Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MRCP > Respiratory > Flashcards

Respiratory Flashcards

1
Q

What is the most common organism causing exacerbations of COPD?

A

Infective: s.pneumoniae

Non-infective: h.influenzae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the symptoms of A1AT?

A

Panacinar/lower lobe emphysema

Cirrhosis and HCC adults, cholestasis children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the criteria for LTOT?

A

Blood gases on 2 occasions at least 3 weeks apart:
pO2<7.3kPa
pO2 7.3-8 AND secondary polycythaemia, peripheral oedema, or pulmonary hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the indications for lung transplant in cystic fibrosis?

A

Life threatening exacerbation requiring ICU admission, pulmonary hypertension, FEV1<30% predicted, recurrent exacerbations requiring antibiotic therapy, recurrent/refractory pneumothorax
Recurrent haemoptysis not controlled by emobolisation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is a contraindication to lung transplant in CF?

A

Colonisation with burkholderia cepacia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is Orkambi?

A

Lumacaftor/Ivacaftor
For CF pts who are homozygous for delta F508 mutation
Lumacaftor increases the number of CFTR proteins that are transported to the cell surface

Ivacaftor is a potentiator of CFTR is already at the cell surface, increases the probability that the defective channel will be open and allow chloride ions to pass through the channel pore

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is pulmonary hypertension?

A

Sustained elevation in mean pulmonary arterial pressure >25mmHg at rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the causes of Group 1 PAH?

A

Idiopathic
Familial
Associated with HIV, drugs, vascular disease, congenital heart disease with systemic to pulmonary shunts
Persistent PHTN of the newborn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is group 2 pulmonary hypertension?

A

Related to left heart disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is group 3 pulmonary hypertension?

A

Secondary to lung disease/hypoxia, includes high altitude

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is group 4 pulmonary hypertension?

A

Due to thromboembolic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the inheritance of alpha-1 anti-trypsin deficiency?

A

Autosomal recessive/co-dominant

Chromosome 14

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How are alleles classified in A1AT?

A

Alleles classified according to electrophoretic mobility: M for normal, for slow, Z for very slow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the genotypes in A1AT and which one is most likely to manifest disease?

A

PiMM - normal
PiSS - 50% normal A1AT
PiZZ - 10% normal A1AT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the symptoms of PiMZ genotype?

A

Unlikely to develop clinically significant symptoms

Increased risk of liver and lung disease therefore should avod smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the causes of occupational asthma?

A 
Isocyanates (spray painting)
Platinum salts
Flour
Soldering flux resin
Glutaraldehyde
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How is occupational asthma diagnosed?

A

Serial PEFR measurements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the FeNO test?

A

Fractional exhaled nitric oxide

Levels of NO rise in inflammatory cells particularly eosinophils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the treatment of primary pneumothorax?

A

<2cm and not SOB - discharge

>2cm: aspiration –> still >2cm/SOB –> chest drain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the treatment of secondary pneumothorax over 50 years?

A

<1cm –> oxygen and admit 24h
1-2cm –> aspiration –> chest drain
>2cm/SOB –> chest drain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the causes of a transudate pleural effusion?

A 
<30g/L protein
Heart failure
Hypoalbuminaemia e.g. liver disease, nephrotic syndrome, malabsorption
Hypothyroidism
Meig's syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the causes of an exudate pleural effusion?

A 
Infection
CTD
Malignancy
Pancreatitis
PE
Yellow nail syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the cause of ARDS?

A

Increased permeability of the alveolar capillaries leading to fluid accumulation in the alveoli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which patients are more likely to develop Klebsiella pneumonia?

A

Diabetes
Alcoholism
Immunocompromised
IVDU

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is aspergilloma?

A

Mycetoma that colonises an existing lung cavity e.g. secondary to TB, cancer, or CF

26
Q

How is aspergilloma diagnosed?

A

CXR: round opacity, crescent sign

Aspergillus IgG precipitins

27
Q

What are the symptoms of psittacosis?

A 
History of bird contact
Flu like symptoms
Pneumonia with dry cough and chest pain
Headache
Organomegaly
Failure to respond to penicillin
28
Q

What is the treatment of psittacosis?

A

1st line tetracyclines e.g. doxycycline

29
Q

What are the paraneoplastic features of squamous cell lung cancer?

A

PTH-rp
Hypertrophic pulmonary osteoarthropathy
TSH secretion

30
Q

What are the paraneoplastic features of small cell lung cancer?

A

ADH
ACTH
Lambert-Eaton syndrome

31
Q

What are 4 risk factors for lung cancer?

A

Smoking - 10x
Asbestos - 5x
Arsenic/radon/nickel/chromate
Cryptogenic fibrosing alveolitis

32
Q

What are the indications for steroids in sarcoidosis?

