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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
What is the correct position for a chest drain?
4-6th intercostal space, mid-axillary line
26
What are the CURB65 criteria?
``` C - confusion U - urea >7 R - RR >30 B - BP <90/60 65 ```
27
Sudden haemoptysis in bronchiectasis is likely due to what?
Bronchial circulation bled --> treat with embolization of the bronchial artery
28
What may provide symptoms relief in asbestosis?
Oxygen
29
After amoxicillin as a first-line agent, what are the second-line oral agents for CAP?
Doxycycline or levofloxacin
30
Which chemo agent used in lung cancer is used for people with an eGFR< 30?
Carboplatin
31
Why is FEV1 preserved in restrictive lung disease?
Because the elastic recoil is normal, maintaining appropriate forced expiration. Hence FEV1/FVC overall increases (FVC reduces and FEV1 = maintained)
32
Which organism is responsible for whooping cough, and if it causes bronchitis, which bx should be used?
Bordetella pertussis --> Azithromycin
33
Which organism causes rust-coloured sputum?
Streptococcus pneumoniae
34
What are the first-line Abx choices in HAP?
Non-severe features - Co-amox, PO | Severe/risk of MDR - Taz, IV
35
Which agent is used in a bronchoprovication test?
Methacholine
36
How is chronic hypersensitivity pneumonitis managed?
Low dose oral prednisolone
37
How should asthma be investigated in adults?
FeNO test + spirometry with reversibility
38
What condition is Lambert-Eaton Myasthenic Syndrome associated with?
SCLC
39
What is the pattern of muscle weakness associated with Lambert-Eaton Myasthenic Syndrome?
Muscle weakness in LEMS mainly affects the proximal muscles, with symptoms being worst in the morning, improving with exercise
40
What is Caplan syndrome?
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
What are the signs of overinflation on CXR?
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
What indicates a pleural effusion caused by an exudate?
Protein >35g/L
43
What indicates a pleural effusion caused by an transudate?
Protein <25g/L
44
Exposure to asbestos is most likely to cause which type of cancer?
Lung cancer | Mesothelioma = a rare form of cancer
45
How is COPD diagnosed?
Post-bronchodilator spirometry
46
Which type of lung cancer is associated with hypercalcaemia?
Squamous cell carcinoma
47
How does silicosis present on CT?
'Egg shell' calcification of lymph nodes
48
An Epworth score greater than what indicates excessive day time sleepiness?
>10
49
What criteria are used to differentiate between transudative and exudative pleural effusions?
Light's criteria
50
What is the most common type of lung cancer in people that have never smoked?
Adenocarcinoma
51
What is the other name for infection with saccharopolyspora rectivirgula?
Farmer's Lung
52
What condition might cause black sputum production?
Coal miner's pneumoconiosis

MSRA (18 decks)

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