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urology > respi > Flashcards

respi Flashcards

1
Q

A 37-year-old woman presents to A&E with shortness of breath, a dry cough and a fever. She has recently been on a business trip to Romania and stayed in a local hotel.

What is the best investigation to obtain a definitive diagnosis in this patient?

A

urinary antigen for legionaire disease

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2
Q

what is the most common cause of pneumonia in HIV patient

A

strep pneumoniae

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3
Q

what are the ecg changes you will see in a patient with COPD?

A

prominent p wave in the anterior chest lead. absent r wave in the right sided leave nad right axis deviation

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4
Q

what is teh procedure that is shown to reduce mortality in the ARDS patient

A

low tidal volume mechanical ventiation…ARDS presents with acute onset respiratory failure which fails to improve with supplemental oxygen, the symptoms of which include severe dyspnoea, tachypnoea, confusion, and presyncope.

Physical examination typically reveals fine bibasal crackles, but no other features of heart failure.

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5
Q

klebsiella is which type of bacteria

A

gram negetive anaerobic rod

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6
Q

in a patient with asthma who is on saba and ics what would e the addition after that according to te BTS guideline

A

bts suggests adding laba but nice recomends addint LTRAntagonist

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7
Q

legs and arms weakness that gets better on working and bilateral ptosis in a patient with weight loss nd haemotysis is most likely di=ue to

A

lambert eatons and the antibody will be voltage gated sodium channel antibdy

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8
Q

target lesions with pneumonia history

A

mycoplasma pneumonia… preceeding flu like symptoms

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9
Q

what are the causes of exudative pleural effusion

A

ra, tb,pneumonia and malignancy like mesothelioma…meigs is associated with transudative type of effusion

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10
Q

how can you ensure that the chest drain is patent

A

if there is swinging of fluid during respiration

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11
Q

ace is raised in

A

sarcoidosis

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12
Q

adult onset asthma, nasal congestion ,parathesia in leg and glomerulonephritis. what is the most likely antibody present

A

p-anca/ mpo anca….for chrugg strauss disorder.

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13
Q

having a brain fog and nocturia reduced libido and fatigues in a overweight patient

A

obstructive sleep apnoea

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14
Q

which drug is linked with pulmonary fibrosis?

A

methotrexate

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15
Q

ct with signet ring sign is the pathognomic for

A

bronchiectasis

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16
Q

what is the ecg finding you will find in a copd patient and physical exam finding?

A

right ventricular hyoertrophy and right ventricularhaeve….you will also see p pulmonale meaning really high p wave

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17
Q

in a case of tension pneumothorax what Is the management

A

its a medical emergency and you do not require a chest x-ray and decompression if the chest with 14-16 gauge needle is the most imp

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18
Q

what is the antibiotic used for aspirational pneumonia and has a potential side effect of increasing the inr

A

metronidazole

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19
Q

in an emergency situation where you see hypercalcemia what is the management

A

iv saline fluid …. look out for lung cancer- small cell,…. patient with weight loss and cough.

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20
Q

what is the cause of pulmonary effusion?

A

due to hight pressure in the cappilary fluid leaks out from the capillary into the pleural cavity.

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21
Q

what is the limit if rr in CURB 65

A

30

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22
Q

A 75-year-old man presents with increasing shortness of breath, right-sided pleuritic chest pain and haemoptysis over the course of 2 months. Before retiring, he spent 40 years working as a miner. A chest X-ray shows a large right-sided pleural effusion. what is the material he is most exposed to causing him symptoms?

A

asbestose - there is a lag between the exposure and the presentation and it is a highly malignant type of tumour(mesothelioma),

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23
Q

what is the most common cause of ARDS

A

SEPSIS OF PULMONARY ORIGIN….ards is life threatening non cardiogenic pulmonary oedema and it will present with new fine bibasal creps and opacification on the chest xray

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24
Q

The cough has progressively worsened, and now he is producing large amounts of green sputum with red streaks. He has had frequent episodes in the past which have required hospital admission. On examination he has finger clubbing, nasal polyps and coarse inspiratory crackles.

A

cystic fibrosis. sweat sodium and chloride will be more than 60

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25
Q

aesbestose causes the pulmonary fibrosis in which zone

A

lower zone

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26
Q

in a patient with copd background who has come in with exacerbation of copd and after the oxygen therapy is found to have high co2 concentration what is the managemnt

A

you do NIV

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27
Q

in malignancy and empyma what is the ph of the pleural fluid

A

its low-<7.2.

