RESP INVESTIGATIONS Flashcards
bronchiolitis
PCR on throat
ILD
CT scan
fibrosis
CT scan
Allergic Alveolitis
lung biopsy
Obstructive Sleep apnoea
polysomography
Lung cancer
bronchoscopy + CT guided biopsy
Pneumothorax
CXR
Epiglottitis
Blood Culture
Pneumonia
CXR
sputum culture + viral PCR
Legionella pneumonia
Legionella urinary antigen testing
BAL/tracheal aspirates
serology
PCR test on sputum
Aspergillus
BAL (bronchoalveolar lavage) or fungal culture for PCR
Pneumocystis Pneumonia
sputum culture + PCR
BAL/tracheal aspirates
direct immunofluorescence
Bronchiectasis
HRCT
Idiopathic Pulmonary Fibrosis
HRCT - reticulonodular fibrotic shadowing (worse at lung bases), honey combing cystic changes
CXR
mycoplasma tuberculosis
\+ve to acid alcohol fast bacilli sputum/tissue microscopy - ZN stain IGRT PCR culture on selective media (3 months)
sarcoidosis
CXR - bilar lymphadenopathy
CT - peripheral nodular infiltrate
Biopsy - non-caseating granuloma
Asthma
spirometry - FEV1/FVC ration < 75%
reversibility to salbutamol
Provocation testing
COPD
spirometry - FEV1/FVC ratio < 75%
less reversibility to salbutamol
Exac. of COPD
sputum culture
CXR
Restrictive lung disease
spirometry - FEV1/FVC ratio > 75% TLCO reduced decreased O2 on exercise or at rest CXR serology CT
lung cancer - to see cell type and proximity to carina
bronchoscopy (if within 2cm then inoperable)
lung cancer - to see size and mets
CT
PET (more expensive)
pleural malignancy
aspiration of pleural effusion
CT guided tissue biopsy
thoracoscopy
chlamydia / coxiella pneumonia
serology
Mycoplasma pneumonia
serology/PCR
influenza
PCR nasopharyngeal swab
bronchiolitis
PCR
Bordatella pertussis (whooping cough)
Bacterial culture from nasal swab
PCR
pneumocystis
BAL (better than sputum culture) for immunofluorescence or PCR
Empyema
US and frank pus
pneumoconiosis
CXR
what would asbestosis show in a CXR
holly leaf from pleural plaques
what would silicosis show on a CXR
egg shell calcification
pulmonary hypertension
ECG and CXR
Stridor
laryngoscope
Bronchoscopy
CXR, CT
sleep apnoea
snoring and raised Epworth scale
overnight sleep study - oximetry
how do you differentiate T1 and T2 respiratory failure
ABGs
T1 - O2 low, CO2 normal
T2 - O2 low, CO2 high
test for CF done in GP
faecal elastase
quick and simple
assesses exocrine pancreatic disfunction
2 other tests for CF
sweat test - high sodium
genetic testing
CXR of CF
bronchiectasis and hyperinflation
US of CF
fatty liver and chronic pancreatitis
spirometry of CF
obstructive
Chronic granulomatous disease
NBT test (nitroblue tetrazolium) - change colour in H2O2 sensitive dye - don’t have disease
T/B cell deficiency
total WBC count differential
serum immunoglobulins + protein electrophoresis
Quantitation of lymphocyte subpopulation
allergy
skin prick test
RAST test for patients on antihistamine
flu
PCR using nasopharyngeal/throat swab
antibody detection
atypical pneumonia
serology or PCR
chlamydia trachiomatis
PCR on mothers urine
prenasal/throat swab of child
pneumocystis jiroveci
BAL
induced sputum
direct immunofluorescence (antigen detection)
suspected pneumonia
blood culture
serology
ABGs, FBC, U+Es, LFTs
CXR
RSV
PCR on throat/pernasal swab
metapneumovirus
PCR on throat/nasopharyngeal swab
haemophillus influenza
X and V test
culture on chocolate agar
Lung cancer
CXR
+/- CT
+/- PET
+/- Bronchoscopy - if central lesion and patient fit enough
+/- percutaneous FNA biopsy
+/- sputum cytology if not fit enough for bronchoscopy
what is used to subtype LC on small biopsy
immunohistochemistry
what is TTF-1 expressed in
small cell carcinomas
adenocarcinoma
what is p63 expressed in
squamous cell carcinoma
atypicals
clotted blood cultures
viral
throat swab
bacterial culture
sputum