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First year > resper > Flashcards

resper Flashcards

1
Q
  • where is trachea palpated
A

suprasternal/jugular notch

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2
Q
  • where does larynx become trachea and pharynx become oesophagus
A

c6

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3
Q
  • where does trachea bifurcate (vertebral levels)
A

T5-T7/carina

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4
Q
  • nerve that supplies the diaphragm
A

C3,4,5 keep the diaphragm alive (phrenic nerve)

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5
Q

ptosis, miosis, anhydrosis

A
  • Horners syndrome
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6
Q
  • Non-smoker lung cancer
A

adenocarcinoma

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7
Q
  • Antigen in squamous cell carcinoma of lung
A

p63

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8
Q

narrowest part of larynx where foreign bodies tend to block

A
  • Rima glottidis
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9
Q
  • obstructive lung disease – raised eosinophils
A

asthma

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10
Q
  • obstructive lung disease – raised neutrophils
A

COPD

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11
Q
  • Asian man with night sweats, fever and weight loss
A

TB

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12
Q
  • Alveolar bat’s wings, Kerley B lines, cardiomegaly, dilated prominent upper lobe vessels Pleural effusion
A

→ Pulmonary oedema

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13
Q
  • Ziehl-Neelsen stain positive for acid fast bacilli
A

TB

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14
Q
  • “D sign on X ray”
A

empyema

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15
Q

4 C’s of fibrosis

A

clubbing, cough, cyanosis, crackles

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16
Q
  • Increased ACE and Ca
A

sarcoidosis

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17
Q
  • where is the Respiratory rhythm is established
A

medulla

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18
Q

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

A

henrys law

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19
Q

pseudostratified ciliated columnar epithelium with goblet cells

A
  • Respiratory epithelium
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20
Q

common cold due to rhinovirus

A

coryza

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21
Q

(birds) – headache, mucoid sputum

A
  • chlamydiophilia psittaci
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22
Q

(sheep/farm) - fever

A
  • coxiella burnetti
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23
Q

(water foreign holiday) – GI upset – ‘urine antigen testing’

A
  • Legionella
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24
Q

dry cough/young people

A
  • Mycoplasma
25
Q

red current jelly sputum + COPD/alcoholics/elderly

A
  • Klebsiella pneumonia
26
Q

HIV, AIDS, immunosuppressed

A
  • Pneumocystis carinii pneumonia
27
Q

rusty sputum

A
  • Streptococcus pneumonia
28
Q
  • Common cause in CF patients
A

staph aureus/pseudomonas aeruginosa

29
Q

COPD/alcoholics/elderly

A
  • Haemophilus influenzae
30
Q

whooping cough/bronchopneumonia

A
  • Bordetella pertussis
31
Q

CF – UTI, GI, burns, scars – gram neg bacillus

A
  • Pseudomonas aeruginosa
32
Q
  • Large PE
A

thrombolysis

33
Q

small pe

34
Q

Young non-smoker and potentially liver damage

A
  • Alpha 1-antitypsin deficiency
35
Q
  • Rheumatoid arthritis and pneumoconiosis
A

caplans syndrome

36
Q
  • Pink puffer, pursed lips, prolonged expiration
37
Q

pressure exerted by gas varies inversely with the volume of gas – as volume increases, pressure decreases

A
  • Boyles law
38
Q

o Type I sensitivity – IgE mediated (Fc receptors)

A

mast cell degradation

39
Q

give causes of Respiratory alkalosis

A 
anxiety leading to hyperventilation
pulmonary embolism
salicylate poisoning*
CNS disorders: stroke, subarachnoid haemorrhage, encephalitis
altitude
pregnancy
40
Q

give causes of respiratory acidosis

A

COPD
decompensation in other respiratory conditions e.g. life-threatening asthma / pulmonary oedema
neuromuscular disease
obesity hypoventilation syndrome
sedative drugs: benzodiazepines, opiate overdose

41
Q

is caused by the increased permeability of alveolar capillaries leading to fluid accumulation in the alveoli, i.e. non-cardiogenic pulmonary oedema.

