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year 1 > resp extra notes > Flashcards

resp extra notes Flashcards

1
Q

what is the most common cause of acute epiglottitis

A

haemophilus influenzae B

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2
Q

what are the 3 main causes of HAP

A

pseudomonas aerginosa
SA/MRSA
Klebsiella

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3
Q

how is acute bronchitis differentiated from pneumonia

A

chest XR clear in bronchitis

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4
Q

what are the 3 main atypical pneumonias

A

mycoplasma
legionella
chlamydophilia pneumonia

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5
Q

what is the most common cause of aspiration pneumonia

A

klebsiella

-ve enterococcus

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6
Q

what microorganism is associated with farm/plants/harvest

A

aspergillus fumigatas

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7
Q

what is the treatment for PE

A

LMWH e.g. dalteparin

warfarin for 3 months or LMWH for 3 months if secondary to malignancy

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8
Q

what does bilateral lower zone reticulonodular shadowing show

A

fibrosis

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9
Q

how is an empyema treated

A

US guided chest drain and antibiotics

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10
Q

what does faecal elastase test test

A

assess exocrine pancreatic dysfunction in CF

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11
Q

what microorganisms infect CF

A 
SA
H. influenzae
LT - 
Pseudomonas Aeruginosa
Burkholderia Cepecia ( less common)
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12
Q 
what are... 
amphotericin
vonconazole 
itraconazole
caspofungin
A

antifungals

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13
Q

what should be measured in acute exac of COPD

A

ABGs

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14
Q 
32 YO
LT asthma
suspected pneumonia
CXR - unusual pattern of changing infiltrates
eosinophilia
inflammatory markers raised 
biopsy of lung tissue - eosinophilic infiltrate, granuloma
p-ANCA +ve
A

Chung Strauss - eosinophilic infiltration causing vasculitis of small arteries and veins

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15
Q

tin miner

A

pneumoconiosis

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16
Q 
smoker
haemoptysis
SOB, tired
inspiratory crackles throughout lungs
impaired renal function
raised anti-GBM antibody
A

Goodpastures syndrome

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17
Q

long standing cough, multiple fits every day, cold 2 months ago

A

pertusis

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18
Q

worked in coal industry
rheumatoid arthritis
worsening breathlessness
Xray - small nodules throughout lung fields

A

Caplans syndrome - rheumatoid pneumoconiosis

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19
Q

early pregnancy
acetalasis on XR
resp assistance required

A

newborn respiratory distress syndrome

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20
Q 
SOB
clubbing
bibasal crepitations
stiff hand joints
lost weight
CRP and ESR raised
A

rheumatoid

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21
Q

SOB when active
non-productive cough
pmhx rheumatoid arthritis
takes methotrexate and folic acid

A

interstitial lung disease - possibly drug induced fibrosis

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22
Q 
chest pain
worse in deep breaths/cough
poorly localised
rash across face
fmhx: T1 diabetes, rheumatoid arthritis
A

pleuritis

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23
Q 
worked in ship yards
weight loss
night sweats
worsening breathlessness
imaging - extensive pleural disease and peritoneal deposits
A

mesothelioma

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24
Q

what is the treatment for croup

A

nebulised adrenaline

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25
Q

what is a s/s SLE

A

pleurisy

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26
Q

inflamed sinuses, lungs, throat, kidney
haemoptysis
nose bleeds

A

wegners granulomas - granulomatous disease affecting small arteries

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27
Q

gradual onset SOB
reduced chest expansion
dullness on percussion

A

pleural effusion

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28
Q

what is a CF screening test that can be done in the GP

A

faecal elastase

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29
Q

what is seen in sweat test of CF

A

high sodium

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30
Q

what does CF show on spirometry

A

obstructive

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31
Q

what is the treatment of a tension pneumothorax

A

large bore cannula 2nd ICS MCL
then chest drain 4th/5th ICS MAL
recurrent - pleurodesis