A

Uveitis
Neuro/cardiac involvement
Parenchymal lung disease
Hypercalcaemia

33
Q

What are the stages of sarcoidosis?

A

I - bilateral hilar lympad
II - bilateral hilar lympah + infiltrates
III - infiltrates
IV - fibrosis

34
Q

What are 5 poor prognostic features of sarcoidosis?

A 
Insidious onset
Absence of erythema nodosum
Lupus pernio
Stage III or IV on CXR
Afro-Caribbean
35
Q

How is sarcoidosis diagnosed?

A

EBUS

ACE sensitivity 60%, specificity 70%
Spirometry - restrictive

36
Q

What is the cause of hypercalcaemia in sarcoidosis?

A

Increased concentrations of calcitriol as a result of increased activity of 1a hydroxylase produced by sarcoid macrophages

37
Q

What subtype of sarcoidosis is characterised by parotid enlargement, fever, and anterior uveitis?

A

Heerfordt syndrome

38
Q

What is Lofgren’s sydrome

A

Acute form of sarcoidosis

39
Q

Name the causes of upper zone fibrosis.

A

CHARTS

Coal worker's pneumoconiosis
Histocytosis/hypersensitivity pneumonitis
Ankylosing spondylitis
Radiation
Tuberuclosis
Sarcoidosis/silicosis
40
Q

Name the causes of lower zone fibrosis

A

CADI

CTDs except ankylosing spondylitis
Asbestosis
Drugs e.g. amiodarone, bleomycin, methotrexate
Idiopathic pulmonary fibrosis

41
Q

What type of hypersensitivity reaction is EAA?

A

Type III

42
Q

What are the symptoms of EAA?

A

Acute (4-8 hours):
Dyspnoea, dry cough, fever

Chronic:
Dyspnoea, productive cough, lethargy, anorexia, WAL

43
Q

How is EAA diagnosed?

A

Upper/midzone fibrosis
BAL - lymphocytosis
No eosinophils

44
Q

Sillicosis is a risk factor for what?

A

TB - silica is toxic to macrophages

45
Q

How is ABPA diagnosed?

A

Eosinophilia
Positive RAST test to aspergillus
Positive IgG precipitins
Raised IgE >1000IU/ml

46
Q

What are the symptoms of ABPA?

A

Asthma features
Proximal bronchiectasis
Fungal elements/brown flecks in sputum

47
Q

What is the management of ABPA?

A

Oral steroids

Itraconazole 2nd line

48
Q

What are the symptoms of Churg-Strauss syndrome?

A 
Asthma
Eosinophilia
Mono/polyneuropathy
Flitting pulmonary infiltrates
Paranasal sinus abnormalities
Extravascular eosinophils
49
Q

What is the unmasking agent in Churg-Strauss syndrome?

A

Montelukast

50
Q

Name 5 respiratory manifestations of rheumatoid arthritis

A 
Bronchiolitis obliterans (obstructive picture)
Pulm fibrosis
Pleural effusion
Pulm nodules
Methotrexate pneumonitis
Caplan's syndrome
51
Q

What is cryptogenic organising pneumonia?

A

Diffuse interstitial lung disease that affects the distal bronchioles, respiratory bronchioles, alvolear ducts and walls

52
Q

How is IPF diagnosed?

A 
Restrictive spirometry
Reduced TLCO
Ground glass --> honeycombing
High res CT
ANA +ve in 30%, RF +ve in 10%
53
Q

What is the treatment of IPF?

A

Pulm rehanb
Pirfenidone
O2
Lung Tx

54
Q

What are the symptoms of acute mountain sickness?

A

Headache
Nausea Fatigue

Develops above 2500-3000m, over 6-12 hours

55
Q

What is the cause of AMS?

A

Chronic hypobaric hypoxia

56
Q

What is the prophylaxis for AMS?

A

Acetazolamide

57
Q

What is the treatment of HACE and HAPE?

A

HACE: descent, dexamethasone
HAPE: decent, nifedipine, acetazolamide, oxygen

58
Q

What are the features of carbon monoxide poisoning?

A 
Lactic acidosis
Dizziness, vertigo, vomiting
Headache
Ataxia
Severe- pink skin and mucosa, hyperpyrexia, arrhythmias, extra-pyramidal
59
Q

How is CO poisoning diagnosed?

A

Elevated carboxyhaemoglovin >3% non smoker, >10% smoker

Normal pO2, reduced SaO2

Pulse ox may be high

60
Q

What is the pathophysiology of CO poisoning?

A

Co has 210 times the affinity for Hb than oxygen
Impaired O2 delivery to tissues
Left shift of dissociation curve
Hypoxia

61
Q

What is the treatment of CO poisoning?

A

100% high flow O2 minimum 6 hours
Target saturations 100%
Decreases the half life of COHb

MRCP (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions