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Year 4 Gen Med > Resp Pass Med > Flashcards

Resp Pass Med Flashcards

1
Q

What decreases first CRP or white cells

A

White cells

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2
Q

Benign ovarian tumour as cites and plural effusion

A

Meigs syndrome

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3
Q

NG tubes are safe to use if the pH is what on aspirate

A

<5.5

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4
Q

If pH >5.5 on NG tube aspirate do what

A

Request a CXR to confirm position of tube

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5
Q

Pleural fluid with protein > 30 is indicative of an

A

Exudate

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6
Q

Give 4 causes of a transudative pleural effusion (protein <30)

A

HF
Liver disease nephrotic syndrome malabsorption
Hypothyroid
Meigs syndrome

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7
Q

Give causes of an exudative pleural effusion

A

Infection CTD neoplasia pancreatitis PE dresslers yellow nail syndrome

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8
Q

Alpha one antitrypsin causes what type of pattern on spriometry

A

Obstructive

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9
Q

What can abx be prescribed for in upper Resp tract infections as exceptions

A

3 or more of centir criteria
Younger than 2 years with bilateral otitis media
Otorrhoea and acute otitis media in kids

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10
Q

What are the cantor criteria

A

Tonsillitis mar exudate
Lymphadenopathy
Fever of history of
No cough

3 or more can prescribe

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11
Q

When can non invasive ventilation be given in COPD

A

pH between 7.25 and 7.35

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12
Q

If in COPD the pH is <7.25 then use

A

Invasive ventilation

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13
Q

Parallel line shadows on ct

A

Tram lines in bronchiectasis

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14
Q

Collapsing during exertion is associated with what

A

Aortic stenosis

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15
Q

Diagnose mesothelioma

A

Thoracoscopy and histology

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16
Q

Before starting azithromycin do what

A

An ECG to rule out prolonged QT interval and also do baseline LFTs

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17
Q

What is the diagnostic criteria for COPD

A

FEV1/fvc ratio <70% and symptoms suggestive of COPD

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18
Q

What features of COPD would make you think that it would be steroid responsive

A

Previous diagnosis of asthma or atopy
A higher blood eosinophil count
A substantial variation in FEV1 over time (at least 400mls)
Substantial diurnal variation in peak flow (at least 20%)

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19
Q

How long should you hold your breath after using an inhaler

A

10 seconds

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20
Q

How long should you wait between inhaler doses

A

30 seconds

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21
Q

What is the triangle of safety for a chest drain

A

Base of axilla
Lateral edge of pec major
5th ICS
Anterior border of lat Dorsi

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22
Q

BiPAP is a form of

A

Non invasive ventilation

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23
Q

What can mimic a pneumothorax in COPD

A

Emphysematous Bullae

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24
Q

What are the biochemical features of an empyema

A

Turbid effusion with pH <7.2 low glucose high LDH

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25
Q

First line COPD

A

Sama or Saba (salbutamol or salmetarol)

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26
Q

Vaccines in COPD

A

One off pneumococcal and annual flu

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27
Q

Treatment of exacerbation of asthma

A

Short course of oral pred and daily inhaled corticosteroid to control asthma

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28
Q

Scale used in OSA

A

Epworth

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29
Q

Are inhalers safe in pregnancy

A

Yes no need to stop as there is a need for good control throughout

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30
Q

If copd and on Saba/sama and still breathless but is steroid responsive

A

Add a Laba and ICS

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31
Q

What is chest drain swinging

A

The water seal rises on inspiration and falls on expiration

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32
Q

What can cause pulmonary fibrosis of the upper lobs

A 
CHaRTS
Coal workers pneumoconiosis 
Hypersensitivity pneumonitis 
Ank spond 
Radiation 
TB 
Silicosis and sarcoidosis
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33
Q

What type of fibrosis mainly affects the lower zones

A

Idiopathic pulmonary fibrosis
CTD
Drugs (amiodarone methotrexate bleomycin)
Asbestosis

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34
Q

Prevent high altitude cerebral oedema with

A

Acetazolamide

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35
Q

Treat high altitude cerebral oedema with

A

Dexamethasone

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36
Q

Ground glass on CT

A

Fibrosis

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37
Q

What are pleural plaques

A

Benign features of asbestos exposure

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38
Q

What is the most dangerous form of asbestosis

A

Crocidolite (blue)

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39
Q

How is military TB spread

A

Through the pulmonary venous system

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40
Q

Sudden deterioration after initiating ventilation suggests

A

Tension pneumothorax

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41
Q

Indications for steroid treatment for sarcoid are

A

Parenchyma lung disease
Uveitis
Hypercalcaemia
Neurological or cardiac involvement

42
Q

Hyponatraemia is seen in what type of lung cancer

A

Small cell

43
Q

What does SCC of the lung cause

A

Hypercalcaemia (increases PtH) or hyperthyroid (increased Tsh)

44
Q

What is the criteria for a post bronchodilator response indicative of asthma

A

FEV1 of 12%

45
Q

How can mitral stenosis cause haemoptysis

A

Rupture of the bronchial veins caused by raised left atrial pressure

46
Q

Gynaecomastia is associated with what type of lung cancer

A

Adenocarcinoma

47
Q

How can you further investigate asthma if spirometry is negative?

