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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
Q

Oxygen dissociation: shift to left

A 
LOWER
Low H+
Low pCO2
Low 2,3-DPG
Low temperature
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26
Q

Respiratory alkalosis: causes

A 
Anxiety
PE
Salicylate poisoning
CNS disorders
Altitude
Pregnancy
27
Q

Asthma Mx

A
  1. SABA
  2. SABA + ICS
  3. SABA + ICS + LTRA
  4. SABA + ICS + LABA +/- LTRA
  5. SABA + ICS + MART
28
Q

Tidal Volume

A

Inspired at at rest

500ml in males, 350ml in females

29
Q

Inspiratory reserve volume

A

Maximum volume of air that can be inspired

2-3L

30
Q

Inspiratory capacity

A

TV + IRV

31
Q

Expiratory reserve volume

A

Maximum volume of air that can be expired

750ml

32
Q

Residual volume

A

Volume of air remaining after maximal expiration
Increases with age
FRC - ERV
~1.2L

33
Q

Functional residual capacity

A

Volume in lungs at end of expiration

FRC = ERC + RV

34
Q

Vital Capacity

A

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
Q

TLC

A

VC + Residual volume

36
Q

Raised TLCO

A 
Asthma 
Pulmonary haemorrhage
Left to right shunt
Polycyaethemia
Hyperkinesis
Male
37
Q

Lower TLCO

A 
Fibrosis
Pneumonia
PE
Oedema
Emphysema
Anaemia 
Low CO
38
Q

Candidates for LTOT in COPD

A 
FEV1 <30%
Cyanosis
Polycythaemia
Peiripheral oedema 
Raised JVP
<92%
pO2 <7.3
39
Q

IPF: features

A

Progressive exertional dyspnoea
Bibasal fine end-expiratory crackles
Dry cough
Clubbing

40
Q

IPF: diagnosis

A

Restrictive spirometry
Reduced TLCO
Bilateral interstitial shadowing

41
Q

Atelectasis: features

A

Dyspnoea and hypoxia 72 hours post op

42
Q

Lung Ca: RF

A 
Smoking (x10)
Asbestos (x5)
Arsenic
Radon
Nickel
Chromate
Aromatic hydrocarbon
Cryptogenic fibrosing alveolitis
43
Q

Churg-Strauss Syndrome: what?

A

ANCA positive small vessel vasculitis

44
Q

Churg-Strauss: features

A 
asthma
eosinophilia
paranasal sinusitis
mononeuritis multiplex
pANCA
45
Q

Churd-Strauss: precipitant

A

Leukotriene receptor antagonist

46
Q

Transudate effusion

A

<30g/L protein

47
Q

Causes of transudate effusion

A

Heart failure, hypoalbuminaemia, hypothyroid, Meigs’

48
Q

Exudate effusion

A

> 30g/L protein

49
Q

Causes of exudate effusion

A

Infection, connective tissue disease, neoplasia, pancreatitis, PE, Dressler’s syndrome, yellow nail syndrome

50
Q

a-1 antitrypsin: normal

A

PiMM

51
Q

a-1 antitrypsin: 50% normal

A

PiSS

52
Q

a-1 antitrypsin: 10% normal

A

PiZZ

53
Q

Most common cause of IECOPD

A

H. influenzae

54
Q

AMS: Mx

A

descent

acetazolamide

55
Q

HACE: Mx

A

Descent

Dexamethasone

56
Q

HAPE: Mx

A 
Descent
Nifedipine
Dexamethasone
Acetazolamide
Oxygen
57
Q

Occupational asthma: causes

A 
Isocyanates
Platinum salts
Soldering resin
Glutaraldehyde
Flour
Epoxy resins
Protelytic enzymes
58
Q

Causes of bilateral hilar lymphadenopathy

A

Lymphoma/maligancy
Pneumoconiosis
Fungi

59
Q

Cavitating lung lesions: causes

A 
Abscess (Staph aureus, Klebsiella, Pseudomonas)
Squamous cell LC
TB
Wegener's
PE
RA
Aspergillosis
Histoplasmosis
60
Q

Sarcoid: 0

A

normal

61
Q

Sarcoid: 1

A

BHL

62
Q

Sarcoid: 2

A

BHL + interstitial infiltrates

63
Q

Sarcoid: 3

A

Diffuse interstitial inflitrates

64
Q

Sarcoid: 4

A

Diffuse fibrosis

MRCP 1 (16 decks)

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