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revision year 1 > Resp Corrections > Flashcards

Resp Corrections Flashcards

1
Q

What is a palpable reference point that can be used in BEC?
a) Right 4th rib

b) Rib 2
c) Rib 6
d) Superior to the clavicle
e) Between right ribs 4 and 6
f) 2nd intercostal space
g) T11 vertebra
h) Xiphoid process
i) T3 vertebra
j) 5th intercostal space

A

Xiphoid process

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2
Q

What site is used in decompressing a tension pneumothorax?

A

2nd intercostal space

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3
Q

Whta increase pulmonary ventilation more resp rate or tidal volume?

A

tidal volume

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4
Q

What is an anatomical landmark for cardiopulmonary resusitation?

A

xiphoid process

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5
Q

What respiratory pathogen, if present in a patient with CF, is a contraindication for a lung transplant?

A

Burkholderia cenocepacia

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6
Q

what is a common pulmonary manifestation of aspergillus infection?

A

allergic asthma

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7
Q

what is normally seen in the emergency department for CF pneumothorax/PE?

A

pneumothorax

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8
Q

what is a test where pilocarpine is administered aka?

A

sweat test

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9
Q

what type of respiratory failure are you at risk for with OSA?

A

respiratory failure 2

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10
Q

what antibiotic is a contraindication for theophylline?

A

ciprofloxacin

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11
Q

what is the mechanism of action for aminophylline?

A

binds to adenosine receptors and blocks the action of adenosine mediated bronchoconstriction

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12
Q

what arterial blood gas finding would you find for maple syrup disease?

A

metabolic acidosis

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13
Q

On the rigjht side of the patients chest, which one of the following surface landmarks would most likely mark the boundary between the middle and lower lobes?

a) fourth costal cartilage
b) horizontal line at level of sternal angle
c) horizontal line at the level of the nipple
d) ninth costal cartilage
e) sixth rib

A

e) sixth rib

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14
Q

Name the respiratory causes of clubbing

A 
empyema
bronchiectasis
pulmonary edema
carcinomas (except small cell)
CF
fibrosis
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15
Q

what is the +ve value in sweat test for CF?

A

chloride > 60mmol/L

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16
Q

which asthma drug has an association with HYPOkalaemia?

A

salbutamol

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17
Q

what organism is an individual likely to develop pneumonia from after recovering from influenza?

A

staph aureus

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18
Q

where should a chest drain be inserted?

A

2nd intercostal space mid clavicular line

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19
Q

what does a wedge shape on CXR indicate?

A

pulmonary infarction

ie a pulmonary embolism

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20
Q

what pneumonia causative organism is likely found in student accomodation/ living spaces?

A

mycoplasma pneumoniae

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21
Q

what is the most common lung cancer in patients who dont smoke?

A

adenocarcinoma

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22
Q

what is miosis a symptom of?

A

horner’s syndrome

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23
Q

name some transudates?

A 
heart failure
pericarditis
cirrhosis
malabsoprtion
hypo thyroidism
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24
Q

name some exudates?

A

infection, inflammation and malignancy

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25
Q

what is the ABG result for pnuemothorax in patients with chronic lung disease?

A

resp acidosis

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26
Q

where are pancoast tumours found and what do they invade?

A

apex of the lung

bronchial plexus

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27
Q

what are the paraneoplastic syndromes for adenocarcinoma?

A

thromboplebitis

fingerclubbing

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28
Q

what type of lung cancer is keratinising?

A

squamous cell carcinoma

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29
Q

what are the paraneoplastic syndromes of squamous cell carcinoma?

A

parathyroid hormone secretion

hypercalcaemia

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30
Q

who are small cell carcinomas common in?

A

smokers

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31
Q

which lung cancer type has the worst prognosis?

A

small cell

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32
Q

what lung cancers have finger clubbing as a side effect?

A

adenocarcinoma

mesothelioma

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33
Q

paraneoplastic syndromes of small cell cancer?

A

ACTH secretion -cushings syndrome

ADH secretion- hypotraemia, increased fluid retention

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34
Q

What cancers get HPOA?

A

non small cell and mesothelioma

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35
Q

what nerve is affected if a hoarse voice is present?

A

recurrent laryngeal

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36
Q

symptoms of cushings?