28
Q

gram negetive cocco bacilli is

A

haemophillus influenza the mostcommon cause of infective exacerbation of copd

29
Q

what is the 3 findings on xray that confirm copd?

A

hemi diaphragm flattening, thining of the heart and increased number of anterior ribs on the chest x ray…. because there is trapping of air

30
Q

increased vocal resonance is there

A

when there is consolidation

31
Q

psmoma bodies are found in

A

mesothelioma

32
Q

curschmann spiral are seen in

A

asthma- shep epithelium is whorled by mucous plug

33
Q

x ray finding of lower lobe consolidation with air fluid levels and central cavitation is due to

A

lung abscess

34
Q

ground glass opacification especially in the lower zones

A

pneumocystis jerovici

35
Q

coryza like symptoms before pneumonia nad erythema multiforme . what is the test done for confirmation

A

pcr for mycoplasma pneumonia

36
Q

what are the four condition for long term oxygen therapy?

A

if the pao2 is less than 7.3 or its 7.3 to 8 and there is polycythemia or peripheral edema or pulmonary htn or nocturnal hypoxemia

37
Q

the paraneoplastic syndrome of hyperparathyroidsm is associated with which lung cancer

A

squamous cell lung cancer

38
Q

SIADH is associated with whoch type of cancer?

A

small cell… urine osmolality will be very high and serum sodium low and

39
Q

what is the lights criteria

A

pleural fluid to serum protein ratio is more than 0.5 and pleural fluid to serum ldh ratio is more than 0.6 then consider the fluid as exudative

40
Q

what happens to DLCO in emphysema?

A

it reduces as there is less surface area to difuse and total lung capacity increases.

41
Q

which antibiotic used in UTI is known to cause pulmonary fibrosis

A

nitrofurantoin

42
Q

fascial flushing with late onset asthma and diarrhoea in a patient with nodule found i the upper lobe what is the most likely first line investigation?

A

urinary 5 HIAA 24 hr

43
Q

most common and 2 nd most common cause of svco is

A

lung tumor and hodgkin lymphoma

44
Q

in an acute exacerbation of astma patient if the pa co2 is raised thent he attack is termed ad

A

near fatal

45
Q

what is te eart sound in cor pulmonale

A

there is splitting of te second heart sound with

46
Q

what is the heart defect seen in marfan syndrome patient

A

aortic root dissection, aortic regur

47
Q

in pneumothorax what would be the expected vq sacn

A

very low vq scan in pe there will be very hugh vq around the clot and low vq away from the clot

48
Q

the indurated purple rash on te face of a sarcoidosis patient is called

A

lupus pernio

49
Q

when are antibiotic presecibed in URTI?

A

when crp>100 or if the patient has asthma

50
Q

pneumocystis jerovici is best stained in

A

silver stain

51
Q

in pulmonary fibrosis what happens to TLCO

A

reduced

52
Q

whqt is the o2 sats limit for life threatening asthma

A

less than 90

53
Q

what are the 4 conditions a patient needs to meet for lung volume reductio surgery in COPD?

A

If he is still breathless after a maximum of medical therpay..and his ct shows predominant upper lobe emphysema, FEV1 of more than 20% predicted and pco1 below 7.3 and TICO of mre than 20% predicted

54
Q

what is the eye manifestation of sarcoidosis?

A

Anterior uveitis

55
Q

what is the time frame NICE recommends to get a chets x ray in suspected lung cancer

A

2 weeks

56
Q

which medication is recommended by NICE for pulmonary fibrosis

A

perfenidone

57
Q

what is the length of anticoagulation therapy in apatient who has thrombophilia and what i sthe target inr

A

lifelong and target is 3-4

58
Q

what is the antibiotic recommended for hospital acquired pneumonia

A

iv cipro because the cause is pseudomonas aeroginosa

59
Q

which bacteria causig pneumonia is associated with herpes labiais

A

strep pne

60
Q

what is the definitive diagnosic of sarcoidosis

A

biopsy showing non casseating granuloma

61
Q

what is the characteristic of pleural effusion casued by sle ?

A

exudative raised ana but low complement

62
Q

adenosine diaminase is found in pleuritic fluid which type of disease

A

tb and in RA the pleuritic fluid will have low glucose

63
Q

which pneumonia is most likely associated with cold haemolytic anaemia

A

mycplasma neumonia with erythema multiforme(bull eye)

64
Q

what is the first line investigation of asthma

A

spirometery and if not conclusive then go for FINO (>40)

65
Q

curb 65 score of 3 equates to

A

17 % mortality

urology (10 decks)

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