Resp Flashcards
what sign do you get in bronchiectasis on CT?
signet ring due to bronchioles being bigger than adjacent
common sites of mets for lung cancer?
brain, liver, bone
small cell lung cancer associated with which syndrome?
lambert eaton
which caner expresses TTF1 ?
adenocarcinoma
mucous producing tumours seen in peripheries of lungs?
adenocarcinoma
keratinized tumour that found centrally and frequently cavitates
squamous cell
what does squamous cell secrete ?
PTH
if lung cancer invades sympathetic chain, which syndrome can you get?
horners syndrome
pleural tap - where is fluid taken from ?
pleural cavity
in general, small cell cancers are more? (chemo/radio sensitive)
chemosensitive
which cancer develops as a result of asbestos exposure
malignant mesothelioma
what do you see on x ray in mesothelioma?
recurrent pleural effusions
what is pleurodesis?
adhere the two lung surfaces together
bibasal, fine end inspiratory crackles
IPF
management of IPF?
not much can be done
50% will be dead in 5 years
anti fibrotic agent = perfenidone
calcium in sarcoidsis ?
high
in sarcoisosis, you get increase in serum?
ACE
honey comb lung
extrinsic allergic alveolitis
extrinsic allergic alveolitis - what kind of hyersensitivtiy?
type 3
egg shell calcification at hilar nodes?
silicosis
asbestosis can lead to ?
asbestosis
influenza cuased by influenza?
A and B
pseudo membrane formation?
diptheria
rusty red sputum?
strep pneumonia
comes in waves every 4 years?
mycoplasma pneumonia
mycoplasma pneumonia most likely to infect?
children and elderly
coxiella spread from?
animals such as sheep and goats
all atypical pneumonias respond to clarithromycin
y
bilateral cavitating pneumonia?
staph aureus
pneumonia that alcoholics/elferly/diabetics/neuro musclar disease get ? presents with red jelly like sputum
klebsiella (kronenburg)
pneumocystis pneumonia - who gets this?
immunocmpromised _ HIV
pneumocstis - treated with?
co trimaxazol
pneumonia seen in patients with CF/bronchiectasis?
pseudamonas ( treated with ciprofloxacin)
how would legionella present?
colonises water tanks - seen in those who have been abroad. presents with dry cough, flu like symptoms and GI upset
biochem in legionella?
hyponatraemia
what is CURB 65
measure of severity of community acquired pneumonia
confusion Urea over 7 resp rate over 30 bp <90 <65 age over 65
1st line tx of community acquired pneumonia if nil by mouth ?
IV clarithromycin
severe community acquired pneumonia severe
co amox and dox
severe CAP and pen allergic
levofloxacin + dox
in ITU with CAP?
co amoxiclav and clarithromycin
in ITU with pen allergy?
levofloxacin and clarithromycin
non severe hospital acquired?
oral amoxicilin and metronidazole
severe hospital acquired step down ?
co trimoxazole and metronidazole
TB affects which part of the lungs?
upper
lesion at primary site of infection in lungs is called?
gohn focus
granulomas heal with?
calcification
dermatological of TB?
erythema nodosum
TB on chest x ray?
o Consolidation.
o Cavitating upper lobe lesions.
o Bilateral hilar lymphadenopathy.
Latent: fibrosis, calcified lesions
what is the test called on sputum sample
zeil neilson. can also do PCR
what is the tuberculin skin test called?
mantoux test
which drug turns body fluids orange ?
rifampicin
categories of pleural effusion - more than 30g/l
exudate - malignancy, infection PE
what is the triad of MEIGS syndrome?
ascites, pleural effusion, benign ovarian tumour
D sign on x ray?
empyema
turbid yellow empyema ?
empyema
lymphocytes
malignancy
TB
autoimmune
most common mutation in CF?
deltaF508
investigations for CF?
genetic screening
sweat test - chloride > 60 mmol
hypoxia is defined as oxygen less than?
8
signs of hypercapnia?
morning headache, peripheral vasodilation, tachycardia, bounding pulse,
type 1 respiratory failure ?
low oxygen
low or normal co2
target sats in type 1 resp failure?
94-98%
type 2 resp failure ?
low oxygen
high co2
target sats 88-92
what is cor pulmonale?
right sided heart failure
when can you send a pneumothorax home?
less than 2 cm and no SOB
do you have to inform DVLA of sleep apnea?
yes
pulmonary oedeam management ?
LMNOP loop diuretic morphine nitrate oxygen posture - sit up
why is morphine used in pulmonary oedema?
it has vasodilator properties
