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MRCP 1 > Respiratory > Flashcards

Respiratory Flashcards

1
Q

NIV: Indications

A
  • COPD with respiratory acidosis
  • T2RF secondary to chest wall deformity, NM disease or OSA
  • Cardiogenic pulmonary oedema
  • Weaning for intubation
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2
Q

Saccharopolyspora rectivirgula

A

Farmer’s lung

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3
Q

Asperillus clavatus

A

Malt workers lung

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4
Q

EAA: imaging

A

Fibrosis in upper / mid-zone

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5
Q

EAA: Mx

A

PO steroids

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6
Q

Varenicline: MoA

A

Partial nicotinic receptor agonist

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7
Q

Varenciline: SE

A

Nausea
Headache
Insomnia
Abnormal dreams

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8
Q

Bupropion: MoA

A

Norephinephrine and dopamine reuptake inhibitor

Nicotinic antagonist

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9
Q

Bupropion: CI

A

Epilepsy, pregnancy and breast feeding

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10
Q

When to discharge patient with primary PTX

A

Rim of air <2cm and not SoB

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11
Q

Insertion of chest drain for secondary PTX

A

> 50 years and >2cm +/- SoB

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12
Q

Aspiration of secondary PTX

A

1-2 cm and admit for 24 hours

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13
Q

Bronchiectasis: Causes

A 
A SICK AIRWAY
Airway obstruction / lesion
Sequestration
Infection / inflammation
CF
Kartagener's 
ABPA
Immunodeficiencies
William Campbell 
Aspiration 
Yellow nail syndrome
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14
Q

CI to surgery in NSCLC

A 
Stage IIIb or IV
FEV1 <1.5L
Malignant pleural effusion
Near hilum
Vocal cord paralysis 
SVC obstruction
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15
Q

Small cell LC: Paraneoplastic Sx

A

ADH, ACTH, Lambert-Eaton

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16
Q

Squamous cell LC: Paraneoplastic Sx

A

Parathyroid related protein
Clubbing
Hypertrophic pulmonary osteoarthropathy
Hyperthyroid

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17
Q

Sarcoidosis: Indications for steroids

A

CXR stage 2 or 3
Hypercalcaemia
Eye. heart or neuro involvement

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18
Q

Sarcoidosis: poor prognosis

A

Insidious onset, symptoms >6 months
Absence of erythema nodosum
Extra-pulmonary manifestations
CXR: III-IV

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19
Q

COPD: no asthmatic features

A

LABA + LAMA

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20
Q

COPD: asthmatic features

A

LABA + ICS

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21
Q

Safety triangle

A

Base of axilla
Lateral edge pec major
Lateral edge lat dorsi
5th intercostal space

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22
Q

Lung fibrosis: upper lobes

A 
CHARTS
Coal worker's
Hypersensitivity pneumonitis / histiocytosis
AS
Radiation 
TB 
Silicosis / sarcoidosis
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23
Q

Lung fibrosis: lower zones

A

Idiopathic
SLE
Amiodarone, bleomycin, methotrexate
Asbestosis

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24
Q

Loffler’s Syndrome: features

A

CXR shadowing and eosinophilia
Fever, cough, and night sweats
Self limiting

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25
Oxygen dissociation: shift to left
``` LOWER Low H+ Low pCO2 Low 2,3-DPG Low temperature ```
26
Respiratory alkalosis: causes
``` Anxiety PE Salicylate poisoning CNS disorders Altitude Pregnancy ```
27
Asthma Mx
1. SABA 2. SABA + ICS 3. SABA + ICS + LTRA 4. SABA + ICS + LABA +/- LTRA 5. SABA + ICS + MART
28
Tidal Volume
Inspired at at rest | 500ml in males, 350ml in females
29
Inspiratory reserve volume
Maximum volume of air that can be inspired | 2-3L
30
Inspiratory capacity
TV + IRV
31
Expiratory reserve volume
Maximum volume of air that can be expired | 750ml
32
Residual volume
Volume of air remaining after maximal expiration Increases with age FRC - ERV ~1.2L
33
Functional residual capacity
Volume in lungs at end of expiration | FRC = ERC + RV
34
Vital Capacity
Maximum volume of air that can be expired after maximal inspiration Decreases with age VC = IC + ERC 4.5L in males, 3.5L in females
35
TLC
VC + Residual volume
36
Raised TLCO
``` Asthma Pulmonary haemorrhage Left to right shunt Polycyaethemia Hyperkinesis Male ```
37
Lower TLCO
``` Fibrosis Pneumonia PE Oedema Emphysema Anaemia Low CO ```
38
Candidates for LTOT in COPD
``` FEV1 <30% Cyanosis Polycythaemia Peiripheral oedema Raised JVP <92% pO2 <7.3 ```
39
IPF: features
Progressive exertional dyspnoea Bibasal fine end-expiratory crackles Dry cough Clubbing
40
IPF: diagnosis
Restrictive spirometry Reduced TLCO Bilateral interstitial shadowing
41
Atelectasis: features
Dyspnoea and hypoxia 72 hours post op
42
Lung Ca: RF
``` Smoking (x10) Asbestos (x5) Arsenic Radon Nickel Chromate Aromatic hydrocarbon Cryptogenic fibrosing alveolitis ```
43
Churg-Strauss Syndrome: what?
ANCA positive small vessel vasculitis
44
Churg-Strauss: features
``` asthma eosinophilia paranasal sinusitis mononeuritis multiplex pANCA ```
45
Churd-Strauss: precipitant
Leukotriene receptor antagonist
46
Transudate effusion
<30g/L protein
47
Causes of transudate effusion
Heart failure, hypoalbuminaemia, hypothyroid, Meigs'
48
Exudate effusion
>30g/L protein
49
Causes of exudate effusion
Infection, connective tissue disease, neoplasia, pancreatitis, PE, Dressler's syndrome, yellow nail syndrome
50
a-1 antitrypsin: normal
PiMM
51
a-1 antitrypsin: 50% normal
PiSS
52
a-1 antitrypsin: 10% normal
PiZZ
53
Most common cause of IECOPD
H. influenzae
54
AMS: Mx
descent | acetazolamide
55
HACE: Mx
Descent | Dexamethasone
56
HAPE: Mx
``` Descent Nifedipine Dexamethasone Acetazolamide Oxygen ```
57
Occupational asthma: causes
``` Isocyanates Platinum salts Soldering resin Glutaraldehyde Flour Epoxy resins Protelytic enzymes ```
58
Causes of bilateral hilar lymphadenopathy
Lymphoma/maligancy Pneumoconiosis Fungi
59
Cavitating lung lesions: causes
``` Abscess (Staph aureus, Klebsiella, Pseudomonas) Squamous cell LC TB Wegener's PE RA Aspergillosis Histoplasmosis ```
60
Sarcoid: 0
normal
61
Sarcoid: 1
BHL
62
Sarcoid: 2
BHL + interstitial infiltrates
63
Sarcoid: 3
Diffuse interstitial inflitrates
64
Sarcoid: 4
Diffuse fibrosis

MRCP 1 (16 decks)

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