Respiratory Flashcards

1
Q

Name the different types of lung cancer

A
Non-small cell (80%)
- Adenocarcinoma 
- Squamous cell carcinoma 
- Large cell carcinoma 
Small cell (20%)
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2
Q

Describe small cell lung cancers

A

Contain neurosecretory granules that release neuroendocrine hormones - multiple paraneoplastic syndromes

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3
Q

Give the signs and symptoms of lung cancer

A
SOB
Cough - haemoptysis
Clubbing
Recurrent pneumonia
Weight loss
Lymphadenopathy - supraclavicular
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4
Q

What are signs of lung cancer on CXR?

A

Hilar enlargement
Peripheral opacity
Pleural effusion - unilateral
Collapse

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5
Q

What is the first line treatment for non-small cell lung cancer

A

Surgery - lobectomy or segmentectomy or wedge resection

Chemo or radiotherapy

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6
Q

What is the treatment for small cell lung cancer

A

Chemo or radiotherapy

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7
Q

Describe recurrent laryngeal nerve palsy

A

Hoarse voice - caused by the cancer pressing on or affecting the recurrent laryngeal nerve as it passes through the mediastinum

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8
Q

Describe phrenic nerve palsy

A

Compression causing diaphragm weakness and presents as SOB

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9
Q

Describe superior vena cava obstruction

A

Compression of the tumour on the superior vena cava

Presents with facial swelling, difficulty breathing and distended veins in the neck and upper chest

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10
Q

Describe Pembertons sign

A

SVC obstruction

Raising arms above head causes facial congestion and cyanosis

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11
Q

Describe Horner’s syndrome

A

Partial ptosis, anhidrosis and miosis

Associated with Pancoast tumour (pulmonary apex)

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12
Q

How does SIADH present?

A

Euvolemic hyponatraemia

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13
Q

Describe limbic encephalitis

A

Autoimmune antibodies to the limbic tissues causing inflammation and short term memory impairment, hallucinations, confusion and seizures
Associated with anti-HU antibodies

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14
Q

Describe lambert eaton myasthenic syndrome

A

Result of antibodies produced by the immune system against SCLC. They target voltage gated Ca channels on the presynaptic terminals in motor neurone leading to weakness of the proximal muscles and causes diplopia, ptosis, slurred speech and dysphagia. They also experience dry mouth, blurred vision, impotence and dizziness due to autonomic dysfunction

Reduced reflexes which become normal after a period of maximal contraction (post tetanic potentiation)

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15
Q

Describe mesothelioma

A

Lung mesothelial cells of the pleura
Strongly linked to asbestos and development of mesothelioma - 45years
Prognosis is poor and chemotherapy is palliative

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16
Q

Define hospital acquired pneumonia

A

Develops >48hrs of hospital admission

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17
Q

Describe the presentation of pneumonia

A
SOB
Cough - haemoptysis 
Pleuritic chest pain 
Delirium 
Sepsis 
Tachycardia
Tachypnoea 
Hypoxia
Hypotension 
Fever
Confusion 

Bronchial breath sounds - harsh breath sounds on inspiration and expiration

Focal coarse crackles - air passing through sputum

Dullness to percussion - lung tissue collapse and or consolidation

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18
Q

What is the CURB 65 score

A

Prediction of the severity of pneumonia and helps guide treatment

Confusion
Urea >7
RR >30 
BP <90/60 
Age >65 

0 or 1 - home treatment
>2 - hospital admission
>3 - consider ICU

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19
Q

What are the common causes of pneumonia

A

Streptococcus pneumoniae

Haemophilus influenza

Moraxella catarrhalis
Pseudomonas aeruginosa
Staphylococcus aureus

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20
Q

What is an atypical pneumonia?

A

One that cannot be cultured in the normal way or detected using gram stain

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21
Q

Describe legionella pneumonophila

A

Caused by infected water supplies or air conditioning units

Causes a hyponatraemia - causing SIADH

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22
Q

Describe mycoplasma pneumoniae

A

Milder pneumonia
Erythema multiformed rash - target lesions formed by pink rings with pale centres - can also cause neurological symptoms in young patients