A

fat deposits
muscle weakness
headache
glucose intolerance

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37
Q

what stages of cancer can get surgfery?

A

stage 0-3a

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38
Q

what is the score used for fitness for treatment in lung cancer?

A

ECOG

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39
Q

what disease has tramline and ring shadows on CXR and cystic shadowing?

A

bronchiectasis

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40
Q

is you see an orange shaped sign on CXR/CT what is it?

A

lung abscess

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41
Q

if you see a D sign on CXR what is the disease?

A

empyema

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42
Q

if you see a banana sign on CT what is it?

A

empyema

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43
Q

if a patient recovering from pneumonia still has a recuurant fever what should you expect the cause is?

A

a pleural effusion

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44
Q

if a patient is found to have haemolytic anaemia, what type of pneumonia?

A

mycoplasma

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45
Q

if someone has a bird what type of pneumonia?

A

chlamydia psittaci

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46
Q

what type of pneumonia for sheep workers or farmers?

A

coxiella burnetti

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47
Q

what type of pneumonia for alcoholics?

A

kleibsiella pneumonae

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48
Q

red jelly sputum indicates what?

A

kleibsiella pneumonia

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49
Q

rusty suptum indicates what?

A

pneumoccoal pneumonae

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50
Q

if the agar test comes back chocolatey for pneumonia what is it?

A

h. influenzae

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51
Q

what organism causes COPD exacerbation pneumonia?

A

h influenzae

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52
Q

if someone has pneumonia, dry cough and diahorrea what pneumonia is it?

A

legionella

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53
Q

what curb score is needed for hospitalisation?

A

2

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54
Q

what pneumonias do you need a urine test for?

A

LEGIONELLA AND PNEUMOCCOAL

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55
Q

what type of pneumonia for HIV?

A

pnemocyctis pneumonia

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56
Q

what type of pneumonia IV drug users?

A

endocarditis

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57
Q

what causes LRTI of CF?

A

pseudonomas aeroguinosa

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58
Q

antibiotics for severe HAP?

A

AGM

amoxicillin gentamycin and metronizadole

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59
Q

d:diaphoresis

A

sweaty

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60
Q

name the 4 antibiotics used to treat TB and the management plan

A 
rifampicin
isoniazid
pyrazinamide
ethambutol
2M all 4M RI
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61
Q

se of rimfampicin

A

orange pee

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62
Q

SE of isoniazid

A

neuropathy

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63
Q

SE pyrazanamide

A

joint pain

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64
Q

SE of ethambutol

A

colour blindness

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65
Q

what patients do you need to be wary of with rimfampicin?

A

warfarin and liver

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66
Q

what are the causative agents in TB/

A 
mycobacterium:
tuberculosis
bovis
africans
microti
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67
Q

what is a gohn focus?

A

TB encapsulated by a granuloma made up of epitheliod and langerhans cells

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68
Q

what is a gohn complex?

A

ghon focus + lymph nodes

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69
Q

what lymph nodes are commonly affected in TB?

A

hilar

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70
Q

what type of hypersensitivity reaction is TB?

A

IV

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71
Q

what type of necrosis is present in TB?

A

caseous

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72
Q

what test do you do on sputum and what is result for TB?

A

zheil neelson and yellow/red/orange

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73
Q

what is auramine used to test for?

A

TB

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74
Q

if there was bilateral lymphadenopathy, scar tissue/granulomas on CXR what disease?

A

TB

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75
Q

what is are millet seed infiltrates on CXR indicative of?

A

miliary TB

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76
Q

when does TB become miliary?

A

when it has been reactivited the second time and spreads around lungs

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77
Q

type I resp failure is what?

A

hypoxia +/- low/normal CO2

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78
Q

what is hypoxia?

A

PaO2<8kPa

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79
Q

type II resp failure is what?

A

hypoxia + hypercapnia

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80
Q

common resp failure 1 diseases?

A

asthma, pulmonary odema, pneumonia, PE

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81
Q

common resp 2 failures?

A

myasthenia gravis, gullain barre syndrome, COPD exaceration, acute asthma, neuro problems

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82
Q

what tyoe of lung cancer most commonly cavitates?

