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Resp Flashcards

1
Q

Stony dull to percuss

A

Pleural Effusion

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2
Q

Right sided pleuritic chest pain

A

most likely pneumonia

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3
Q

Alveolar bat’s wings, Kerley B lines, cardiomegaly, dilated prominent upper lobe vessels, pleural effusion

A

Pulmonary oedema

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4
Q

Ground-glass appearance on X-ray

A

Pulmonary fibrosis
OR Respiratory Distress
Syndrome (in newborn)

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5
Q

Ziehl-Neelsen stain positive for acid fast bacilli

A

TB

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6
Q

Caseous necrosis

A

TB

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7
Q

Assmann focus

A

Apical lesion of secondary TB infection

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8
Q

Apical TB

A

most likely secondary TB

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9
Q

Miliary TB

A

spread of organism into bloodstream

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10
Q

If TB spread via pulmonary artery, it spreads to ———

A

the lung

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11
Q

If TB spread via pulmonary vein, it spreads to ———

A

liver, spleen and kidneys

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12
Q

Positive anti-glomerular basement membrane antibodies (anti-GBM)

A

Goodpasture’s syndrome

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13
Q

Chest infection with a parrot/pigeon as pet

A

caused by chlamydophila psittaci

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14
Q

Dry cough and diarrhoea after holiday abroad, some indication of water spread

A

Legionella pneumophila (test urine for antigens)

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15
Q

“Very tall, thin young man who indulges in marijuana”

A

probably pneumothorax (Marfan’s)

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16
Q

Bilateral hilar lymphadenopathy, erythema nodosum, granulomas, fatigue, uveitis and weight loss

A

Sarcoidosis

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17
Q

Signet ring sign (bronchiole wider than neighbouring arteriole on CT)

A

Bronchiectasis

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18
Q

D sign on x ray

A

Empyema

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19
Q

“Steeple” sign on x ray

A

croup

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20
Q

laryngotracheobronchitis

A

croup

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21
Q

Child with barking cough

A

croup

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22
Q

Pneumocystis pneumonia

A

HIV

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23
Q

Pneumocystis pneumonia is treated with ———

A

Co-tramoxazole (± prednisolone if

severe)

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24
Q

Asthma + nasal polyps + salicylate sensitivity

A

Samter’s triad

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25
Q

Alcoholic (danger of aspiration pneumonia)

A

Klebsiella pneumoniae

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26
Q

Red Jelly sputum

A

Klebsiella Pneumoniae

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27
Q

Mucoid sputum

A

Chlamydia psittaci

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28
Q

Rusty sputum

A

Pneumococcal pneumonia

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29
Q

Cannonball metastases

A

Primary renal cell carcinoma

also weight loss and haematuria

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30
Q

Morning headache

A

Hypercapnia OR

side effects of organic nitrates

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31
Q

ACTH secreting lung tumour

A

Small cell lung cancer

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32
Q

PTH secreting lung tumour

A

Squamous cell lung cancer

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33
Q

Small-cell carcinoma

A

neuroendocrine, highly malignant, may be associated with ectopic endocrine syndromes

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34
Q

Female, heavy smoker - lung cancer

A

Small cell lung cancer

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35
Q

Young black female

A

probably sarcoidosis

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36
Q

Non-smoker + lung cancer

A

(peripheral) adenocarcinoma

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37
Q

Increased serum ACE and Ca2+

A

Sarcoid

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38
Q

Eggshell calcification at hilar region

A

Silicosis

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39
Q

Haemosiderin

A

In ‘heart-failure cells’ seen in alveolar spaces.
Macrophages absorb haemosiderin (found in chronic pulmonary oedema, associated with severe LVHF, or long-standing pulmonary hypertension)

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40
Q

Ghon Focus

A

TB - caseous necrosis at periphery of lung,

beneath the pleura

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41
Q

‘Coin lesion’ found on chest radiographs

A

rounded solitary lesion, commonly primary cancer, metastatic tumour (esp of kidney), bronchial hamartoma, granulomatous inflammation, or lung abscess.