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23
Q

Describe coxiella burnetii

A

Q fever

Farmers - caused by contact with animals and body fluids

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24
Q

Describe chlamydia psittaci

A

Contracted from contact with infected birds

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25
Q

Describe fungal pneumonia

A

Pneumocystis jiroveci

Occurs in HIV patients

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26
Q

What is given to patients with fungal pneumonia

A

co-trimoxazole

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27
Q

What antibiotics are given to those with a mild CAP

A

5 day PO course - amoxicillin or macrolide

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28
Q

What antibiotics are given to those with moderate to severe CAP

A

7-10 day course of dual antibiotics - amoxicillin and macrolide

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29
Q

List some complications of pneumonia

A
Sepsis 
Pleural effusions
Empyema 
Lung abscess
Death
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30
Q

Describe FEV1

A

Forced expiratory volume in 1 second

The amount of air a person can exhale as fast as they can in 1 second

Will be reduced if there is any obstruction

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31
Q

Describe FVC

A

Forced vital capacity

The total amount a person can exhale after a full inhalation - measure of the total volume of air a person can take into their lungs

Reduced if any restriction to the capacity of the lungs

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32
Q

Describe obstructive disease

A

FEV1:FVC ratio <75%

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33
Q

What type of lung picture is asthma and COPD

A

Obstructive

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34
Q

Described restrictive disease

A

FEV1:FVC>75%

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35
Q

List some causes of restrictive lung disease

A
Interstitial lung disease
Neurological - MND 
Scoliosis 
Chest deformity 
Obesity
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36
Q

Explain how to complete a peak flow

A

Stand up tall, take a deep breath in, make a good seal around the device with the lips and blow as hard and as fast as possible into the device - take 3 attempts and record the best one

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37
Q

What does peak flow vary with?

A

Age, Sex and height of the patient

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38
Q

What does peak flow measure

A

How much obstruction is in a patients lungs

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39
Q

List some triggers of asthma

A
Infection
Night time or early morning 
Exercise
Animals
Cold/damp
Dust
Strong emotions
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40
Q

Describe features of a presentation suggesting asthma

A
Episodic symptoms 
Diurnal variability - worse at night 
Dry cough with wheeze and SOB 
History of other atopic conditions such as eczema, hay fever and food allergies
Family history 
Bilateral widespread polyphonic wheeze
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41
Q

How is asthma diagnosed?

A

High probability- trial of treatment
Moderate probability - spirometry for reversibility testing
Low probability - referral and investigating for other causes

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42
Q

What are the first line investigations for asthma

A

Fractional exhaled nitric oxide

Spirometry with bronchodilator reversibility (>12% improvement)

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43
Q

Describe the long term management for Asthma

A

SABA
SABA + ICS
LABA or LTRA

Annual flu jab
Annual asthma review
Advise exercise
Stop smoking

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44
Q

Describe the mechanism of action of SABAs

A

Relax the bronchial smooth muscle causing bronchodilation

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45
Q

Describe the management of ICS

A

Reduce the inflammation and reactivity of the airways

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46
Q

Describe the mechanism of action of LAMAs

A

Block the acetylcholine receptors which are normally stimulated by the parasympathetic nervous system and cause inflammation, bronchoconstriction and mucus secretion

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47
Q

Describe the mechanism of action of theophylline

A

Relax bronchial smooth muscle and reduce inflammation

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48
Q

When is theophylline monitored

A

5 days after starting treatment

3 days after a dose change

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49
Q

List some features of severe acute asthma

A

PEF 33-50% best or predicted
RR >25
HR >110
Inability to complete sentences in one breath

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50
Q

List the features of life threatening asthma

A

PEFR <33% best or predicted
Oxygen sats <92%
Normal PCO2
Silent chest, cyanosis, feeble respiratory effort, bradycardia, dysrhythmia or hypotension, exhaustion, confusion or coma

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51
Q

List the features of moderate asthma

A

PEFR 50-75% best or predicted
Speech normal
RR <25/min
Pulse <110

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52
Q

Describe the treatment of a moderate asthma attack

A

Nebulised salbutamol and ipatropium bromide
Steroids - oral prednisolone for 5 days
Antibioitcs if sign of infection

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53
Q

Describe the treatment of severe asthma

A

Oxygen to maintain sats 94-98%
Aminophylline infusion
IV salbutamol

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54
Q

Describe the treatment of life threatening asthma

A

IV magnesium sulphate
Admission to HDU/ICU
Intubation in worst cases

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55
Q

Describe the initial ABG picture of a person with acute asthma

A

Respiratory alkalosis - tachypnoea causes a drop in CO2

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56
Q

What are some concerning ABG signs in acute asthma

A

Normal PCO2 or hypoxia - tiring and indicates life threatening asthma
Respiratory acidosis - high PCO2

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57
Q

How can you monitor the response of treatment in acute asthma

A
RR
Respiratory effort 
Peak flow
O2 sats
Chest auscultation
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58
Q

Which electrolyte should you monitor when on salbutamol for acute asthma

A

Potassium - absorbed into cells with salbutamol

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59
Q

Which peripheral sign does COPD NOT cause?