A

squamous cell

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83
Q

what is the most common organism isolated from patients with bronchiectasis?

A

haemophilus influenza

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84
Q

what is the protein thats mutated in CF?

A

CFTR

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85
Q

what are the two mutations of CFTR in CF?

A

F508 del or G115D

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86
Q

Name the ILD for which you use the four C’s?

A

IPF

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87
Q

What is a the pathology of IPF?

A

honeycombing

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88
Q

4c’s of IPF?

A

progressive dry COUGH
CLUBBING
CYANOSIS
bilateral fine end CREPITATIONS

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89
Q

CXR results for IPF?

A

bilateral/lowerzone reticulonodular shadows

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90
Q

what happens to the lung volume in IPF?

A

decreases

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91
Q

what is the test everyone must get if IPF is suspected?

A

HRCT

92
Q

ground glass appearance on HRCT?

A

early IPF

93
Q

Honeycombing on HRCT?

A

late IPF

94
Q

what lobes is IPF commonly found in?

A

lower lobes

95
Q

PFTs for IPF?

A

restrictive

96
Q

if the pathology result says Usual INterstital pneumonia- what is it?

A

IPF

97
Q

is there is a antibody titre> 1:160 what is the cause of IPF?

A

collagen vascular disease

98
Q

outline treatment for IPF?

A

antifibrotic drugs
O2
Lung transplant
Steroids/immunosupressant but not that useful

99
Q

name 2 antifibrotic drugs?

A

pirfenidone and nintedanib

100
Q

what type of resp failure do you get after IPF?

A

type 2

101
Q

what type of hypersensitivity reaction is extrinisc allergic alveolitis?

A

type 3

102
Q

what type of Ig complex is involved in pathology of EAA?

A

IgG

103
Q

what causes bird fanciers lung/ pigeons?

A

avian/bird droppings (proteins found in here)

104
Q

cause of farmers/mushroom/sugarcanes lung?

A

thermophilic actinomyocytes

105
Q

what is the cause of malt/cheese workers lung?

A

fungus (aspergillus)

106
Q

if the pathology report says hypersensitivity pneumonitis- what is it?

A

EAA

107
Q

how many hours after exposure does a flu-like illness occur for EAA?

A

6-18hrs

108
Q

is there wheeze in EAA?

A

no

109
Q

what is acute CXR EAA?

A

patchy infiltrates

110
Q

what is the chronic CXR EAA?

A

pulmonary fibrosis, commonly in UPPER ZONES

111
Q

how do you tell difference between EAA chronic and IPF on CXR?

A

IPF is lower lobes

EAA is Upper lobes

112
Q

what do PFTs show for chronic EAA?

A

restrictive, but reversible and decreased TLCO

113
Q

what would a lung biopsy show of EAA?

A

non-caseating granulomas

114
Q

treatment for EAA?

A

remove antigen exposure
steroids
O2 poss antifibrotic drugs

115
Q

what inhaled dust disease if mining/construction worker?

A

silica

116
Q

what inhaled dust disease if underground mining?

A

coal

117
Q

what inhaled dust disease if ore processing, workinh, nuclear bombs?

A

beryllium

118
Q

what inhaled dust disease if shipyeard, roof, textiles?

A

asbestosis

119
Q

what is UL round opacities on CXR if underground miner?

A

coal workers pneumoconiosis

120
Q

what happens to DLCO in coal workers?

A

decreases

121
Q

what is caplans syndrome?

A

rheumatoid arthritis and pneumoconiosis( especially coal workers)

122
Q

CXR shows egg shell calcification of hilar lymph nodes?

A

silicosis

123
Q

which is a more dangerous asbestos serpentine or amphibole?

A

amphibole

124
Q

if someone has chest pain and pleural effusion with asbestos exposure what is it?

A

mesothelioma

125
Q

clubbing is seen in asbestosis true/false

A

true

126
Q

CXR and HRCT for asbestosis?

A

linera interstilial fibrosis

bilateral plueral thickening and pleural plaques

127
Q

PFTs for asbestosis?

A

restrictive or obstructive if patient has COPD

128
Q

treatments plan for asbestosis?

A

stop smoking
supportive care- bronchodilators and antibiotics
pulmonary rehab

129
Q

what type of hypersensitivity reaction is sarcoidosis?