A

Acute respiratory distress syndrome (ARDS)

42
Q

what does CURB65 stand for

A

C Confusion (abbreviated mental test score <= 8/10)
U. Urea>7 mmol/l
R Respiration rate >= 30/min
B Blood pressure: systolic <= 90 mmHg and/or diastolic <= 60 mmHg
65 Aged >= 65 years

43
Q

give the mechanism and examples of type 1 hypersensitivity reactions (anaphylactic)

A

Antigen reacts with IgE bound to mast cells

  • Anaphylaxis
  • Atopy (e.g. asthma, eczema and hayfever)
44
Q

give the mechanism and examples of type 2 hypersensitivity reactions (cell bound)

A

IgG or IgM binds to antigen on cell surface

  • Autoimmune haemolytic anaemia
  • ITP
  • Goodpasture’s syndrome
  • Pernicious anaemia
  • Acute haemolytic transfusion reactions
  • Rheumatic fever
  • Pemphigus vulgaris / bullous pemphigoid
45
Q

give the mechanism and examples of type 3 hypersensitivity reactions (immune complex)

A

Free antigen and antibody (IgG, IgA) combine

  • Serum sickness
  • Systemic lupus erythematosus
  • Post-streptococcal glomerulonephritis
  • Extrinsic allergic alveolitis (especially acute phase)
46
Q

give the mechanism and examples of type 4 hypersensitivity reactions (delayed hypersensitivity)

A

T-cell mediated

  • Tuberculosis / tuberculin skin reaction
  • Graft versus host disease
  • Allergic contact dermatitis
  • Scabies
  • Extrinsic allergic alveolitis (especially chronic phase)
  • Multiple sclerosis
  • Guillain-Barre syndrome
47
Q

non-caseating granulomas, erythema nodosum, bilateral hilar lymphadenopathy, swinging fever, polyarthralgia

A

sarcoidosis

48
Q

PO2<8kPa + normal or low CO2

examples= pneumonia, P.E, pulmonary oedema, ARDS

A

type I respiratory failure

49
Q

PO2<8kPa + PCO2>6.5kPa

COPD

A

type II respiratory failure

50
Q

initial management for croup

A

a single dose of oral DEXAMETHASONE (0.15mg/kg) to all children regardless of severity

51
Q

stridor
barking cough (worse at night)
fever
coryzal symptoms

52
Q

Respiratory syncytial virus (RSV) is the pathogen in 75-80% of cases

most common cause of a serious lower respiratory tract infection in < 1yr olds (90% are 1-9 months, with a peak incidence of 3-6 months). Maternal IgG provides protection to newborns against RSV

Features
coryzal symptoms (including mild fever) precede:
dry cough
increasing breathlessness
wheezing, fine inspiratory crackles (not always present)
feeding difficulties associated with increasing dyspnoea are often the reason for hospital admission

A

Bronchiolitis

53
Q

Secrete mucins to immobilise pathogens and foreign bodies in the respiratory tract

A

goblet cell

54
Q

Secrete glycosaminoglycans which protect the epithelial lining of bronchioles

55
Q

typically central
associated with parathyroid hormone-related protein (PTHrP) secretion → hypercalcaemia
strongly associated with finger clubbing
hypertrophic pulmonary osteoarthropathy (HPOA)

A

Squamous cell cancer

56
Q

typically peripheral
most common type of lung cancer in non-smokers, although the majority of patients who develop lung adenocarcinoma are smokers

A

adenocarcinoma

57
Q

typically peripheral
anaplastic, poorly differentiated tumours with a poor prognosis
may secrete β-hCG

A

Large cell lung carcinoma

58
Q

usually central
arise from APUD* cells
associated with ectopic ADH, ACTH secretion
ADH → hyponatraemia
ACTH → Cushing’s syndrome
ACTH secretion can cause bilateral adrenal hyperplasia, the high levels of cortisol can lead to hypokalaemic alkalosis
Lambert-Eaton syndrome: antibodies to voltage gated calcium channels causing myasthenic like syndrome

A

small cell

59
Q

what curb score requires admission?

A

1> usually 2 or higher

First year (10 decks)

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