A

Clubbing

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60
Q

Describe the MRC dyspnoea scale

A

Grade 1 - Breathless on strenuous exercise
Grade 2 - breathless on walking up a hill
Grade 3 - Breathless that slows walking on the flat
Grade 4 - Stop to catch their breath after walking 100m on the flat
Grade 5 - unable to leave the house due to breathlessness

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61
Q

Describe the spirometry picture of COPD

A

Obstructive
FEV1:FVC <0.7
No reversibility with SABA

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62
Q

Describe the severity of COPD

A

Stage 1: FEV1 >80% predicted
Stage 2: FEV1 50-79%
Stage 3: 30-49%
Stage 4: <30%

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63
Q

Describe type 1 respiratory failure

A

Low PaO2

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64
Q

Describe type 2 respiratory failure

A

Raised PCO2 despite low PaO2

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65
Q

Describe the ABG in someone with COPD

A

Acutely retaining CO2 - respiratory acidosis

The kidneys produce bicarbonate to try and normalise the pH

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66
Q

What are the target O2 sats for a COPD patient who chronically retains CO2

A

88-92%

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67
Q

Why is it dangerous to give too much O2 to a COPD patient?

A

These patients rely on their respiratory drive and therefore too much O2 will slow down their respiratory effort

68
Q

Describe Venturi masks

A

Have holes in them - bigger the hole, the less O2

24% blue 
28% white
31% orange
35% yellow 
40% red
60% green
69
Q

Describe the severity of COPD

A

Stage 1: FEV1 >80%
Stage 2: FEV1 50-79%
Stage 3: FEV1 30-49%
Stage 4 : FEV1 <30%

70
Q

Describe the long term management of COPD

A

SABA or Short acting antimuscarinic

LABA plus LAMA or LABA plus ICS if asthmatic features

More severe cases - nebulisers, oral theophylline, oral mucolytic therapy (carbocisteine), long term prophylactic antibiotics (azithromycin), long term O2 therapy at home

71
Q

Who is long term O2 therapy reserved for in COPD?

A

Chronic hypoxia
Polycythaemia
Cyanosis
heart failure secondary to pulmonary hypertension

72
Q

Describe the medical treatment of a mild exacerbation of COPD

A

Prednisolone 30mg OD for 7-14 days

Regular inhalers or home nebulisers

Antibiotics

73
Q

Describe the medical management of a moderate to severe COPD exacerbation

A

Nebulised bronchodilators - salbutamol or ipatropium

Steroids
Antibiotics
Physiotherapy

74
Q

Describe the treatment of severe COPD exacerbations

A

IV aminophylline
NIV
Intubation and ventilation with admission to ITU
Doxapram

75
Q

Describe BiPAP

A

Bilevel positive airway pressure - involves a cycle of high an low pressure to correspond to the patients inspiration and expiration. Used when type 2 resp failure and resp acidosis not responding to medical treatment

76
Q

Describe CPAP

A

Continuous positive airway pressure
Provides continuous air being blown into the lungs to keep the airway open so air can travel in easily
Used to maintain the patients airway in conditions where it is prone to collapse
- Obstructive sleep apnoea
- Congestive cardiac failure
- Acute pulmonary oedema

77
Q

Describe the presentation of idiopathic pulmonary fibrosis

A

Pt aged >50yo
Insidious onset SOB and dry cough > 3months
Finger clubbing and binasal crackles

78
Q

Which drugs may lead to pulmonary fibrosis

A

Amiodarone
Cyclophosphamide
Methotrexate
Nitrofurantoin

79
Q

Which conditions may lead to secondary pulmonary fibrosis

A

Alpha 1 antitrypsin deficiency
RA
SLE
Systemic sclerosis

80
Q

Which drugs can be given in pulmonary fibrosis

A

Pirfenidone - antifibrotic and anti-inflammatory

Nintedanib - antibody targeting tyrosine kinase

81
Q

Describe hypersensitivity pneumonitis (extrinsic allergic alveolitis)

A

Type 3 hypersensitivity reaction to environmental allergen that causes parenchymal inflammation and destruction in people sensitive to that allergen

82
Q

How is EAA diagnosed?

