Resp Buzzwords Flashcards
Stony dull to percuss
Pleural Effusion
Right sided pleuritic chest pain
Most likely pneumonia
Alveolar bat’s wings, Kerley B lines, cardiomegaly, dilated prominent upper lobe
vessels, pleural effusion
Pulmonary oedema
Ground-glass appearance on X-ray- Newborns and adults?
Pulmonary fibrosis and Respiratory Distress
Syndrome of the newborn
Ziehl-Neelsen stain positive for acid fast bacilli
TB
Caseous necrosis
TB
Apical disease
Most likely (secondary) TB; apical lesion is called an Assmann focus
Miliary Tuberculous
- If organism spread via pulmonary artery:
- If organism spread via pulmonary vein:
Spread of organism into bloodstream
-Miliary dissemination into the lung occurs
-Systemic dissemination to the liver,
spleen, and kidneys.
Positive anti-glomerular basement membrane antibodies
Goodpasture’s syndrome
Chest infection with a parrot/pigeon as pet
Caused by chlamydophila psittaci
Dry cough and diarrhoea after holiday abroad, some indication of water spread
Legionella pneumophila (test urine for antigens)
Tall, thin young man who indulges in marijuana
Pneumothorax (Marfan’s)
Bilateral hilar lymphadenopathy, erythema nodosum, granulomas, fatigue, uveitis and
weight loss
Sarcoidosis
Bronchiole wider than neighbouring arteriole (on CT) (signet ring sign)
Bronchiectasis
D sign on X ray
Empyema
“Steeple” sign on X ray
Laryngotracheobronchitis/croup
Child with barking cough
Croup
Pneumocystis pneumonia
How do you treat?
HIV (treat with Co-tramoxazole [± prednisolone if
severe])
Samter’s Triad
Asthma + Nasal Polyps + Salicylate sensitivity
Danger of aspiration pneumonia
Alcoholic + Klebsiella pneumoniae
Red Jelly sputum
Klebsiella Pneumoniae
Mucoid sputum
Chlamydia psittaci
Rusty sputum
Pneumococcal pneumonia
Cannonball metastases (also weight loss and haematuria)
Primary renal cell carcinoma
Morning headache
Hypercapnia or side effects of organic nitrates
ACTH secreting lung tumour
Small cell carcinoma of the lung (highly malignant)
PTH secreting lung tumour
Squamous cell cancer of lung
What are some features of small-cell carcinoma?
Neuroendocrine, highly malignant, and may be associated with ectopic endocrine syndromes
Increased serum ACE and Ca2+
Sarcoidosis
Eggshell calcification at hilar region
Silicosis
‘Heart-failure cells’ seen in alveolar spaces
-Macrophages that have absorbed
haemosiderin - found in chronic pulmonary oedema, and associated (severe) left-
ventricular heart failure.
-Also long-standing pulmonary hypertension.
Ghon Focus
An area of infection and caseous necrosis at the periphery of the lung, beneath the pleura - found in tuberculosis infection.
Ghon Focus rupture (rare)
Ruptures through the the visceral pleura into the pleural cavity which will produce tuberculous pleurisy.
When does Horner’s Syndrome occur? Name some signs
Can occur when there is a local spread of cancer to the
intrathoracic nodes or a Pancoast’s tumour.
-Ptosis (drooping of theeyelid)
-Enophthalmos (sunken eye)
-Miosis (small pupil)
-Lack of sweating on the ipsilateral (same side as invasion) side of the face. This is due to invasion, of the cervical sympathetic chain.
Acute management of Asthma?
OSHIT MAN:
a. Oxygen (a non-rebreather mask)
b. Salbutamol (Nebulised back-to-back)
c. Hydrocortisone IV (or Prednisolone orally)
d. Ipratropium Bromide (Nebulised hourly)
e. Theophylline IV (or aminophylline IV)
f. Magnesium and call an
g. Anaesthetist
Thumbprint sign on head x-ray
Epiglottitis
Inspiratory whoop/barking cough
Pertussis
Snow storm appearance on x ray
Baritosis
Silicosis
Management of infective exacerbation of COPD?
iSOAP
i - ipratropium
S - Salbutamol
O - Oxygen
A - amoxicillin
P - prednisolone
Non-smoker + lung cancer
(peripheral) adenocarcinoma
Squamous + Small-cell Lung cancers
CENTRAL
What do high d-dimers indicate? What tests should follow?
Suspect pulmonary Embolism (send for CTPA or V/Q scan to diagnose)
Low d-dimers
Exclude Pulmonary Embolism
What do you do in large PE vs small PE?
Thrombolysis for big
Low Molecular Weight Heparin for small
Respiratory alkalosis
Panic attack
Frank pus on aspiration
Empyema
Obstructive lung disease + Raised Eosinophils
Asthma
Obstructive lung disease + Raised neutrophils
COPD
Who does pickwickian disease? What does it cause? What might they need?
Obese people whose body fat preventing air getting in.
Causes sleep apnoea and hypercapnia (high levels
of carbon dioxide in the blood)
Buzzword: overnight nasal ventilation
What is Guillian-Barre disease? What is it preceded by? What are signs of it?
A disease which causes paralysis. Normally preceded by a strep. throat/infection of respiratory or GI tract. Polyneuritis (meaning rapidly
progressive, ascending motor neurone paralysis, beginning in the feet and ascending
to the other muscles)
Coal workers pneumoconiosis - two types? Where are problems usually found?
Simple coal worker’s pneumoconiosis (the disease in its early form)
Progressive massive fibrosis (the disease in its later
form)
Problems found at the apex of the lung
When does adult respiratory distress syndrome occur? What does the Xray show?
Occurs when non-cardiogenic pulmonary oedema leads to acute respiratory failure.
CXR shows bilateral alveolar shadowing.
What does TLCO show?
How well oxygen can diffuse into the blood
What is asbestosis?
Problems found at the base of the lung
How does diabetic ketoacidosis usually present?
Type 1 diabetic presents with vomiting and not taking her insulin. Dehydrated and deep laboured breathing – leading to metabolic acidosis
APX-ray? → Anterior Posterior usually A Portable
Anterior → Posterior (usually A Portable)
22 year old woman, weight loss, sputum, night sweats, tender well defined nodules on
shins bilaterally
erythema nodosum
Honeycomb lung
fibrosing alveolitis
How does extrinsic allergic alveolitis present? What are the 2 types?
-Granulomatous inflammation of the lungs
-Acute and subacute cause pneumonitis
-Chronic cause fibrosis
-Emphysema
-Farmer’s lung; major antigen is Saccharopolyspora rectivirgula. (Buzzwords; farmer, lymphocyte, “positive test”)
-Bird-fancier’s lung; due to exposure to avian proteins. (Buzzwords; pigeons, parrots)
How is extrinsic allergic alveolitis treated?
Treated with steroids and antigen
avoidance
What does EAA show on CXR?
Can show bilateral reticulonodular shadows on a CXR.
What is exudate? transudate?
Exudate = “Extra” protein (>30)
Transudate = “Tiny” protein (<30)
Most common cancer in smokers?
Squamous cell cancer
What do squamous cell cancers secrete?
Parathyroid hormone and causes hypercalcemia
What are some features of large cell cancer?
Poorly differentiated, sex hormone releasing → gyneocomastia (male breasts)
Most common cancer in non-smokers?
Adenocarcinoma
