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Clerkship Prep > Respiratory > Flashcards

Respiratory Flashcards

1
Q

DDx hemoptysis broad categories

A

Bronchial circulation/airway, pulmonary circulation/airway, overlapping disorders

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2
Q

What is a granuloma of the lung

A

A non specific type of inflammatory response, compact, organized collection of epithelioid histiocytes/macrophages

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3
Q

What stain is used to detect mycobacterium

A

Acid fact

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4
Q

What stain is used to detect fungi

A

Silver stain

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5
Q

Primary TB infection occurs

A

Within year of exposure

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6
Q

Ghon focus

A

The initial Tb infection in the lung, calcifies once healed

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7
Q

Post primary Tb favours which lung areas

A

Apical posterior upper lobes, superior segments of lower lobe (areas of higher oxygen tension)

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8
Q

Miliary nodules in CXR post primary TB indicate

A

Hematogenous spread of infection

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9
Q

Findings on CXR suggesting active TB disease

A

Airspace consolidation, miliary pattern, tree in bud nodularity, cavitation

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10
Q

Transmission of TB is

A

Via droplets

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11
Q

Intensive phase of TB treatment

A

Isoniazid, rifampin, ethambutol, pyrazinamide

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12
Q

Continuation phase of TB treatment

A

Isoniazid, rifampin

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13
Q

Treating a pneumothorax

A

Insert a chest tube between the 4th and 5th intercostal space just anterior to the midaxillary line

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14
Q

Intercostal neurovascular bungle

A

Sits under each rib (place chest tube just superior to a rib)

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15
Q

Flail chest is caused by

A

2 or more fractures in contiguous ribs creating a free floating segment of the chest wall

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16
Q

Characteristic findings of CF include

A

Recurrent sinopulmonary infections and digital clubbing due to chronic hypoxia

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17
Q

Clinically relevant dermatome at nipples

A

T4

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18
Q

Clinically relevant dermatome at umbilicus

A

T10

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19
Q

Barrel chest is a sign of

A

COPD

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20
Q

RREDS mnemonic for breathing

A

Rate, rhythm, effort, depth, symmetry

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21
Q

Signs of respiratory distress

A

Tachypnea, accessory muscle use, pursed lips, tripoding, costal indrawing

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22
Q

Blue fingers

A

Peripheral cyanosis, a sign of inadequate circulation

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23
Q

Blue lips

A

Central cyanosis, indicative of poor gas exchange

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24
Q

Swollen Epi trochlear lymph node may be a sign of

A

Malignancy, syphilis

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25
Q

Swollen axillary nodes may be a sign of

A

Chest wall infection, breast, intrathoracic

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26
Q

Inguinal node swelling may be a sign of

A

STDs, infection of pelvis, cancer

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27
Q

Normal chest expansion during breathing

A

4-5cm

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28
Q

Dullness to lung percussion could indicate

A

Pneumonia, empyema, tumour, pulmonary embolism

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29
Q

Diaphragm sits around which vert level

A

T8

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30
Q

Hyperresonnace to percussion of lungs could indicate

A

Emphysema, asthma, pneumothorax

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31
Q

DIPS mnemonic for auscultation

A

Duration of breath, intensity, pitch, symmetry

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32
Q

Contraindications to spirometry

A

MI in the last month

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33
Q

Lung volumes in obstructive lung disease

A

Normal or increased

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34
Q

Lung volumes in restrictive lung disease

A

Reduced

35
Q

Stridor is characteristic of

A

Airway obstruction

36
Q

What kind of crackles in CHF, pneumonia

A

Harsh crackles

37
Q

What kind of crackles in pulmonary fibrosis

A

Fine crackles

38
Q

Asthma wheeze is typically

A

Biphasic

39
Q

COPD wheeze is typically

A

Expiratory

40
Q

Measuring DLCO on spirometry can establish the presence of

A

Emphysema

41
Q

COPD is characterized by

A

Partially reversible airway obstruction and lung hyperinflation

42
Q

Necessary feature on PFT for COPD is

A

FEV1/FVC post bronchodilator <0.70

43
Q

What deficiency is a risk factor for COPD?