A

Bronchoalveolar lavage - collecting cells from airway by washing airway with fluid during bronchoscopy

83
Q

How is EAA managed?

A

Remove allergen

O2 where appropriate

84
Q

Describe cryptogenic organising pneumonia

A

Used to be called bronchiolitis obliterans organising pneumonia

Focal areas of inflammation of lung tissue

Idiopathic or triggered by infection, inflammatory disorders, medications, radiation or environmental toxins and allergens

Presentation is very similar to infectious pneumonia so delayed diagnosis

Treatment is with systemic corticosteroids

85
Q

What is the long term effects of asbestosis

A

Lung fibrosis
Pleural thickening and pleural plaques
Adenocarcinoma
Mesothelioma

86
Q

How is interstitial lung disease diagnosed

A

Ground glass appearance on High resolution CT scan

87
Q

What is interstitial lung disease

A

Umbrella term for the conditions that affect the lung parenchyma causing inflammation and fibrosis

88
Q

What is a pleural effusion

A

Fluid in the pleural space

89
Q

What is a transudative pleural effusion

A

Fluid moving across into the pleural space

90
Q

List some causes of transudative pleural effusion

A

Congestive cardiac failure
Hypoalbuminemia
Hypothyroidism
Meigs syndrome

91
Q

What is Meigs syndrome

A

Right sided pleural effusion with an ovarian malignancy

92
Q

What is an exudative pleural effusion

A

Related to inflammation

Protein leaking out of the tissue into the pleural space

93
Q

List the causes of exudative pleural effusion

A

Lung cancer
Rheumatoid arthritis
Pneumonia
Tuberculosis

94
Q

Describe the signs and symptoms of pleural effusions

A

Shortness of breath
Dullness to percussion over the effusion
Reduced breath sounds
Deviation of the trachea away from the effusion if massive

95
Q

Describe the CXR appearance of pleural effusion

A

Blunting of the costophrenic angles

Tracheal and mediastinal deviation away from the pleural effusion if massive

Fluid in the lung fissures

Larger effusions have a meniscus

96
Q

Describe the treatment of pleural effusion

A

Conservative - treat underlying cause

Pleural aspiration - aspirate the fluid

Chest drain - drain the effusion and prevent it from occurring

97
Q

What is an empyema and when is it suspected?

A

Infected pleural effusion

Suspected when pneumonia is resolving but patient has a new and ongoing fever

98
Q

What does pleural aspiration show in empyema

A

pH <7.2
Low glucose
High LDH

99
Q

How is empyema treated

A

Chest drain and antibiotics

100
Q

What is a pneumothorax

A

Air in the pleural space separating the lung from the chest wall

101
Q

What causes a pneumothorax?

A

Spontaneous
Trauma
Iatrogenic
Secondary to lung pathology

102
Q

How is pneumothorax diagnosed

A

Erect CXR

103
Q

How is the size of a pneumothorax measured

A

Measure horizontally from the lung edge to the inside of the chest wall at the level of the hilum

104
Q

How is pneumothorax managed

A

If <2cm rim of air on CXR and no SOB - spontaneous resolution and OP follow up in 2-4 weeks

If SOB and/or >2cm rim on CXR then aspirate and reassessment

If aspiration fails twice then chest rain

Unstable patients of bilateral or secondary pneumothoraxes generally require a chest drain

105
Q

Describe a tension pneumothorax

A

Trauma to chest wall that reates a one way valve that lets air in but not out of the pleural space

One way valve means more air is pulled in with each inspiration and the air becomes trapped. Pressure in the thorax keeps building, pushes the mediastinum across, kinks the big vessels and can cause cardiorespiratory arrest

106
Q

List some signs of tension pneumothorax

A

Tracheal deviation away from side of pathology
Reduced air entry to affected side
Increased reasonant to percussion on afected side
Tachycardia
Hypotension

107
Q

Describe the management of a tension pneumothorax

A

Insert a large bore cannula into the 2nd ICS mid clavicular line

Chest drain is definitive treatment

108
Q

Where is the chest drain inserted

A

Triangle of safety

109
Q

Describe the borders of the triangle of safety

A

5th ICS - inferior nipple line

Mid axillary line - latissimus dorsi

Anterior axillar line - lateral edge of pectoris major

110
Q

Where is the needle inserted when putting in a chest drain

A

Just above the rib to avoid the neurovascular bundle

111
Q

Describe the gas picture in someone with a PE

A

Respiratory alkalosis - blowing off the CO2 (low CO2 and low O2)

112
Q

Who is a V/Q scan performed in?