A

type IV hypersensitvity

130
Q

if the patient is black, has erythmateous nodular rash what is it?

A

sarcoidosis

131
Q

what is it if bilateral hilar lymphadenopathy?

A

sarcoidosis

132
Q

what may you see in a FBC for sarcoid?

A

increased ACE and raised Ca2+ levels

133
Q

do small cell lung cancers cavitate?

A

nay

134
Q

where is the trachea palpated?

A

suprasternal/jugular notch

135
Q

where is the sternal angle/ angle of louis clinically palpable?

A

rib 2

136
Q

where does larynx become trachea and pharynx become oeophageus?

A

C6

137
Q

where does trachea bifurcate and what is it aka?

A

t5-7 and carina

138
Q

give the 3 characteristics of horners syndrome?

A

MAP
Miosis
anhydrosis
ptosis

139
Q

what antigen is present in squamous cell carcinoma?

A

p63

140
Q

what is the narrowest part of the larynx where foreign bodies tend to block?

A

rima glottidis

141
Q

asian man with night sweats, fever and weight loss?

A

TB

142
Q
  • T1DM with vomiting and not taking their insulin – dehydrated and deep labored breathing what is it?
A

metabolic acidosis, DKA, diabetatic keratosis

143
Q

what is a thumprint sign on HEAD xr?

A

epiglottitis

144
Q

what causes epiglottidis?

A

h influenze

145
Q

what should epiglottidis be treated with?

A

ceftriaxone

146
Q

what should you deffo not do in epglottidis?

A

toch with tongue depressor

147
Q

where is resp rhythm established?

A

medulla

148
Q

what does apneustic area do in pons?

A

prolong inspiration

149
Q

what does pneumotaxic area do in pons?

A

inhibits inspiration

150
Q

What is henrys law?

A

volume of the gas is proportional to the partial pressure of gas in equilibrium with liquid

151
Q

what is coryza?

A

common cold

152
Q

what do positive cold agglutinins indicate?

A

mycoplasma infection

153
Q

what test would you do to look for bone mets?

A

99M Tc radionuclide bone scanning

154
Q

what is samters triad?

A

asthma, salicylate sensitivity (aspirin) and nasal polyps

155
Q

what causes centriacinar emphysema?

A

smoking

156
Q

what causes panacinar emphysema?

A

A1AT

157
Q

where is horizontal fissure?

A

rib 4

158
Q

where is oblique fissure?

A

rib 6

159
Q

what vein and artery supplies the anterior intercostal muscles?

A

internal thoracic artery/ vein

160
Q

what vein and artery supplies the posterioir intercostal spaces?

A

throacic aorta ad azygous vein

161
Q

what bone scan is used to diagnose osetoprosis?

A

DEXA

162
Q

is bronchopneumonia neutrophilic or eosinophilic?

A

neutrophilic

163
Q

how to differentiate between direct and indirect hernias?

A

on occlusion and cough, direct lump will reappear, indirect will not reappear

164
Q

what disease is this the pathological descriptiojn for?

Idiopathic inflammation of alveoli with thickening of alveolar walls

A

IPF

165
Q

what disease is this the pathological description for?

Reversible airway obstruction and bronchospasm

A

acute asthma

166
Q

what disease is this the pathological description for?

Non-caseating granuloma formation

A

sarcoid

167
Q

what disease is this the pathological description for?

Uncontrolled proliferation of epithelial cells in large airways of lung

A

cancerrrr

168
Q

where are the peripheral chemoreceptors?

A

carotid and aortic arches

169
Q

what do peripheral chemoreceptors respond to?

A

decrease O2, pH or an increase in CO2 and H+

170
Q

what does serum tryptase mark?

A

mast cell degranulation ie immune response to allergen

171
Q

what nerve travels infront of hilum?

A

phrenic

172
Q

what nerve travels behind of hilum?

A

vagus

173
Q

what muscles attach to ribs?

A

scalenes

174
Q

what direction of external intercostal muscles run in?

A

direction of hand into pockets

175
Q

where is the visceral pleura?

A

stuck to the lungs

176
Q

if you cant see the R heart border which lobe is consolidated?

