resp buzzywords 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
- ABCDE
Pulmonary oedema
Ground-glass appearance on X-ray
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
spread of organism into bloodstream
in miliary TB If organism spread via pulmonary artery,
miliary dissemination into the lung occurs.
if military TB If organism spread via pulmonary vein, there is
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” - or a Mr. Snoop Dogg or Mr.
Martin Mitchell →
probably 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 →
HIV (treat with Co-tramoxazole [± prednisolone if
severe])
what is samter’s triad
Asthma + Nasal Polyps + Salicylate sensitivity
Alcoholic (danger of aspiration pneumonia) or red jelly sputum →
Klebsiella pneumoniae
Mucoid sputum →
Chlamydia psittaci
Rusty sputum →
Pneumococcal pneumonia
Cannonball metastases (also weight loss and haematuria) →
classically from primary
renal cell carcinoma
Morning headache →
hypercapnia or Side effects of organic nitrates
ACTH secreting lung tumour →
Small cell carcinoma of the lung. Small-cell carcinoma
are neuroendocrine, highly malignant, and may be associated with ectopic endocrine syndromes.
PTH secreting lung tumour →
Squamous cell ca. of lung
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, seen in 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.
Note: Ghon Focus rupture (rare)
through the visceral pleura into the pleural cavity will produce tuberculous pleurisy.
Assmann Focus →
Apical lesion of secondary tuberculous infection
Horner’s syndrome
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.
acronym for acute management of Asthma
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
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
High d-dimers →
suspect (but not diagnose) Pulmonary Embolism (send for CTPA or V/Q scan)
Low d-dimers →
exclude Pulmonary Embolism
Large PE:
Small PE:
thrombolysis.
Low Molecular Weight Heparin
Frank pus on aspiration –
empyema
obstructive lung disease – raised eosinophils –
asthma
obstructive lung disease – raised neutrophils –
COPD
Coal workers pneumoconiosis -
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
Adult respiratory distress syndrome -
occurs when non-cardiogenic pulmonary oedema leads to acute respiratory failure.
CXR shows bilateral alveolar shadowing.
Pulmonary oedema –
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)
Treatment of a pneumothorax -
options are observation, needle, chest tube
insertion, surgery
Asbestosis -
problems found at the base of the lung
Type 1 diabetic presents with vomiting and not taking her insulin. Dehydrated and deep labored breathing –
metabolic acidosis (diabetic ketoacidosis).
22 year old woman, weight loss, sputum, night sweats, tender well defined nodules on shins bilaterally –
erythema nodosum
cavitating lesion
squamous cell lung cancer
honeycombing
pulmonary fibrosis
postural flapping tremor
acute CO2 retention
