Respiratory Flashcards
CXR: Wedge shape opacification?
PE
Common organism in aspiration pneumonia?
Klebsiella
Examination finding in adenocarcinoma of the lung?
Gynocomastia
Exudative pleural effusion (pleural fluid: serum protein)
> 0.5 or > 30g/L
Transudative pleural effusion (pleural fluid: serum protein)
< 0.5 or < 30g/L
Causes of exudative pleural effusion?
(PPP MCT)
Pneumonia (most common)
Pulmonary embolism
Pancreatitis
TB
Connective tissue disease
Mesothelioma
Causes of transudative pleural effusion? (HHHM)
Heart failure (most common)
Hypoalbuminaemia (nephrotic syndrome, liver disease, malabsorption)
Hypothyroidism
Meige’s syndrome
When should a chest tube be placed in pleural effusion?
ALL patients with pleural effusion associated with sepsis or pneumatic illness should receive diagnostic pleural fluid sampling, chest tube should be placed if:
1. Fluid is purulent, turbid/cloudy
2. Fluid is clear but pH is < 7.2
Causes of lower zone fibrosis? (ICD-A)
Idiopathic
Connective tissue disease (RA, SLE but NOT and spond)
Drug induced (Amiodarone, bleomycin, methotrexate)
Asbestosis
Causes of upper zone fibrosis? (CHARTS)
Coal workers pneumoconiosis
Histocytosis/ hypersensitivity pneumonitis
Ank Spond
Radiation
TB
Silicosis
First line treatment of allergic bronchopulmonary aspergillosis?
Oral prednisolone
(2nd line agent is itraconazole)
Major feature of allergic bronchopulmmonary aspergillosis?
Eosinophilia
(Positive RAST to aspergillus)
Criteria for LTOT in COPD?
pO2 <7.3 or 7.3-8 AND one of:
1. Secondary polycythaemia
2. Peripheral oedema
3. Pulmonary hypertension
2-level PE Wells test?
> 4 points - PE likely
< or = 4 points - PE unlikely
Most common asbestos related lung change?
Pleural plaques (do not undergo malignant change)
Diagnosis on mycoplasma pneumonia?
Serology
Spirometry in restrictive lung disease?
FEV1: Reduced
FVC: Significantly reduced
FEV1:FVC ratio: Normal or increased
Spirometry in obstructive lung disease?
FEV1: Significantly reduced
FVC: Reduced or normal
FEV1:FVC ratio: Reduced
Aspiration of empyema?
Turbid effusion
pH < 7.2
Glucose: low
LDH: raised
Diagnosis of mesothelioma?
Histology following thoracoscopy
Type of lung cancer in which cavitating lesions are most common?
Squamous cell lung cancer
Where are caveatting lesions in Klebsiella pneumonia?
Upper lobes
Where are caveatting lesions in Klebsiella pneumonia?
Upper lobes
Organism that can cause empyema formation?
Klebsiella
Limitations following pneumothorax?
Lifelong ban from deep sea diving
In bronchodilator reversibility testing, what is indicative of asthma?
Increase in FEV1 of 12% or more
Which pneumonia does preceding influenza infection pre-dispose you to?
Staph Aureus
Antibiotic in acute bronchitis?
Doxycycline
Measurement of lung function in myasthenia gravis?
FVC
Indication for mechanical ventilation in myasthenia gravis?
- FVC 15 mL/kg or less
- NIF (negative inspiratory force) of 20 cm H₂O or less
CXR: Parallel line shadows?
Common in bronchiectasis
Indicate dilated bronchi due to peribronchial inflammation and fibrosis
Often called tram lines
Most common organisms isolated in bronchiectasis?
Hame influenza (most common)
Pseudomonas Aerginosa
Klebsiella
Strep pneumoniae
Bronchiectasis exam findings?
Coarse crackles
Wheeze
Which pneumonia is associated with cold sores?
Strep pneumoniae
Most common cause of occupational asthma?
Isocyanates
Latenet TB CXR?
Calcified Gohn complex
Discahrge in asthma?
After 24 hours medical management PEFR >75%
Diurnal variability < 25%
Most common cause of bilateral hilar lynphadenopathy?
TB
When is prophylactic azithromycin considered in COPD?
If patient does NOT smoke and:
1. Optimised pharmacological and inhaled therapies, have relevant vaccines and are referred for pulmonary rehab
And continue to have1 or more of:
1. Frequent (4x per year) exacerbations with sputum production
2. Prolonged exacerbations with sputum production
3. Exacerbations resulting in hospitalisation
Test required before starting TB treatment?
FBC, U&Es, LFTs and visual acuity
COPD and pneumothorax mimic?
Large emphysematous bull
Difference in emphysema in COPD vs A1AT?
Emphysema is most prominent in the lower lobes in A1AT deficiency and the upper lobes in COPD
Management of alpha 1 anti-trypsin deficiency?
Lung volume reduction surgery
Which lung cancer is medial (near bronchus)
Squamous cell carcinoma