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32
Q

how does a pneumothorax look on a CXR

A

straight line with no lung markings outside it

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33
Q

what is kartageners syndrome

A

AR disease
ciliary dyskinesia assoc. abnormal mucociliary clearance –> recurrent resp infections, infertility, pancreatic problems
dextrocardia

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34
Q 
35 year old woman
chest pain
SOB
red rash across face (butterfly rash)
raised ds-DNA and ANA abs
A

SLE

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35
Q

14 month old baby

sternal recession and indrawing

A

bronchiolitis

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36
Q

infection affecting distal airspaces usually accompanied by inflammatory exudate causing consolidation

A

pneumonia

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37
Q

fixed dilation of bronchi usually as a result of scarring or distal to a chronic obstruction

A

bronchiectasis

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38
Q

infection at 4 months old

developing normally, after supportive treatment goes on to develop normally

A

transient hypogammaglobulinaemia of infancy

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39
Q

3 month old infections
family history early infant death
differential WBC - low T cell and raised B cell
diarrhoea

A

SCID

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40
Q 
15 day old baby
severely unwell
febrile
difficult to settle 
extensive oral ulcers 
lost weight
low neutrophil count
A

AR - Kostmann syndrome

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41
Q 
repeated infections
recurrent oral candidiasis
multiple facial features suggesting genetic cause
low T cell count and hypocalcaemia
abnormal CVS
A

DiGeorge syndrome

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42
Q

what can you test the function of with NBT

A

neutrophils

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43
Q

what is a test for haemophilus influenza

A

X and V test, chocolate agar

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44
Q

what are the most common microorganisms seen to infect in COPD

A

haemophilus influenza
strep. pneumonia
moraxella catarrhalis

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45
Q

what are 4 common causes of coryza

A

adenovirus
rhinovirus
RSV
coronavirus

46
Q

what is a cause of pharyngitis

A

adenovirus

47
Q

what is youngs syndrome

A

bronchiectasis + rhinosinusitis + reduced fertility

AR

48
Q

what is chronic bronchial sepsis

A

bronchial sepsis but no bronchiectasis on HRCT

younger patients esp women in child care

49
Q

what is the most common cause of brochiectasis

A

CF

50
Q

what does inhalation of NO do to V/Q

A

improves

51
Q

what happens in CF

A

Failed opening of Cl channel -> ↑cAMP, resulting in ↓Cl and ↑Na -> ↑viscosity of airway secretions.

52
Q

what is there a deficiency of in bronchiectasis

A

IgA

53
Q

what cells do glucocorticoids act on

A

Th2

54
Q

what is seen in bronciectasis

A

tram track signs

signet ring signs?

55
Q

what is seen in a ghon focus

A

epithelial cells

langhans giant cells

56
Q

where does TB tend to stay

A

apices of lungs

- fibrosing and cavitating apical lesions

57
Q

what is IGRT

A

specific test for M. tuberculosis - but doesn’t differentiate latent, active or previously treated TB

58
Q

what is the main side effect of Rifampicin

A

orange urine and tears

hepatitis

59
Q

what is the main side effect of isoniaside

A

pins and needles

hepatitis

60
Q

what is the main side effect of pyrazinamide

A

gout

hepatitis

61
Q

what is the main side effect of ethambutol

A

arthralgia

retrobulbar neuritis

62
Q

what does steeple sign on CXR indicate

A

croup

63
Q

egg shell calcification in hilar region

A

silicosis

64
Q

heart failure cells in alveolar spaces

A

chronic pulmonary oedema/LV failure/LT pulmonary hypertension

65
Q

assman focus

A

secondary TB

top of lung

66
Q

coin lesion

A

primary/secondary cancer
granuloma
abscess

67
Q

thumbprint sign of head Xray

A

epiglottitis

68
Q

snow storm appearance on X ray

A

baritosis/silicosis

69
Q

large PE tx

A

thrombolysis

70
Q

small PE tx

A

LMWH

71
Q

child with barking cough

A

croup

72
Q

right sided chest pain

A

probably pneumonia

73
Q

CT scan showing bronchiole wider than neighbouring arteriole

signet ring sign

A

bronchiectasis

74
Q

CXR showing tram line

A

bronchiectasis

75
Q

what are some job causes of silicosis

A

glass working
mining
stone working
foundry working

76
Q

what causes a spontaneous pneumothorax

A

rupture of sub pleural air cysts (blebs)

