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MSRA > Respiratory > Flashcards

Respiratory Flashcards

1
Q

What type of Abx prophylaxis might be given in COPD?

A

Azithromycin

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2
Q

What are the obstructive lung diseases?

A

Asthma
COPD
Bronchiectasis
Bronchiolitis obliterans

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3
Q

What is the pattern on pulmonary function test in obstructive lung disease?

A

FEV1 - significantly reduced
FVC - reduced or normal
FEV1% (FEV1/FVC) - reduced

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4
Q

What are the restrictive lung diseases?

A 
Pulmonary fibrosis
Asbestosis
Sarcoidosis
Acute respiratory distress syndrome
Infant respiratory distress syndrome
Kyphoscoliosis e.g. ankylosing spondylitis
Neuromuscular disorders
Severe obesity
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5
Q

What is the pattern on pulmonary function test in restrictive lung disease?

A

FEV1 - reduced
FVC - significantly reduced
FEV1% (FEV1/FVC) - normal or increased

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6
Q

What are the causes of bilateral hilar lymphadenopathy?

A 
Sarcoidosis
TB
Lymphoma/other malignancy
Pneumoconiosis e.g. berylliosis
Fungi e.g. histoplasmosis, coccidioidomycosis
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7
Q

What is the most common organism causing infective exacerbations of COPD?

A

Haemophilus influenzae

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8
Q

What are Horder’s spots (characteristic facial rash) associated with?

A

Psittacosis - chlamydia psittaci

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9
Q

What skin manifestation does sarcoidosis cause?

A

Erythema nodosum

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10
Q

Which lung function parameter tends to be the same in both obstructive and restrictive lung disease?

A

Tidal volume - approx. 80% of predicted in both types

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11
Q

What type of lung disease is associated with alpha-1-anti-tripsin?

A

Emphysema (usually in the young)

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12
Q

Which parameter scores the most points in the Wells score for DVT?

A

Clinical signs and symptoms of DVT = 3 points

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13
Q

Which way does the trachea deviate in tension pneumothorax?

A

AWAY from the affected side

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14
Q

Which type of pneumonia tends to affect IVDU?

A

Staphylococcus pneumonia

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15
Q

Which drug is commonly associated with pulmonary fibrosis?

A

Methotrexate

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16
Q

When should a pneumothorax be aspirated?

A

When breathless or when rim of air >2cm

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17
Q

Which disease most commonly predisposes to secondary pneumothorax?

A

COPD

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18
Q

What is the most frequent site of GI TB?

A

Ileocecal

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19
Q

What is yellow nail syndrome?

A

Rare genetic condition - yellow thickened nails + lymphoedema + respiratory involvement (e.g. pleural effusions)

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20
Q

What are the criteria for LTOT?

A
  1. Non-smokers
  2. paO2<7.3 when stable (2 measurements, 3 weeks apart) OR paO2 7.3-8 with secondary polycythaemia/peripheral oedema/pulmonary HTN
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21
Q

What features would be indicative of bronchiectasis on MDCT?

A
  1. Bronchoarterial ratio >1
  2. Lack of tapering of bronchi
  3. Distance from airway to costal pleural surface <1cm
22
Q

What is the first-line treatment for histoplasmosis?

A

Itraconazole

23
Q

What is the gold standard investigation for pulmonary HTN?

A

Right heart catheterisation

24
Q

What is the criteria for lung transplant in COPD?

A

FEV1 <20% predicted despite maximal medical therapy

25
Q

What is the correct position for a chest drain?

A

4-6th intercostal space, mid-axillary line

26
Q

What are the CURB65 criteria?

A 
C - confusion
U - urea >7
R - RR >30
B - BP <90/60
65
27
Q

Sudden haemoptysis in bronchiectasis is likely due to what?

A

Bronchial circulation bled –> treat with embolization of the bronchial artery

28
Q

What may provide symptoms relief in asbestosis?

29
Q

After amoxicillin as a first-line agent, what are the second-line oral agents for CAP?

A

Doxycycline or levofloxacin

30
Q

Which chemo agent used in lung cancer is used for people with an eGFR< 30?

A

Carboplatin

31
Q

Why is FEV1 preserved in restrictive lung disease?

A

Because the elastic recoil is normal, maintaining appropriate forced expiration. Hence FEV1/FVC overall increases (FVC reduces and FEV1 = maintained)

32
Q

Which organism is responsible for whooping cough, and if it causes bronchitis, which bx should be used?

A

Bordetella pertussis –> Azithromycin

33
Q

Which organism causes rust-coloured sputum?

A

Streptococcus pneumoniae

34
Q

What are the first-line Abx choices in HAP?

A

Non-severe features - Co-amox, PO

Severe/risk of MDR - Taz, IV

35
Q

Which agent is used in a bronchoprovication test?

A

Methacholine

36
Q

How is chronic hypersensitivity pneumonitis managed?

A

Low dose oral prednisolone

37
Q

How should asthma be investigated in adults?

A

FeNO test + spirometry with reversibility

38
Q

What condition is Lambert-Eaton Myasthenic Syndrome associated with?

39
Q

What is the pattern of muscle weakness associated with Lambert-Eaton Myasthenic Syndrome?

A

Muscle weakness in LEMS mainly affects the proximal muscles, with symptoms being worst in the morning, improving with exercise

40
Q

What is Caplan syndrome?

A

A type of pulmonary fibrosis, seen in RA patients, usually in coal miners/people who have breathed in a lot of dust.
Presents as multiple, round, well-defined nodules.

41
Q

What are the signs of overinflation on CXR?

A
  1. Flattened diaphragm
  2. > 6 anterior or 10 posterior ribs - ribs appear more horizontal
  3. Air below the heart
  4. Increased AP diameter of the chest
  5. Hyperlucent lungs
42
Q

What indicates a pleural effusion caused by an exudate?

A

Protein >35g/L

43
Q

What indicates a pleural effusion caused by an transudate?

A

Protein <25g/L

44
Q

Exposure to asbestos is most likely to cause which type of cancer?

A

Lung cancer

Mesothelioma = a rare form of cancer

45
Q

How is COPD diagnosed?

A

Post-bronchodilator spirometry

46
Q

Which type of lung cancer is associated with hypercalcaemia?

A

Squamous cell carcinoma

47
Q

How does silicosis present on CT?

A

‘Egg shell’ calcification of lymph nodes

48
Q

An Epworth score greater than what indicates excessive day time sleepiness?

49
Q

What criteria are used to differentiate between transudative and exudative pleural effusions?

A

Light’s criteria

50
Q

What is the most common type of lung cancer in people that have never smoked?

A

Adenocarcinoma

51
Q

What is the other name for infection with saccharopolyspora rectivirgula?

A

Farmer’s Lung

52
Q

What condition might cause black sputum production?

A

Coal miner’s pneumoconiosis

MSRA (18 decks)

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