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Year 4 part 2 > Respiratory > Flashcards

Respiratory Flashcards

1
Q

First line management of non-small cell lung cancer

A

Lobectomy

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2
Q

Management of Idiopathic pulmonary fibrosis

A

Pirfenidone (antibrinolytic)

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3
Q

What drugs can induce pulmonary fibrosis

A

Amiodarone
Cycylophosphamide
Methotrexate
Nitrofurantoin

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4
Q

What does co-amoxiclav not cover

A

Atypical bacteria

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5
Q

What does clarithromycin cover

A

Gram +ve and atypical

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6
Q

What does Clindamycin cover

A

Gram +ve and Anaerobes

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7
Q

What does cprofloxacin cover

A

Grame -ve and Atypical

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8
Q

What does doxycycline cover

A

Everything + anaerobes

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9
Q

What is a more sensitive inflammatory mediator: CRP or ESR

A

CRP

ESR i snormal in first 24 hours

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10
Q

Management of acute bronchitis

A

First line: Nothing

Second Line : Doxycycline

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11
Q

What blood result can guide if antibiotics are required or not for bronchitis

A

CRP >100

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12
Q

Symptoms of Bronchitis

A

Initial dry cough for 3-4 days -> productive cough

Resolves on own

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13
Q

What factors indicate the need for steroids in sarcoidosis

A

Hypercalcaemia
Uveitis
Nueorlogical or cardiac involvement
Parenchymal lung disease

Symptomatic

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14
Q

Name four obstructive lung diseases

A

Asthma
COPD
Bronchiectasis

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15
Q

Name some restrictive lung diseases

A

Sarcoidosis
PF
Asbestosis
ARDS
NMDs

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16
Q

Side-effect of amiodarone

A

Lung fibrosis

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17
Q

What paCO2 levels indicate the need for NIV in COPD

A

PaCO2 > 6Kpa

pH <7.35

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18
Q

When does the target saturation in COPD move to 94-98%, under what circumstances

A

If CO2 is normal on an ABG

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19
Q

What L/min is high flow oxygen

A

15 liters/min

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20
Q

When is the 40% venturi mask indicated in COPD exacerbation

A

Second line if ABG has not com eback.

First Line: 24-28%

Second Line: 40%. if sats have not improved

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21
Q

Management of COPD exacerbation

A

Prednisolone 30mg for 5 days

If pneumonia:

Pred + Amoxicillin

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22
Q

Most common cause of COPD exacerbations (infective)

A

H. influenzae

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23
Q

What zone gets fibrosed in TB

A

Upper zone fibrosis

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24
Q

What blood test is deranged in sarcoidosis

A

ACE level

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25
Q

What does an X-Ray show for mesothelioma

A

Pleural Effusion/thickecning

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26
Q

After a Chest X-Ray for suspected mesothelioma, what should be done next

A

CT pleura

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27
Q

Diagnostic investigation for mesothelioma

A

Thoracoscopy + biopsy

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28
Q

What antibiotic prophylaxis is given for COPD

A

Azithromycine

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29
Q

Management of small cell lung cancer

A

Chemo therapy + Radiotherapy

NO SURGERY

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30
Q

What FBC finding indicates lung cancer

A

Raised platelets

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31
Q

What surgery can be used to treat alpha 1 antritrypsin deficiency

A

Lung volume reduction surgery

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32
Q

Management of aspirtaion pneumonia

A

IV cephalosporins + IV metronidazole

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33
Q

What peak flow result indicates asthma

A

> 20%

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34
Q

What FeNO result indicates asthma

A

> 40 in adults, >35 in children

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35
Q

What stepwise approach is used for asthma

A
  1. SABA
  2. SABA + ICS
  3. SABA + ICS + Leukotriene receptor antagonist
  4. SABA + ICS + LABA
  5. SABA + LTRA
  6. SABA + LTRA + MART
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36
Q

In what patients is allergic bronchopulmonary aspergillosis associated with

A

CF

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37
Q

Stepwise management of asthma in children

A
  1. SABA
  2. SABA + low dose ICS
  3. SABA + low dose ICS + LTRA
  4. SABA + ICS + LABA
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38
Q

Name two conditions with bilateral hilar lymphadenopathy

A

Sarcoidosis
TB

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39
Q

What infections can cause bronchiectasis

A

TB
HIV
Measles
Pertussis
Pneumonia

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40
Q

What congenital conditions cause bronchiectasis

A

CF
Kartagener’s syndrome

41
Q

What haemotological condition causes bronchiectaiss

A

Hypogamaglobulinaemia

42
Q

What is hypogammaglobulinaemia

A

Low IgG after an infection

43
Q

Symptoms of bronchiectaiss

A

Productive cough
Large sputum
Haemoptysis
Finger clubbing
Wheeze

44
Q

What part of the resp tract is affected in COPD caused by cigarrettes

A

Centriacinar(upper lobes)

45
Q

What part of the resp treact is affected in COPD with alpha 1 antitrypsin deficiency

A

Pancacinar (lower lobes)

