respiratory 1 Flashcards
What Lung volume decreased in pregnancy and obesity?
FRC
What lung volume reduces in pregnancy but increases in obesity?
RV
Can pleural fluid analysis rule out malignancy?
No, only 60% sensitive
High specificity though
Role of TPA and DNase in intrapleural infection?
TPA lyse pleural fibrins and septations
DNase reduce viscosity of pus
- improve fluid drainage and reduce hospitalization stay
Median survival years of cystic fibrosis?
41 years
Reason women have cystic fibrosis exacerbations during follicular phase of menstruation?
Increased estrogen = increased viscosity
Ivacaftor can be given in what cystic fibrosis mutation?
G551D
Burkholderia cepacia in cystic fibrosis mortality rate?
High 60% in 1 year - not lung transplant, very poor prognosis
Recurrent chest infections, cough + infertile - what disorder likely?
-Normal immunoglobulins/ normal sweat chloride test
Primary ciliary dyskinesia
Melioidosis - what presentation and clinical important things?
Similar presentation like TB - CXR - mimics milliary TB infiltrate picture
A/w Diabetes
Melioidosis cause and treatment?
Burkholderia pseudomallei
Meropenem/Ceftazidime - then oral Bactrim + Doxycyline
Burkholderia cepacia cause what type of pneumonia?
Necrotising cavitating pneumonia
What type of pulmonary fibrosis associated with neutrophils pattern on BAL?
Idiopathic pulmonary fibrosis
Most common cause of clubbing?
Respiratory disorders
Bleomycin cleared by what organ?
Kidney
-if kidney dysfunction - pulmonary toxicity
How Bleomycin works?
glycopeptide abx = Combine with O2/ Ferric FE + inducing dsDNA breakage
Interstitial lung disease pattern due to connective tissue disease?
UIP - basal predominance + honeycombing
Lung nodules associated with what type of pulmonary fibrosis?
Hypersensitivity pneumonitis
Most important predictor of mortality in IPF?
Reduction in FVC - 10% drop in 6 months
Most common side effect of Pirfenidone?
Nausea
- reduces FVC
- skin rash
Pirfenidone used for Pulmonary fibrosis. What it doesn’t improve?
Dyspnea score
Hypercalciuria or Hypercalcemia - which is more common in sarcoid?
Hypercalciuria
Mantoux test cut-off point as positive for immunosuppressed/ old TB/ recent exposure with TB?
> 5 mm
Mantoux test cut-off test for NH resident/ healthcare workers/ born in TB endemic areas?
> 10 mm
What Biologic agents associated with TB reactivation and diagnosis?
Adalimumab and Certolizumab
What age group highest to succumb to TB after exposure?
Infants
Bedaquiline in MDR TB - increases sputum conversion rate but at what cost?
Increase mortality
what enzyme in liver clears Isoniazid?
N-acetyltransferase - slow acetylators have higher rates of hepatotoxicity
Which leg is most affected in pregnancy for DVT and why?
Left leg - compression of left iliac vein by right iliac artery
Highest risk factor of VTE in pregnancy?
Previous VTE in pregnancy
