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Respiratory Flashcards

1
Q

lung cancer associated with Cushings/paraneoplastic syndromes
very fast growing

A

small cell lung cancer

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2
Q

lung cancer associated with gynacomastia, in women

A

adenocarncinoma

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3
Q

lung cancer most associated with smoking, and causes hypercalcaemia

A

squamous cell carcinoma

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4
Q

progressively worsening dyspnoea, cough in older men, smoker
fine end inspiratory crackles

A

pulmonary fibrosis

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5
Q

pulmonary fibrosis Ix

A

CT chest, honeycomb appearance

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6
Q

unilateral pleural effusion, protein level >30, causes????

A

exudative
cancers; SLE, rheumatoid, pancreatitis, infection

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7
Q

bilateral pleural effusion, protein <30

A

transudative
due to increased cap pressure (CHF); damaged basement membrane (renal dysfunction)

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8
Q

bilateral pulmonary infiltrates/opacities
bibasal crackles
diffuse alveolar damage
hyaline membrane formation

A

Acute respiratory distress syndrome

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9
Q

pathophys of ARDS

A

severe inflammatory response in lungs, 2ndary to lung illness
non cariogenic pulmonary oedema
damage to alveolar-capillary membrane causes fluid to move into the lung -> pulmonary oedema

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10
Q

general signs of sarcoidosis

A

dry cough, dyspnoea
lymphadenopathy, enlarged parotid gland
bilateral bells palsy
anterior uveitis
erythema nodosum

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11
Q

vena cava syndrome diagnostic tool

A

positive pembertons sign

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12
Q

peripheral cyanosis, dyspnoea, cough, systemically unwell
epigastric pain, high lipase

A

ARDS associated with pancreatitis

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13
Q

Mx of acute bronchitis

A

avoid empirical ABs
CRP 20-100: delayed prescription
CRP >100: doxycycline

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14
Q

ECG in COPD

A

P pulmonale, high P waves in inf leads, right axis deviation, low voltage QRS

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15
Q

chronic asthma Mx

A
  1. inhaled ICS + LABA as AIR (anti-inflammatory reliever)
  2. low dose MART (maintenance and reliever - used regularly and as required)
  3. moderate dose MART
  4. check blood eosinophils.
    if raised: refer to resp specialist

if normal: LTRA / LAMA trial for 8-12 weeks

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16
Q

acute asthma Mx

A
  1. salbutamol
  2. oral prednisolone
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17
Q

croup Px and Mx

A

barking cough, infection of upper airway
dexamethasone

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18
Q

Mx of lung abscess

A

IV then oral ABs for 8 weeks. clindamycin + ceftriaxone

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19
Q

Mx of chronic COPD

A
  1. salbutamol
  2. ICS (beclometasone)
  3. LABA + LAMA
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20
Q

Dx of CF in newborns and adults

A

Newborns = heel prick
Adults = sweat test

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21
Q

Px of pneumocystis pneumonia, Ix, Mx

A

associated with HIV/immunocompromised
bifilar infiltrates on CXR

Mx: co-trimoxazole

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22
Q

Px and Ix of TB

A

fever, weight loss, night sweats, S asians
patchy opacifications in upper lungs on CXR

