Respiratory Flashcards

1
Q

Stony dull to percuss

A

Pleural effusion

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2
Q

Right side pleuritic chest pain

A

Most likely pneumonia

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3
Q

Alveolar bat’s wings, Kerley Blines, Cardiomegaly, Dilated prominent upper lobe vessels, pleural Effusion

A

Pulmonary Oedema

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4
Q

Ground glass-like appearance on CXR

A

Pulmonary Fibrosis or respiratory distress syndrome of the newborn

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5
Q

Ziehl-neelsen stain positive for acid fast bacilli

A

TB

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6
Q

Caseous necrosis

A

TB

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7
Q

What is Apical disease most likely caused by?

A

Most likely (secondary) TB

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8
Q

What is an apical lesion called?

A

Assmann focus

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9
Q

Miliary TB?

A

Widespread dissemination of infection through blood stream

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10
Q

In miliary TB, where does dissemination occur if organism spread through:

  • Pulmonary artery
  • Pulmonary vein
A
  • lungs

- liver, spleen and kidneys

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11
Q

Positive anti-glomerular basement membrane antibodies

A

Goodpasture’s syndrome

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12
Q

What bacteria causes a chest infection with a parrot/pigeon as a pet?

A

chlamydophila psittaci

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13
Q

What bacteria causes a Dry cough and diarrhoea after a holiday abroad, some indication of water spread?
What would you test for antigens?

A

Legionella Pneumophila

Urine

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14
Q

“Tall thin young man who indulges in marijuana”

A

Probably pneumothorax (Marfan’s)

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15
Q

Bronchiole wider than neighbouring arteriole on CT?

What is this called?

A

Bronchiectasis

Signet ring sign

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16
Q

Bilateral hilar lymphadenopathy, erythema nodosum, granulomas, fatigue, uveitis, weight loss

A

Sarcoidosis

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17
Q

D sign on x-ray

A

Empyema

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18
Q

Steeple sign on Chest x-ray

A

Laryngotracheobronchitis/ croup

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19
Q

Child with barking cough

A

Croup

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20
Q

What patients do Pneumocystis pneumonia frequently occur in?

Treatment?

A

HIV

Co-tramoxazole (+ prednisolone if severe)

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21
Q

Which triad is asthma + nasal polyps + salicylate sensitivity

A

Samter’s triad

22
Q

What bacteria tends to cause pneumonia in alcoholics (danger of aspirating vomit)?

A

Klebsiella Pneumoniae

23
Q

Red jelly sputum?

A

Klebsiella Pneummoniae

24
Q

Mucoid Sputum?

A

Chlamydia psitaci

25
Q

Rusty sputum?

A

Pneumococcal Pneumonia

26
Q

Cannonball metastases (also weight loss and haematuria) - where from?

A

Primary renal cell carcinoma

27
Q

Morning headaches?

A

Hypercapnia or side effect of organic nitrates

28
Q

ACTH secreting lung tumour

A

Small cell carcinoma of the lung

29
Q

PTH secreting lung tumour

A

Squamous cell carcinoma of the lung

30
Q

What type of tumour is neuroendocrine, highly malignant and may be associated with ectopic endocrine conditions?

A

Small cell carcinoma

31
Q

Increased serum ACE and Ca2+

A

Sarcoidosis

32
Q

Eggshell calcification at hilar region

A

Silicosis

33
Q

What are “heart failure cells” found in alveolar spaces?

Found in?

A

Macrophages that have absorbed haemosiderin
Chronic pulmonary oedema and associated (severe) left ventricular heart failure
Also seen in long standing pulmonary hypertension

34
Q

What is Ghon focus?
Found in what type of infection?
What happens if the Ghon focus ruptures through the visceral pleura into the pleural cavity?

A

Area of infection and caseous necrosis at the periphery of the lung, beneath the pleura
TB
Tuberculosis Pleurisy is produced

35
Q

What is a “coin lesion” on a chest x-ray?

Common causes of this (6)

A
A rounded solitary lesion
Primary bronchial carcinoma
Metastatic tumour (especially of kidney)
Bronchial Hamartoma
Carcinoid tumour
Granulomatous inflamation
Lung abscess
36
Q

What is Horner’s syndrome?
Caused by?
Symptoms? (4)

A

Group of symptoms caused by damage to the cervical sympathetic chain.
Local spread of cancer to the intrathoracic nodes or a Pancoast’s tumour
Ptosis (drooping of the eyelid), enophthalmos (sunken eye), miosis (small pupil), and lack of sweating on the ipsilateral (same side as invasion) side of the face

37
Q

Acute management of asthma

A
Oxygen 100% through a non-rebreather mask
Salbutamol nebulised back to back
Hydrocortisone IV or Prednisolone PO
Ipraptropium Bromide nebulised hourly
Thiophylline IV or Aminophylline IV
Magnesium and call an
Anaesthetist 
OSHIT MAN
38
Q

Thumbprint sign on head x-ray

A

Epiglottitis

39
Q

Inspiratory whoop/ barking cough

A

Pertussis

40
Q

Snow storm appearance on x-ray

A

Baritosis/ silicosis

41
Q

Management of infective exacerbation of COPD

A
ipratropium
Salbutamol
Oxygen
Amoxicillin
Prednisolone
42
Q

Non-smoker and lung cancer

A

(peripheral) adenocarcinoma

43
Q

Location of squamous and small cell lung cancer

A

Central

44
Q

High d-dimers, suspect what?

A

Pulmonary embolism (send for CTPA or V/Q scan)

45
Q

What can you exclude if low d-dimer?

A

Pulmonary Embolism

46
Q

Treatment for large PE?

Small PE?

A

Thrombolysis

Low molecular weight heparin

47
Q

TB drugs?

A

2months Rifampicin, Isoniazid, Pyrazinamide, Ethambutol, 4months Rifampicin, Isoniazid
(2 RIPE, 4 RI)

48
Q

PE risk factors

A
Hereditary eg factor V Leiden
History - previous DVT or PE
Hypomobility eg fracture or long trip
Hypovolaemia eg dehydration
Hypercoagulability eg smoking
Hormones eg oestrogen
Hyperhomocysteinemia 
Hyperviscosity states eg malignancy, post-surgery
(8 H's)
49
Q

1 side effect for each TB drug

A
Rifampicin = orange coloured tears/ urine
Isoniazid = peripheral neuropathy/ hepatitis
Ethambutol = colour blindness
Pyrazinamide = gout
Streptomycin = hearing problems
50
Q

Features of sarcoidosis?

A
G-Granulomas 
E-Erythema nodosum 
R-Restrictive lung defect (PFTs) 
M-Multiple systemic manifestations 
A-Asteroid bodies (inclusions) 
N-Noncaseating granuloma, Negative TB test 
(GERMAN)