resp buzzywords

Question 1

stony dull to percuss

Answer 1

pleural effusion

Question 2

right sided pleuritic chest pain

Answer 2

most likely pneumonia

Question 3

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

Answer 3

Pulmonary oedema

Question 4

Ground-glass appearance on X-ray

Answer 4

Pulmonary fibrosis and Respiratory Distress Syndrome of the newborn

Question 5

Ziehl-Neelsen stain positive for acid fast bacilli

Answer 5

TB

Question 6

caseous necrosis

Answer 6

TB

Question 7

apical disease

Answer 7

Most likely (secondary) TB; apical lesion is called an Assmann focus!

Question 8

Miliary Tuberculous

Answer 8

spread of organism into bloodstream

Question 9

in miliary TB If organism spread via pulmonary artery,

Answer 9

miliary dissemination into the lung occurs.

Question 10

if military TB If organism spread via pulmonary vein, there is

Answer 10

systemic dissemination to the liver, spleen, and kidneys.

Question 11

Positive anti-glomerular basement membrane antibodies →

Answer 11

Goodpasture’s syndrome

Question 12

Chest infection with a parrot/pigeon as pet →

Answer 12

caused by chlamydophila psittaci

Question 13

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

Answer 13

Legionella pneumophila (test urine for antigens)

Question 14

“Tall, thin young man who indulges in marijuana” - or a Mr. Snoop Dogg or Mr.
Martin Mitchell →

Answer 14

probably pneumothorax (Marfan’s)

Question 15

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

Answer 15

Sarcoidosis

Question 16

Bronchiole wider than neighbouring arteriole (on CT) (signet ring sign) →

Answer 16

Bronchiectasis

Question 17

“D sign on X ray” →

Answer 17

Empyema

Question 18

“Steeple” sign on X ray →

Answer 18

laryngotracheobronchitis/ croup

Question 19

Child with barking cough →

Answer 19

Croup

Question 20

Pneumocystis pneumonia →

Answer 20

HIV (treat with Co-tramoxazole [± prednisolone if
severe])

Question 21

what is samter’s triad

Answer 21

Asthma + Nasal Polyps + Salicylate sensitivity

Question 22

Alcoholic (danger of aspiration pneumonia) or red jelly sputum →

Answer 22

Klebsiella pneumoniae

Question 23

Mucoid sputum →

Answer 23

Chlamydia psittaci

Question 24

Rusty sputum →

Answer 24

Pneumococcal pneumonia

Question 25

Cannonball metastases (also weight loss and haematuria) →

Answer 25

classically from primary renal cell carcinoma

Question 26

Morning headache →

Answer 26

hypercapnia or Side effects of organic nitrates

Question 27

ACTH secreting lung tumour →

Answer 27

Small cell carcinoma of the lung. Small-cell carcinoma are neuroendocrine, highly malignant, and may be associated with ectopic endocrine syndromes.

Question 28

PTH secreting lung tumour →

Answer 28

Squamous cell ca. of lung

Question 29

Increased serum ACE and Ca2+ →

Answer 29

sarcoidosis

Question 30

Eggshell calcification at hilar region →

Answer 30

Silicosis

Question 31

‘Heart-failure cells’ seen in alveolar spaces →

Answer 31

Macrophages that have absorbed haemosiderin - found in chronic pulmonary oedema, and associated (severe) left- ventricular heart failure. Also, seen in long-standing pulmonary hypertension.

Question 32

Ghon focus

Answer 32

→ An area of infection and caseous necrosis at the periphery of the lung, beneath the pleura - found in tuberculosis infection. Note: Ghon Focus rupture (rare) through the visceral pleura into the pleural cavity will produce tuberculous pleurisy.

Question 33

Assmann Focus →

Answer 33

Apical lesion of secondary tuberculous infection

Question 34

Horner's syndrome

Answer 34

Can occur when there is a local spread of cancer to the intrathoracic nodes or a Pancoast’s tumour. Signs include: - ptosis (drooping of the eyelid), - 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.

Question 35

acronym for acute management of Asthma

Answer 35

O SHIT MA Oxygen 100% through a non-rebreather mask Salbutamol Nebulised back-to-back. Hydrocortisone IV or Prednisolone PO Ipratropium Bromide Nebulised hourly Theophylline IV or aminophylline IV Magnesium and call an Anaesthetist

Question 36

Thumbprint sign on head x ray →

Answer 36

epiglottitis

Question 37

Inspiratory whoop/barking cough →

Answer 37

pertussis

Question 38

Snow storm appearance on x ray →

Answer 38

baritosis, silicosis

Question 39

Management of infective exacerbation of COPD →

Answer 39

ISOAP i - ipratropium S - Salbutamol O - Oxygen A - amoxicillin P - prednisolone

Question 40

Non-smoker + lung cancer =

Answer 40

(peripheral) adenocarcinoma

Question 41

Squamous + Small-cell Lung cancers =

Answer 41

CENTRAL

Question 42

High d-dimers →

Answer 42

suspect (but not diagnose) Pulmonary Embolism (send for CTPA or V/Q scan)

Question 43

Low d-dimers →

Answer 43

exclude Pulmonary Embolism

Question 44

Large PE: Small PE:

Answer 44

thrombolysis. Low Molecular Weight Heparin

Question 45

Frank pus on aspiration –

Answer 45

empyema

Question 46

obstructive lung disease – raised eosinophils –

Answer 46

asthma

Question 47

obstructive lung disease – raised neutrophils –

Answer 47

COPD

Question 48

Coal workers pneumoconiosis -

Answer 48

two types Simple coal worker’s pneumoconiosis (the disease in its early form) and progressive massive fibrosis (the disease in its later form). Problems found at the apex of the lung

Question 49

Adult respiratory distress syndrome -

Answer 49

occurs when non-cardiogenic pulmonary oedema leads to acute respiratory failure. CXR shows bilateral alveolar shadowing.

Question 50

Pulmonary oedema –

Answer 50

CXR showing bats wings(perihilar shadowing), upper lobe venous diversion, fluid in horizontal fissue, kerley B lines (small horizontal lines in the periphery due to fluid in the interlobular septae and pleural effusions)

Question 51

Treatment of a pneumothorax -

Answer 51

options are observation, needle, chest tube insertion, surgery

Question 52

Asbestosis -

Answer 52

problems found at the base of the lung

Question 53

Type 1 diabetic presents with vomiting and not taking her insulin. Dehydrated and deep labored breathing –

Answer 53

metabolic acidosis (diabetic ketoacidosis).

Question 54

22 year old woman, weight loss, sputum, night sweats, tender well defined nodules on shins bilaterally –

Answer 54

erythema nodosum

Question 55

cavitating lesion

Answer 55

squamous cell lung cancer

Question 56

honeycombing

Answer 56

pulmonary fibrosis

Question 57

postural flapping tremor

Answer 57

acute CO2 retention