resper Flashcards
1
Q
- where is trachea palpated
A
suprasternal/jugular notch
2
Q
- where does larynx become trachea and pharynx become oesophagus
A
c6
3
Q
- where does trachea bifurcate (vertebral levels)
A
T5-T7/carina
4
Q
- nerve that supplies the diaphragm
A
C3,4,5 keep the diaphragm alive (phrenic nerve)
5
Q
ptosis, miosis, anhydrosis
A
- Horners syndrome
6
Q
- Non-smoker lung cancer
A
adenocarcinoma
7
Q
- Antigen in squamous cell carcinoma of lung
A
p63
8
Q
narrowest part of larynx where foreign bodies tend to block
A
- Rima glottidis
9
Q
- obstructive lung disease – raised eosinophils
A
asthma
10
Q
- obstructive lung disease – raised neutrophils
A
COPD
11
Q
- Asian man with night sweats, fever and weight loss
A
TB
12
Q
- Alveolar bat’s wings, Kerley B lines, cardiomegaly, dilated prominent upper lobe vessels Pleural effusion
A
→ Pulmonary oedema
13
Q
- Ziehl-Neelsen stain positive for acid fast bacilli
A
TB
14
Q
- “D sign on X ray”
A
empyema
15
Q
4 C’s of fibrosis
A
clubbing, cough, cyanosis, crackles
16
Q
- Increased ACE and Ca
A
sarcoidosis
17
Q
- where is the Respiratory rhythm is established
A
medulla
18
Q
volume of gas is proportional to partial pressure of gas in equilibrium with liquid
A
henrys law
19
Q
pseudostratified ciliated columnar epithelium with goblet cells
A
- Respiratory epithelium
20
Q
common cold due to rhinovirus
A
coryza
21
Q
(birds) – headache, mucoid sputum
A
- chlamydiophilia psittaci
22
Q
(sheep/farm) - fever
A
- coxiella burnetti
23
Q
(water foreign holiday) – GI upset – ‘urine antigen testing’
A
- Legionella
24
Q
dry cough/young people
A
- Mycoplasma
25
red current jelly sputum + COPD/alcoholics/elderly
- Klebsiella pneumonia
26
HIV, AIDS, immunosuppressed
- Pneumocystis carinii pneumonia
27
rusty sputum
- Streptococcus pneumonia
28
- Common cause in CF patients
staph aureus/pseudomonas aeruginosa
29
COPD/alcoholics/elderly
- Haemophilus influenzae
30
whooping cough/bronchopneumonia
- Bordetella pertussis
31
CF – UTI, GI, burns, scars – gram neg bacillus
- Pseudomonas aeruginosa
32
- Large PE
thrombolysis
33
small pe
LMWH
34
Young non-smoker and potentially liver damage
- Alpha 1-antitypsin deficiency
35
- Rheumatoid arthritis and pneumoconiosis
caplans syndrome
36
- Pink puffer, pursed lips, prolonged expiration
emphysema
37
pressure exerted by gas varies inversely with the volume of gas – as volume increases, pressure decreases
- Boyles law
38
o Type I sensitivity – IgE mediated (Fc receptors)
mast cell degradation
39
give causes of Respiratory alkalosis
```
anxiety leading to hyperventilation
pulmonary embolism
salicylate poisoning*
CNS disorders: stroke, subarachnoid haemorrhage, encephalitis
altitude
pregnancy
```
40
give causes of respiratory acidosis
COPD
decompensation in other respiratory conditions e.g. life-threatening asthma / pulmonary oedema
neuromuscular disease
obesity hypoventilation syndrome
sedative drugs: benzodiazepines, opiate overdose
41
is caused by the increased permeability of alveolar capillaries leading to fluid accumulation in the alveoli, i.e. non-cardiogenic pulmonary oedema.
Acute respiratory distress syndrome (ARDS)
42
what does CURB65 stand for
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
give the mechanism and examples of type 1 hypersensitivity reactions (anaphylactic)
Antigen reacts with IgE bound to mast cells
* Anaphylaxis
* Atopy (e.g. asthma, eczema and hayfever)
44
give the mechanism and examples of type 2 hypersensitivity reactions (cell bound)
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
give the mechanism and examples of type 3 hypersensitivity reactions (immune complex)
Free antigen and antibody (IgG, IgA) combine
* Serum sickness
* Systemic lupus erythematosus
* Post-streptococcal glomerulonephritis
* Extrinsic allergic alveolitis (especially acute phase)
46
give the mechanism and examples of type 4 hypersensitivity reactions (delayed hypersensitivity)
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
non-caseating granulomas, erythema nodosum, bilateral hilar lymphadenopathy, swinging fever, polyarthralgia
sarcoidosis
48
PO2<8kPa + normal or low CO2
examples= pneumonia, P.E, pulmonary oedema, ARDS
type I respiratory failure
49
PO2<8kPa + PCO2>6.5kPa
COPD
type II respiratory failure
50
initial management for croup
a single dose of oral DEXAMETHASONE (0.15mg/kg) to all children regardless of severity
51
stridor
barking cough (worse at night)
fever
coryzal symptoms
croup
52
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
Bronchiolitis
53
Secrete mucins to immobilise pathogens and foreign bodies in the respiratory tract
goblet cell
54
Secrete glycosaminoglycans which protect the epithelial lining of bronchioles
club cell
55
typically central
associated with parathyroid hormone-related protein (PTHrP) secretion → hypercalcaemia
strongly associated with finger clubbing
hypertrophic pulmonary osteoarthropathy (HPOA)
Squamous cell cancer
56
typically peripheral
most common type of lung cancer in non-smokers, although the majority of patients who develop lung adenocarcinoma are smokers
adenocarcinoma
57
typically peripheral
anaplastic, poorly differentiated tumours with a poor prognosis
may secrete β-hCG
Large cell lung carcinoma
58
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
small cell
59
what curb score requires admission?
1> usually 2 or higher
