Q

Risk factor for TB

A

HIV

56
Q

Gold standard for TB diagnosis

A

Acid fast bacilli on Lowenstein-Jensen medium

57
Q

PCP Tx

PCP is caused by Pneumocystis jirovecii, previously called Pneumocystis carinii

A

co-trimoxazol

58
Q

cold AIHA

A

mycoplasma

59
Q

warm-type AIH

A

CLL

60
Q

Which paraneoplastic syndrome is associated with lung cancer?

A

Lambert-Eaton

small cell carcinoma

61
Q

clubbing is associated with which lung cancer

A

non small cell

62
Q

CXR with a cavitation with an air-fluid level in it.

A

lung abcess

63
Q

optochin sensitive

A

streptococcus

64
Q

chains

A

steptococcus

65
Q

pruritic vesicular rash

A

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
Q

post-influenza pneumonia

A

staphylococcus

Treatment of staphyloccocal infection is with flucoxacillin or vancomycin if MRSA.

67
Q

HIV positive patients with TB

A

HIV positive patients tend to have a more atypical CXR including effusion, lower zone involvement and a miliary pattern.

68
Q

rusty coloured phlem

A

pneumococcal pneumonia

Resp (13 decks)

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