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42
Q

Ptosis (drooping of eyelid), small pupils, unilateral loss of sweating on one side

A

Horner’s Syndrome

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43
Q

Horner’s Syndrome

A

Pancoast’s tumour OR local spread of cancer to the

intrathoracic nodes

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44
Q

Pancoast tumour

A

Tumour at lung apex

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45
Q

Moderate asthma attack

A

PEF > 50-75%

Speech normal, oxygen sats above 92%, RR/HR normal

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46
Q

Moderate asthma attack management

A

Salbutamol via spacer, oral prednisolone

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47
Q

Acute severe asthma attack

A

PEF > 33-50%

Can’t complete sentences, oxygen sats above 92%, RR > 25, HR > 110

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48
Q

Acute severe asthma attack management

A

Oxygen, salbutamol nebulised, oral prednisolone (OR IV hydrocortisone)

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49
Q

Life-threatening asthma attack

A

PEF < 33%
Loss of consciousness, exhaustion, silent chest, cyanosis, hypotension, arrhythmia etc…
oxygen sats below 92%, RR > 25, HR > 110

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50
Q

Life-threatening asthma attack management

A

Oxygen, salbutamol (+ ipratropium) nebulised, oral prednisolone (OR IV hydrocortisone)

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51
Q

Life-threatening asthma attack - unresponsive to treatment

A

consider continuous nebulised salbutamol, or single dose magnesium sulphate.
consider ventilation

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52
Q

Thumbprint sign on head x ray

A

Epiglottitis

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53
Q

Inspiratory whoop/barking cough

A

Pertussis (whooping cough)

54
Q

6 month-old with wheeze, cough and signs of respiratory distress (e.g. subcostal recession)

A

Bronchiolitis

55
Q

Bronchiolitis infecting organism

A

Respiratory syncytial virus (RSV) in 70% of cases

56
Q

Trauma resulting in tachycardia, tachypnoea and bilateral alveolar shadowing

A

Acute respiratory distress syndrome (ARDS)

non-cardiogenic pulmonary oedema leads to acute respiratory failure

57
Q

ARDS first-line treatment

A

CPAP

also low-dose NO for pulmonary hypertension and conservative fluid management improve outcome

58
Q

Eosinophilic inflammation

59
Q

Neutrophilic inflammation

60
Q

Episodic SOB, cough and wheeze that improves when the pt. is on holiday

A

Occupational asthma

61
Q

Saddle Nose deformity

A

Granulomatosis with polyangiitis (GPA)
Syphilis
Cocaine abuse

62
Q

Haemoptysis, fever, night sweats

A

suspect TB

63
Q

Gradual onset SOB, reduced chest expansion, and dullness on percussion

A

Pleural effusion

64
Q

Reduced FEV1, FVC, and FEV1/FVC ratio

65
Q

Reduced FEV1, normal FVC

66
Q

Reduced FEV1 and FVC, normal FEV1/FVC ratio

A

Restrictive pattern

67
Q

CF chest x-ray

A

bronchiectasis and hyperinflation

68
Q

Human Faecal Elastase (FE-1)

A

Screening test for CF

69
Q

Legionnaire’s is diagnosed with ——-

A

urine antigen test

70
Q

Snow storm appearance on x ray

A

baritosis, silicosis

71
Q

Management of COPD

A

SABA or SAMA (use when needed)
»> LABA + LAMA (if pt. has asthmatic features, consider LABA + ICS)
»> LABA + LAMA + ICS

72
Q

Management of infective exacerbation of COPD

A 
iSOAP
ipratropium
Salbutamol (+ theophylline IV if poor response) 
Oxygen (sparingly)
Amoxicillin (if bacterial infection)
Prednisolone
73
Q

First-line investigation of infective exacerbation of COPD

A

CXR

then blood gases, ECG, FBC, U&Es

74
Q

Central lung cancer

A

Squamous or small-cell

75
Q

High d-dimers

A

Suspect PR

send for CTPA and V/Q scan

76
Q

Low d-dimers

A

Exclude PE

77
Q

Large PE, haemodynamically unstable pt.