A

middle

177
Q

if the lower lobe is consolidated what isn’t seen on CXR?

A

hemidiaphragm

178
Q

when looking at the hilum what is the most posterior bit?

A

bronchus

179
Q

when looking at the hilum what is the most superior bit?

A

arteries

180
Q

when looking at the hilum what is the most anterioir and inferioir bit?

A

pulmonary vein

181
Q

in oxygen haemoglobin dissociation curve what isthe shape?

A

sigmoid

182
Q

what does the steep bit indicate in oxygen dissociation curve?

A

when haemoglobin has a high affinity for O2

183
Q

what does bohr effect do to oxygen haemoglobin dissociation curve?

A

shifts to right as increased CO2 so decreased affinity of haemoglobin for O2

184
Q

if the oxygen haemoglobin curc=ve shifts to the left what does it indicate?

A

high affinity for O2 binding to haemoglobin

185
Q

which ribs are true ribs?

A

1-7

186
Q

which ribs are false ribs?

A

8-10

187
Q

which ribs float?`

A

11 +12

188
Q

where is sternal angle?

A

level of rib 2

189
Q

hiw do you remember the openings of the diagphragm?

A

I 8 10 Eggs At 12

190
Q

what type of muscle is the diagphragm?

A

skeletal

191
Q

what nerve supllies the serratus anterior?

A

long throacic

192
Q

paralysis of what nerve results in a winged scapula?

A

long throacic

193
Q

what groove is the cephalic ein located in?

A

deltopectoral groove

194
Q

what happens at the sternal angle?

A

trachea bifurcates

195
Q

where do inguinal ligaments attach between?

A

ASIS and pubic tubercle

196
Q

where do the anterior intercostal arteries come from?

A

branch of thoracic artery

197
Q

where do posterior intercostal arteries come from?

A

branch of thoracic aorta

198
Q

where do anterior intercostal veins drain into?

A

internal thoracic veins

199
Q

where do posterior intercostal veins drain into?

A

azygous vein

200
Q

how do you tell wether pulmonary artery/vein on CT?

A

arteries run beside bronchus

201
Q

what is the first line treatment for acute respiratory distress?

A

CPAPA

202
Q

what is step 2 in COPD treatment?

A

SABA and LAMA/LABA

203
Q

what is step 2 asthma treatment?

A

ICS alone

204
Q

what is treatment for bronchiolitisin baby?

A

supportive and bronchodialtor

205
Q

what is antibiotic for klebsiella?

A

cefotaxime

206
Q

what is the best test to screen for CF?

A

faecal elastase

207
Q

what 2 drugs can cause pulmonary fibrosis?

A

azathoprine and bleomycin

208
Q

pathophysiology of transudates?

A

increased hydrostatic pressure or low plasma oncotic pressure

209
Q

pathophysiology of exudates

A

inflammation and increased capillary permeability

210
Q

swinging fever?

A

abscess

211
Q

apical disease?

A

most likely secondary Tb

212
Q

Positive anti-glomerular basement membrane antibodies ?

A

goodpastures syndrome

213
Q

steeple sign on CXR?

A

laryngotracheobronchitis/croup

214
Q

mucoid sputum?

A

chlamydia pstattci

215
Q

cannonball mets?

A

renal cell carcinma mets

216
Q

morning headache?

A

hypercapnia or SE of organic nitrates

217
Q

coin lesion on CXR could be what?

A

Primary bronchial or lung carcinoma, Metastatic tumour (esp. of kidney), Bronchial hamartoma, Carcinoid tumour, Granulomatous inflammation, Lung abscess.

218
Q

snow storm appearance on CXR?

A

baritosis/ silicosis

219
Q

1st line treatment for pertussis?

A

erythromycin

220
Q

1st line treatment for croup?

A

steroids

221
Q

1st line investigation for epigglotitids?

A

larynscope

222
Q

treatment for epiglottidis?

A

intubation

223
Q

aetiology for croup?

A

RNA virus eg RSV

224
Q

aetiology for epiglottidis?

A

bacteria gm -ve eg haempphilus influenzae

225
Q

goodpasters syndrome is what?

A

automimmune condition causing buildup of autoimmune proteins in the kidneys and lungs that leads to damage of these organs.

revision year 1 (7 decks)

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