A

Alpha 1 antitrypsin deficiency

44
Q

Pulmonary hypertension is also known as

A

Cor pulmonale

45
Q

COPD percussion

A

Hype resonance

46
Q

COPD diaphragms on CXR

A

Flattened

47
Q

Decreased FEV1/FVC

A

Obstructive lung disease

48
Q

Which lung volumes are increased in COPD

A

Residual volume, total lung cap (hyperinflation), functional residual capacity

49
Q

Treatment for mild COPD

A

Short acting bronchodilator

50
Q

Treatment of symptomatic COPD

A

LAMA or LABA

51
Q

Treating a symptomatic COPD patient with high risk for exacerbation

A

LAMA
LAMA - LABA
LABA - ICS

52
Q

I - Resp OSCE

A

Cyanosis, RREDS, trachea, clubbing

53
Q

Percussion - RESP OSCE

A

4 places bilaterally, plus diaphramatic descent, tactile fremitus

54
Q

Palpation - OSCE RESP

A

Trachea, swallow, evenness

55
Q

Auscultate - OSCE RESP

A

Front, back, sides

56
Q

High pitched inspiratory wheeze

A

Stridor

57
Q

High pitched expiratory sound

A

Wheeze

58
Q

Fine crepitus on every breath

A

Pulmonary edema

59
Q

WELLS score is for

A

PE

60
Q

Bullae are

A

Large open spaces in the lung

61
Q

Emphysema

A

Loss of architecture between alveoli (smaller than bullae)

62
Q

Poor FEV1 is diagnostic of

A

Obstructive issue

63
Q

Scooping on PFT is indicative of

A

Obstructive issue

64
Q

Bronchodilator response of what is considered relevant?

A

> 10%

65
Q

Tension pneumothorax occurs due to

A

Excessive pressure around the lung due to a breach in the lung surface allowing air into the pleural cavity

66
Q

Spontaneous pneumothorax occurs due to

A

The rupture of bullae or blebs

67
Q

Findings of acute respiratory distress syndrome (ARDS)

A

Resp distress, hypoxemia, bilateral alveolar infiltrates not explained by volume overload

68
Q

Mild COPD pharmacotherapy

A

SABD prn

69
Q

Moderate COPD treatment

A

LAAC or LABA, SABA prn

70
Q

Severe COPD treatment

A

LAAC + ICS/LABA + SABA prn +/- theophylline

71
Q

in pleural effusion mediastinum shifts which way

A

Way from the effusion

72
Q

Atelectasis causes a mediastinal shift which way

A

Towards large atelectasis

73
Q

Mediastinal shift with pneumothorax is

A

Away from tension pneumothorax

74
Q

Dullness to lung percussion is seen in

A

Consolidation, pleural effusion, and atelectasis (mucus plugging)

75
Q

Three phases of pertussis

A

Catarrhal and paroxysmal and convalescent

76
Q

Initial pertussis phase in which symptoms are largely non specific

A

Catarrhal

77
Q

Second pertussis phase where patient has coughing, whooops, vomiting, hemoptysis

A

Paroxysmal

78
Q

Final phase of pertussis

A

Convalescent

79
Q

Cough and sputum on most days for at least 3 m of the year, for at least 2 years is called

A

Chronic bronchitis

80
Q

Three puffers commonly used in COPD

A

Beta agonist, anticholinergics, muscarinic

81
Q

Treating mycoplasma pneumoniae

A

Azithromycin

82
Q

Evaluating suspected ventilator associated pneumonia, after xray

A

Lower respiratory tract endotracheal tube sample, culture and microscopy, empiric antibiotics

83
Q

Patient presents with pleuritic chest pain, tachypnea, and tachycardia

A

Pulmonary embolism

Clerkship Prep (34 decks)

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