A

People with contrast allergy
Renal impairment
Pregnancy (however higher risk of leukaemia in the child)

113
Q

If the Wells score for PE is likely what is the next step?

A

CTPA

114
Q

If the Wells score for PE is unlikely, what is the next step

A

D-dimer and if positive then CTPA

115
Q

Describe the Wells score

A

Predicts the likelihood of someone presenting with symptoms of a PE actually having a PE

  • Haemoptysis
  • Tachycardia
  • RF
116
Q

What are the RF for PE

A
Immobility 
Recent surgery 
HRT with oestrogen 
Polycythaemia
SLE
Pregnancy
COCP
Malignancy
117
Q

Describe VTE prophylaxis

A

LMWH - enoxaparin

Compression stockings

118
Q

Who are compression stockings CI in?

A

Peripheral arterial disease

119
Q

Describe the initial treatment of PE

A

Oxygen PRN
Analgesia PRN

Apixaban or rivaroxaban

LMWH (enoxaparin or Dalteparin) -if waiting for a scan or if apixaban or rivaroxaban not suitable/antiphospholipid syndrome

120
Q

Describe the long term anticoagulation in PE

A

Warfarin, DOAC or LMWH

Target INR for warfarin is 2-3

Warfarin plus LMWH for 5 days until INR in range for 24hrs as warfarin as prothrombotic properties to begin with

LMWH long term in pregnancy or cancer

Continue for 3 months if obvious reversible cause, beyond 3 months if the cause is unclear, irreversible underlying cause or active cancer (6 months)

121
Q

Describe the use of thrombolysis in PE

A

Massive PE - haemodynamic compromise

Fibrinolytic agent - streptokinase, Alteplase or Tenecteplase

2 ways of giving it - IV or directly into the pulmonary arteries using a central catheter (catheter directed thrombolysis)

Catheter directed thrombolysis - delivered into the venous system through the right side of the heart into the pulmonary artery - inject the agent directly into the clot

122
Q

What is pulmonary hypertension

A

Increased resistance and pressure of blood in the pulmonary arteries
Causes strain on the right side of the heart trying to pump blood through the lungs - causes back pressure of blood on the systemic venous system

123
Q

List the causes of pulmonary hypertension

A

Group 1 - primary pulmonary hypertension or connective tissue disease (SLE)

Group 2 - left heart failure due to MI or systemic hypertension

Group 3 - chronic lung diseases such as COPD

Group 4 - pulmonary vascular disease - PE

Group 5 - sarcoidosis, glycogen protein disorder, haematological disorders

124
Q

List the symptoms of pulmonary hypertension

A

Syncope
Tachycardia
Raised JVP Hepatomegaly
Peripheral oedema

125
Q

Describe the ECG changes in pulmonary hypertension

A

Right ventricular hypertrophy - Larger R waves on the Right sided chest leads (V1-3) and S waves on the left sided chest leads (V4-6)

Right axis deviation

Right bundle branch block

126
Q

Describe the CXR signs of pulmonary hypertension

A

Dilated pulmonary arteries

Right ventricular hypertrophy

127
Q

Describe the management of pulmonary hypertension

A

Primary - IV prostenoids (epoprostenol), Endothelin receptor antagonists (macitentan), phosphodiesterase 5 inhibitors (sildenafil)

Secondary pulmonary hypertension - treat underlying cause

Supportive therapy for complications

128
Q

Describe the typical sarcoidosis patient

A

Young black female presenting with dry cough, SOB and may have nodules on their shins

129
Q

What is sarcoidosis

A

Granulomatous inflammatory condition - nodules of inflammation full of macrophages develop

130
Q

Describe how sarcoidosis affects the lungs

A

Mediastinal lymphadenopathy
Pulmonary fibrosis
Pulmonary nodueles

131
Q

List the systemic symptoms of sarcoidosis

A

Fever
Fatigue
Weight loss

132
Q

List the liver symptoms of sarcoidosis

A

Liver nodules
Cirrhosis
Cholestasis

133
Q

List the eye symptoms of sarcoidosis

A

Uveitis
Conjunctivitis
Optic neuritis

134
Q

List the skin conditions caused by sarcoidosis

A

Erythema nodosum - tender red nodules on shins by inflammation in the subcutaneous fat