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23
Q

progressive cough, large amounts of yellow sputum, haemoptysis

A

bronchiectasis

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24
Q

lung cancer associated with hypercalcemia

A

squamous

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25
lights criteria is used for...
classifying pleural effusions
26
lights criteria
pleural fluid : serum protein = >0.5 pleural fluid : serum LDH = >0.6 pleural fluid LDH is >2/3 of upper limit
27
stony dullness on percussion/auscultation
pleural effusion
28
hyper-resonant percussion
COPD
29
worsening renal function after starting on ACE inhibitor
flash pulmonary edema
30
aspiration pneumonia Mx
antibiotics (similar to CAP) swallowing assessment if no known cause of dysphagia -> upper GI endoscopy
31
where do adenocarcinomas grow in the lung
commonly present as lesions in the peripheries of the lung
32
where do squamous cell carcinomas grow in the lung
central cavitating lesions
33
productive cough, mucopurulent and blood tinged, recurrent episodes of pneumonia throughout their life suspect...?
bronchiectasis Dx with CT
34
sudden cough and SOB, fine crackles in lung bases. has cardiac risk factors (HTN and hyperlipidaemia) suspect...?
flash pulmonary edema (from taking ACEIs)
35
stoney dullness
pleural effusion
36
protein level of >x is exudative
25
37
Silent chest shows…
Found in asthma. Their chest is so hyper inflated and there is so much residual air that they can’t breathe, so not breathing sounds
38
Stridor
Noise originating from outside the thoracic cavity, noisy inhalation, quiet exhalation Foreign body
39
Wheeze
Inside thoracic cavity Exhalation is noisier
40
Target o2 sats for co2 retainers
88-92
41
When are reservoir masks used
Emergency 10-15 l min
42
Adverse reactions of beta 2 agonists
Sinus tachycardia, fine tremor
43
Adverse reactions of muscarinic antagonists
Dry mouth Blurred vision Urinary retention Constipation
44
two symptoms that are highly suggestive of sarcoidosis
bi hilar lymphadenopathy erythema nodosum
45
symptoms of moderate asthma exacerbation
PEF 50-75% of expected
46
symptoms of acute severe exacerbation
PEF 33-50% of expected can't speak full sentences sats 92% accessory muscle use
47
symptoms of life threatening asthma
PEF < 33% exhaustion confusion altered consciousness silent chest
48
what is the CURB65 score
confusion urea >7 resp rate >30 blood pressure <90/60 age > 65
49
management of curb score 0-1
5 days of amoxicillin
50
management of curb score 2
oral amoxicillin and clarithromycin
51
Mx of curb score 3-5
in hospital IV co amoxiclav
52
what to give for pseudomonas bronchiectasis
ciprofloxacin
53
klebsiella pneumonia is found where and what is the Tx
upper lobe pneumonia meropenem
54
What is meigs syndrome
Benign ovarian tumour Transudative pleural effusion Ascites
55
Smoker presents with cough, eyelid drooping, dryness on one side of face
Could be pancoast tumour (apical region) causing compression of sympathetic nerves Chest x ray !
56
Bronchoscopy vs cxr for lung cancer
Bronchoscopy for central lesions Cxr for general / peripheral lesions
57
wheeze sounds like ..? and indicates..?
noisy exhalation issue inside the thoracic cavity
58
stridor sounds like..? and indicates..?
noisy inhalation issue outside thoracic cavityq
59
cause of unequal air entry
foreign object aspiration
60
4 drugs for TB + 2 continuation drugs
RIPE rifampicin isoniazid (add B6 pyroxidine to prevent peripheral neuropathy) pyrazinamide ethambutol for 2 months continue: rifampicin + isoniazid for 4 more months
61
wheezing, shortness of breath after exposure to irritant fumes what is it Ix Mx
reactive airway dysfunction syndrome (RADS) positive methacholine challenge test inhaled bronchodilators
62
Mx of reactive airway dysfunction syndrome
inhaled bronchodilators cromolyn sodium
63
pneumonia very bad breath cause???
mixed anaerobes
64
most common cause of pneumonia gram stain catalase
strep pneumonia gram + catalase -
65
staphylococcus aureus gram? coagulase?
gram + coagulase +
66
Mx of acute COPD exacerbation
nebulised bronchodilators + O2 aminophylline if no response
67
feverish cough clear sputum
bronchitis
68
white out of the hemithorax after aspiration of foreign body...
atelectasis due to bronchial obstruction
69
mediastinal shift towards the CXR opacification is...
atelectasis
70
mediastinal shift away from the CXR opacification is...
pleural effusion or tension pneumo
71
what is plastic bronchitis
accumulations of fluid and mucus in the shape of the airways when the patient coughs they cough up gelatinous tubular structures
72
most common causative agent of common cold
rhinovirus
73
diagnostic investigation for empyema
thoracocentesis
74
which organism renders a CF pt ineligible for lung transplant
burkholderia
75
lower lobe pneumonia ....
aspiration pneumonia
76
currant jelly sputum....
klebsiella
77
over administration of O2 in a COPD patient leads to what acid base abnormality
respiratory acidosis with compensatory metabolic alkalosis
78
emphysema in lower lobes ...
alpha 1 antitrypsin deficiency
79
emphysema in upper lobes....
COPD
80
allergic bronchopulmonary aspergillosis Mx 1st and 2nd line
1st prednisolone 2nd itraconozole
81
Pneumonia and cold sore is what organism?
Streptococcus pneumonia
82
4 most common organisms of bronchiectasis infection
haemophilus influenza pseudamonas strep pneumonia stash aureus
83
indications for LTOT
pao2 between 7.3 - 8 and secondary polycythemia or pulmonary hypertension or peripheral oedema
84
length of time they need to be on LTOT
15hours daily
85
when should all cases of pneumonia receive a chest x ray?
6 weeks
86
which cancers are assoc with asbestos exposure. what is more common
small cell lung cancer (more common) mesothelioma
87
fever. initial dry cough and now productive. what is this
bronchitis
88
PE Ix + Mx. Wells < 4
d dimer. if + do ctpa
89
PE Wells >4
CTPA. if + give DOAC if - do proximal leg vein Ultrassound
90
DVT Wells < 2
d dimer if + do leg vein ultrasound in 4 hrs if - consider another diagnosis
91
DVT Wells >2
leg vein ultrasound if + start DOAC
92
DVT Mx in oregnancy
lowe molecular weight heparin
93
features of COPD steroid responsiveness
any previous, secure diagnosis of asthma or of atopy a higher blood eosinophil count substantial variation in FEV1 over time (at least 400 ml) substantial diurnal variation in peak expiratory flow (at least 20%)
94
Target O2 sats for non COPD retainer
94-98
95
first line Ix for children aged 5-16 with suspected asthma
FeNO testing
96
empyema
collection of pus in the pleural cavity
97
Mx of empyema
chest drain and antibiotics

AMK (30 decks)

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