A

Fractional exhaled nitric oxide testing

48
Q

A combination of bronchiectasis and dextrocardia is highly suggestive of what syndrome

A

Kartageners syndrome

49
Q

Histology and anatomy of a mesothelioma a

A

Pleural based mass with fibrosis and plaque formation

Mixed sarcomatous and carcinomatous features

50
Q

Needle into pleural cavity is inserted above or below the rib

A

Above as the NVB runs below

51
Q

Tinnitus and overdose

A

?salicylate poisoning

52
Q

Treat psittacosis with

A

Tetracyclines like doxycycline

53
Q

High calcium and lung cancer

A

Squamous cc or bony mets

54
Q

Anti TNF on rheumatoid can do what

A

Reactivate TB

55
Q

Air crescent sign on CT

A

Aspergillosis

56
Q

What is the sweat test for CF

A

Give the muscarinic pilocarpine and then measure the chloride content of sweat

57
Q

Diagnosis of TB is by

A

Sputum microscopy and culture

58
Q

What is contraindicated in massive haemoptysis

A

Non invasive ventilation as may aspirate and positive pressure may prevent clot formation

59
Q

Dry non productive cough T1RF hyponatraemia and mild renal impairemwnt

A

A typical pneumonia like legionella or mycoplasma

60
Q

Bat wing appearance on chest radiograph

A

Pulmonary oedema

61
Q

What is another name for farmers lung

A

Hypersensitivity pneumonitis

62
Q

What are the signs of a pleural effusion

A

Reduced chest explanation on the size of the effusion
Trachea can be deviated
Stony dull to percuss
Reduced vocal resonance

63
Q

Most common cause of pleural effusion in a homeless person apart from trauma

A

Aspiration pneumonia

64
Q

Salbutamol is a beta 1/2 agonist

A

2

65
Q

What are the 5 causes of hypoxaemia

A 
Hypoventillation 
Vq mismatch 
Right to left shunt 
Low inspired o2 
Diffusion abn
66
Q

What is a classic feature of pneumocystis jirovecci

A

Desaturation on exercise

67
Q

What is the main cause of malabsorption in Cf and how do you treat it

A

Pancreatic insufficiency

Replacement pancreatic enzymes

68
Q

Treatment of stable and unstable PE

A

Stable - LMWH

Unstable - thrombolysis

69
Q

Score 0 on MRC dyspnoea scale

A

No breathlessness except with strenuous exercise

70
Q

Score 1 on MRC dyspnoea scale

A

Breathlessness when hurrying on the level or walking up a slight hill

71
Q

Score 2 on MRC dyspnoea scale

A

Walk slower than others or has to stop for own breath when walking at own pace

72
Q

Score 3 on MRC dyspnoea scale

A

Stops for breath after walking for 100m or a few mins on level ground

73
Q

Score 4 on MRC dyspnoea scale

A

Too breathless to leave the house (breathless on dressing and undressing)

74
Q

Which respiratory pathogen associated with Cf is a contraindication to lung transplant

A

Burkholderia cenocepacia

75
Q

Bibasal reticular nodular shadowing on X-ray

A

IPF

76
Q

What type of X-ray is used to detect abn that are obscured by the heart or sternum

A

Lateral

77
Q

Which X-ray view is used to detect small pleural effusion a

A

Lateral decubitus view

78
Q

What type of X-ray is used to study diaphragmatic movement

A

PA view with fluoroscopy

79
Q

Patient with normal obs put peak flow of 30% predicted in surgery what do you don

A

Oral prednisalone salbutamol Neva high flow o2 call ambulance for immediate transfer to hospital

80
Q

If curb score 0-1

A

Home

81
Q

If curb score 2

A

Hospital

82
Q

If curb score >3

A

Consider ITU

83
Q

What actually is alpha 1 antitrypsin in the body

A

A glycoproteins

84
Q

Working in a ceramic factory is a risk factor for the development of

A

Silicosis

85
Q

What is used as a marker of disease severity in CoPD

A

FEV1

86
Q

How would you treat a non infective exac of CoPD I

A

Pred

87
Q

What does the FEV1 need to be for the pt to qualify for a transplant

A

<25%!

88
Q

What disorders are associated with IPF

A

RA SLE SS IBD PBC

89
Q

High calcium cancer

A

Squamous

90
Q

Low na in blood high na in urine cancer

A

SIADH in small cell cancer

91
Q

In any size of pneumothorax and the patient is shoet of breath what do you do

A

Aspirate

92
Q

RA on immunosuppressive therapy and a cough productive of green sputum and repeated chest infections

A

Bronchiectasis

93
Q

What are the three Cs of pulmonary fibrosis

A

Clubbing cyanosis cough

94
Q

SOB in a young person with oedema palpitations syncope exertional angina and a murmur

A

Familia primary pulmonary hypertension

95
Q

Gold standard for TB diagnosis a

A

3 separate sputum cultures for culture and microscopy

96
Q

Describe the blood supply to the lungs

A

Pulmonary artery and bronchial arteries as dial blood supply so if pulmonary artery blocked then they have an option

97
Q

What is the eye condition associated with sarcoidosis

A

Keratoconjunctivitis sicca

98
Q

How would you investigate for sarcoidosis

A 
CXr 
Trans bronchial biopsy and broncheolar lovage 
PFT 
Serum ACE
Kveim test 
Tuberculin test
99
Q

Unilateral pleural effusions are usually caused by

A

Local pathology such as trauma tumour or infection

100
Q

Cancer at upper border of lung

A

Adenocarcinoma

101
Q

Cancer in centre of lung

A

SCC associated with smoking

Year 4 Gen Med (26 decks)

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