77
Q

what causes secondary pneumothorax

A

secondary to resp disease

78
Q

how can resp distress syndrome be prevented

A

steroids to expectant mother

79
Q

what mothers are more prone to children with resp distress syndrome

A

diabetics

80
Q

what is treatment for severe resp distress syndrome

A

artificial surfactant

oxygen

81
Q

what is the blue inhaler

A

salbutamol

82
Q

in obstructive lung disease there is trouble with

A

exhaling

83
Q

what is stridor

A

inspiratory wheeze

84
Q

what are some causes of cor pulmonale

A

COPD
PE
sleep apnoea
CF

85
Q

what are some s/s cor pulmonale

A 
cyanosis
tachycardia
raised JVP
RV heave
Pan systolic murmur (tricuspid regurg)
86
Q

what is the treatment of croup

A

single dose of prednisolone

87
Q

what is a complication of coryza

A

bronchitis

88
Q

what is the treatment of whooping cough

A

erythromycin

89
Q

how is whooping cough diagnosed

A

pernasal swab

serology for bordetella pertussis

90
Q

what is the treatment for obstructive sleep apnoea

A

lose weight
reduce alcohol
CPAP

91
Q

what is the treatment for central sleep apnoea

A

treat cause

NIPPV

92
Q

Cheyne-Strokes respiration

A

central sleep apnoea

93
Q

what is the treatment for ARDS

A

ICU ventilation

94
Q

what breathing is seen in ARDS

A

rapid shallow breathing

95
Q

what are some s/s of a lung abscess

A 
Swinging Fever 
Foul Smelling Sputum 
Pleuritic Chest Pain 
Haemoptysis 
Malaise 
Weight Loss
FBC - anaemia and neutrophilia
CXR - walled cavity with fluid level
96
Q

what is the expansion in pneumonia

A

diminished

97
Q

what is the resonance in pneumonia

A

increased

98
Q

what is seen on XR of pneumonia

A

new shadowing

99
Q

what breathing is seen in pneumonia

A

bronchial breathing

100
Q

patient with resolving pneumonia gets a fever

what do you suspect

A

empyema

101
Q

what are some s/s empyema

A

chest pain on inspiration
pleural rub
CXR
drainage

102
Q

A one year old child, caucasian with loose oily stools and failure to thrive presents. They have had persistent chest infections. Cause?

A

CF

103
Q

what is the treatment for CF

A
  • ABs given early, high dose, for longer
  • salbutamol to relieve symptoms
  • corticosteroids to reduce inflammation
  • pancreatic enzymes, vitamins, high calorie diet
104
Q

what is seen on the CXR of fibrosis

A

reduced lung volume
honeycombing
bilateral lower zone reticulonodular shadows

105
Q

what are some s/s asthma

A

diminished air entry
audible wheeze
hyper inflated chest

106
Q

what are some s/s bronchiectasis

A

lower lobes
course crackles
clubbing

107
Q

what is the treatment for drug induced asthma e.g. by aspirin

A

montelukast

108
Q

what do mast cells in asthma secrete

A

histamine
LTC4
PGD2

109
Q

what is the pathophysiology of coal worker pneumoconiosis

A

Coal dust enters the lungs which cannot be removed or destroyed
It is ingested by macrophages and causes the macrophages to release inflammatory mediators
Causes inflammation and fibrosis

110
Q

what is seen in massive fibrosis of coal worker pneumoconisos

A

Very large, nodular, fibrinotic masses in the upper lungs

Shortness of breath, chronic cough, Black sputum, lung dysfunction

111
Q

what is the general order of treatment for asthma

A 
SABA
ICS
LABA
CysLTA (oral)
prenisolone

year 1 (45 decks)

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