A

thrombolysis

78
Q

Small PE

A

LMWH

Dalteparin/Fragmin

79
Q

Tenecteplase

A

thrombolysis drug

80
Q

Reverse warfarin with ———

81
Q

Respiratory alkalosis

A

panic attack

82
Q

Frank pus on aspiration

83
Q

Pickwickian disease

A

Obesity hypoventilation syndrome

body fat prevents air getting in, causing sleep apnoea + hypercapnia

84
Q

Overnight nasal ventilation

A

Obesity hypoventilation syndrome

Pickwickian disease

85
Q

Guillian-Barre disease

A

causes paralysis a.k.a polyneuritis

normally preceeded by strep. throat or resp/GI tract infection

86
Q

Coal worker

A

Coal workers pneumoconiosis (simple disease, or progressive massive fibrosis)
Lung apex

87
Q

TLCO

A

how well oxygen can diffuse into the blood

88
Q

Asbestosis

A

problems found at the base of the lung

89
Q

Type 1 diabetic, vomiting and not taking her insulin

A

metabolic acidosis (diabetic ketoacidosis)

90
Q

young woman, tender well defined nodules on shins bilaterally
( + weight loss, night sweats, sputum)

A

erythema nodosum

91
Q

Farmer

A

Farmer’s lung

EAA

92
Q

Extrinsic allergic alevolitis

A

granulomatous inflammation of lungs

93
Q

Pigeons, parrots

A

Bird-fancier’s lung, exposure to avian proteins

94
Q

cANCA positive

joint pain, nasal congestion and recurrent nosebleeds

A

granulomatosis with polyangitis (GPA)

95
Q

exudate

A

protein >30g/l

96
Q

transudate

A

protein <30g/l

97
Q

Parathyroid hormone causes —–

A

Hypercalcaemia

bones, stones, groans, moans

98
Q

Smoker, cavitating hilar tumours

A

Squamous cell

99
Q

Lung cancer causing gyneocomastia

A

Large cell

releases sex hormones

100
Q

Hypertrophic pulmonary osteoarthropathy

finger clubbing, periosteal inflammation a.k.a. ankle pain

A

Lung cancer, commonly adenocarcinoma

101
Q

Chemo-sensitive lung cancer

A

Small cell

102
Q

“moon face”, acne, high BP

A

Cushing’s

ACTH (small cell lung cancer)

103
Q

Lung cancer with finger tingling, arm pain

A

Brachial plexus lesions

104
Q

Type 1 respiratory failure

A

low oxygen

105
Q

Type 2 respiratory failure

A

low oxygen, high carbon dioxide

COPD

106
Q

TB drugs

A

2 RIPE

4 RI

107
Q

Rifampicin side effects

A

red-orange urine and tears, rashes, hepatotoxicity

108
Q

Isoniazid side effects

A

peripheral neuropathy, hepatitis

109
Q

Pyrazinamide side effects

A

gout

also joint pain, rash, yellow skin/eyes

110
Q

Ethambutol side effects

A

colour blindness, vision changes

111
Q

Mycobacterial infection

112
Q

Small Ghon focus, large hilar nodes

A

Primary TB

immune activation

113
Q

TB with fibrosing, cavitating apical lesion

A

Secondary TB

reactivation/reinfection - associated with immunosuppressed

114
Q

Q fever

A

coxiella burnetti

sheep/farm

115
Q

Dry cough in young people

A

Mycoplasma pneumoniae

116
Q

Haemophilus influenzae

A

COPD/alcoholics/elderly

117
Q

Pseudomonas aeruginosa

A

Gram neg bacilli

CF

118
Q

Causes of pulmonary fibrosis

A 
BREAST CA
Bleomycin
Radiation
EAA
Anklylosing spondylitis
Sarcoidosis 
TB
Cryptogenic fibrosing alveolitis (IPF)
Asbestosis
119
Q

Chest hyperexpansion

120
Q

Stridor

A

Upper airway obstruction

121
Q

Early onset emphysema

A

alpha-1 antitrypsin deficiency

122
Q

Positive sweat test

> 60mmol/L NaCl

123
Q

Swinging fever, copious foul smelling sputum

A

Lung abscess

124
Q

Left-shift of oxyhaemoglobin dissociation curve

A

Reduced 2,3-DPG, hypothermia, alkalosis, CO

125
Q

Right-shift of oxyhaemoglobin dissociation curve

A

Hyperthermia, hypercapnia, acidosis, sickle-cell diseases

126
Q

Lung cancer of neuroendocrine cells

A

small cell

127
Q

Lung cancer with lymph node involvement

128
Q

Lung cancer, asbestos exposure

A

Mesothelioma

129
Q

COPD first-line treatment

A

SMOKING CESSATION

then drugs

130
Q

Honey-comb appearance on X-ray

A

Late fibrosis

131
Q

Mucin-producing lung cancer cells

A

Adenocarcinoma

132
Q

Rheumatoid arthritis + pneumoconiosis

A

Caplan’s syndrome

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