Lupus pernio - raised, purple skin lesions commonly on the cheeks and nose

Granulomas form in scar tissue

135
Q

List the heart conditions caused by sarcoidosis

A

Bundle branch and heart block

Myocardial muscle involvement

136
Q

List the kidney conditions caused by sarcoidosis

A

Kidney stones (hypercalcaemia)
Nephrocalcinosis
Interstitial nephritis

137
Q

List the CNS sarcoidosis problems

A

Nodules
Pituitary involvement - diabetes insipidus
Encephalopathy

138
Q

List the PNS sarcoidosis problems

A

Facial nerve palsy

Mononeuritis multiplex

139
Q

List the bone problems caused by sarcoidosis

A

Arthralgia
Arthritis
Myopathy

140
Q

Describe Lofgren’s syndrome

A

Bilateral hilar lymphadenopathy
Erythema nodosum
Polyarthralgia

141
Q

What investigations would you do to diagnose sarcoidosis

A
Serum ACE 
Calcium (high) 
Serum soluble IL-2 receptor (high) 
CRP (high) 
Immunoglobulins (high) 
CXR - hilar lymphadenopathy 
HRCT - hilar lymphadenopathy and pulmonary nodules 
MRI - CNS involvement 
PET scan - active inflammation 

Biopsy - non-caseating granulomas with epithelioid cells - bronchoscopy with USS guided biopsy of the mediastinal lymph nodes

142
Q

Describe the treatment of sarcoidosis

A

No treatment if no or mild symptoms

Oral steroids between 6-24months

Second line is methotrexate or azathioprine

Lung transplant if severe pulmonary disease

143
Q

Describe the prognosis of sarcoidosis

A

Spontaneously resolves within 6 months in 60% patients. Small number develop pulmonary fibrosis and pulmonary hypertension

144
Q

List the RF for obstructive sleep apnoea

A
Male
Middle aged
Obesity 
Alcohol
Smoking
145
Q

Describe features of obstructive sleep apnoea

A
Daytime sleepiness
Morning headache 
Snoring
Apnoea episodes during sleep 
Concentration problems 
Waking unrefreshed
146
Q

What can severe cases of sleep apnoea cause

A

Heart failure
Hypertension
Increased risk of MI and stroke

147
Q

What tool can be used to assess for symptoms of sleepiness associated with obstructive sleep aponeoa

A

Epworth sleepiness scale

148
Q

Describe the management of obstructive sleep apneoa

A

Lifestyle - lose weight, stop smoking and drinking
CPAP - continous positive pressure during sleep to maintain patency of airway
Surgery - UPPP

149
Q

How does lung Cancer cause chest pain

A

Chest wall involvement

Rib mets

150
Q

Where does mesothelioma spread to?

A

Other pleural cavity
Hilar lymph nodes
Lung

151
Q

How is mesothelioma diagnosed?

A

Thoracoscopy with biopsy and histology of pleura

152
Q

What can be injected to prevent re-accumulation of pleural effusions in mesothelioma?

A

Sclerosant substances

153
Q

What is the test for TB

A

Acid fast bacilli sputum

154
Q

Where should patients with active TB be treated?

A

Negative pressure isolation room

155
Q

What is a mycetoma

A

Fungus ball forming in a pre-existing lung cavity

156
Q

What investigations would you do for aspergillus?

A

Skin test (positive in 30%)
Serum precipitins
Sputum culture

157
Q

Which anti-TB drug can cause hepatitis?

A

Rifampicin

158
Q

Which anti-TB drug can cause optic neuritis

A

Ethambutol

159
Q

Why is pyridoxine supplementation recommended with isoniazid therapy

A

Isoniazid therapy can cause peripheral neuropathy due to vitamin depletion

160
Q

What is an air bronchogram

A

Consolidated lung outlining an air filled bronchus

161
Q

List the radiographical changes associated with bronchiectasis

A

Thickened bronchial walls
Ring shadows - thickened airways seen end on
Volume loss secondary to mucous plugging
Air fluid levels within dilated bronchi

162
Q

List some causes of bronchiectasis

A
Aspergillosis 
Cystic fibrosis
Immunodeficiency 
Sarcoidosis 
TB
163
Q

Which antibiotic is given to serious gram negative infections

A

Gentamicin

164
Q

Which antibiotic is given to pneumocystis jirovecci

A

Co-trimoxazole

165
Q

List the four drugs used to treat TB

A

Rifampicin
Isoniazid
Pyrazinamide
Ethambutol

166
Q

Which type of organism is the most common cause of aspiration pneumonia

A

Anaerobic