46
Q

ECG findings in COPD

A

RIght atrial hypertrophy and right ventircular hypertrophy

47
Q

What defines a hyperinflated chest

A

> 6 ribs seen on x ray

48
Q

When should someone with COPD be sent from surgery

A

FEV1 > 20% predicted
PaCO2 < 7.3
Upper lobe emphysema

49
Q

What species causes croup

A

Parainfluenza

50
Q

Management of corup

A

Dexamethasone

51
Q

Symptom of courp

A

Barking cough

52
Q

What sweat test finding is indicative of Cf

A

Sodium or chloride >60 mmol

53
Q

What test can check for pancreatic exocrine dysfunction

A

Faecal elastase

54
Q

Name two causes of horner’s syndrome

A

Pancoast tumour
Carotid artery dissection

55
Q

Surgical management of a lung abscess

A

Ct guided drainage

56
Q

Gold standard investigation for obstructive sleep apnoea

A

Polysomnography

57
Q

What sign is distinctive of staphylococcal pneumonia

A

Bilateral pneumonia

58
Q

Outline the CURB-65 criteria

A

C- confusion
U - Urea > 7
R - RR > 30
BP - <90 systolic or <60

65

59
Q

Management of pleuritic chest pain

A

Paracetamol

60
Q

ECG findings specific to PE

A

S1Q3T3

NOt common tho

61
Q

What is Lofgren Syndrome

A

Acute sarcoidosis:

Fever
Polyarthralgia
Erythema Nodosum
Bilateral hilar lymphadenopathy

62
Q

How long can NRt be used for

A

8 weeks

63
Q

Management of TB

A

RIPE - 6 months
Isoniazide + Rifampicin - further 6 months

64
Q

Side effects of isoniazid

A

Peripheral neuropathy

65
Q

Prevention of peripheral neuropathy from isoniazid

A

pyridoxine

66
Q

Side effect of rifampicin

A

Red urine

67
Q

Side effect of ethambutol

A

Visual distrubance

68
Q

Side effect of pyrazinamide

A

LIver toxicity

69
Q

Management of allergic bronchopulmonary aspergillosis

A

Oral Prednisolone (+ oral itraconazole as adjuvant)

70
Q

What lung cancer is associated with hypertrophic pulmonary osteoarthropathy

A

Squamous cell carcinoma (bilateral wrist pain)

71
Q

What bronchodilator reversibility is an indicator for asthma

A

An improvement of 12% or more

72
Q

What prophylaxis must be given for patients with COPD

A

Azithromycin

73
Q

How long is the dose of oral prednisolone given for COPD exacerbations

A

5 Days

74
Q

What serum levels can be used to guide if prednisolone should be given in acute bronchitis

A

If CRP levels are elevated

75
Q

IN what type of lung cancer are caveatting lesions seen in

A

Squamous cell carcinoma

76
Q

What serum levels are elevated in sarcoidosis

A

ACE
Calcium levels

77
Q

What intervention is given for obstructive sleep apnoea

A

CPAP

78
Q

What does a pleural fluid result show for an empyema

A

LDH > 1000

79
Q

At what CRP level should a delayed prescription be given for acute bronchitis

A

20-100 mg/L

80
Q

Where is alpha-1 antitryspin deficiency typically found in the lungs

A

Panacinar (lower lobes)

81
Q

What causes benign pleural plaques

A

Asbestos-related lung disease

82
Q

What zone of the lungs does asbestosis affect

A

Lower lobe fibrosis

83
Q

Management of asbestosis

A

Supportive

84
Q

Management of mesothelioma

A

Palliative chemotherapy

85
Q

What is the most common cause of occupational asthma

A

Spray painting and foam moulding using adhesives

86
Q

Diagnosis of occupational asthma

A

Serial PEFR at work and away

87
Q

How do we step down asthma treatment

A

Push down by 25-50% at a time

88
Q

Clinical features of atelectasis

A

Sudden dyspnoea after operation

89
Q

Management of atelectasis

A

Refer to physio. + make them sit upright

90
Q

What is the most common organism that causes infection in bronchiectasis

A

H. Influenzar

91
Q

Name the safe triangle for chest drain insertion

A

Mid axillary line

5th intercostal space

Bordered by lat doors and lateral border of the pectorals major

92
Q

Most common cause of lobar collapse

A

Lung cancer

93
Q

Signs of lobar collapse on an X-ray

A

Elevation of hemidiaphragm

Tracheal deviation towards side of collapse

94
Q

Where do cannonball mets commonly come from

A

Renal cell cancers

95
Q

Where are fibrotic masses in Progressive Massive fibrosis found

A

Upper lobes of the lungs

96
Q

Management of COPD

A

First line: SABA or SAMA

Second Line: LABA + LAMA (no asthmatic features)

Second Line: LABA + ICS (asthmatic features)

97
Q

Protein level in exudative pleural effusions

A

> 30 g/L

98
Q

Protein level in transudative pleural effusions

A

< 30 g/L

Year 4 part 2 (10 decks)

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