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. salbutamol
  2. ICS (beclometasone)
  3. add LTRA (montelukast)
  4. add LABA (salmetarol)
  5. add LAMA (triotropium)
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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
Q

lights criteria is used for…

A

classifying pleural effusions

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26
Q

lights criteria

A

pleural fluid : serum protein = >0.5
pleural fluid : serum LDH = >0.6
pleural fluid LDH is >2/3 of upper limit

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27
Q

stony dullness on percussion/auscultation

A

pleural effusion

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28
Q

hyper-resonant percussion

A

COPD

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29
Q

worsening renal function after starting on ACE inhibitor

A

flash pulmonary edema

30
Q

aspiration pneumonia Mx

A

antibiotics (similar to CAP)
swallowing assessment
if no known cause of dysphagia -> upper GI endoscopy

31
Q

where do adenocarcinomas grow in the lung

A

commonly present as lesions in the peripheries of the lung

32
Q

where do squamous cell carcinomas grow in the lung

A

central cavitating lesions

33
Q

productive cough, mucopurulent and blood tinged, recurrent episodes of pneumonia throughout their life
suspect…?

A

bronchiectasis
Dx with CT

34
Q

sudden cough and SOB, fine crackles in lung bases. has cardiac risk factors (HTN and hyperlipidaemia)
suspect…?

A

flash pulmonary edema (from taking ACEIs)

35
Q

stoney dullness

A

pleural effusion

36
Q

protein level of >x is exudative

A

25

37
Q

Silent chest shows…

A

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
Q

Stridor

A

Noise originating from outside the thoracic cavity, noisy inhalation, quiet exhalation
Foreign body

39
Q

Wheeze

A

Inside thoracic cavity
Exhalation is noisier

40
Q

Target o2 sats for co2 retainers

A

88-92

41
Q

When are reservoir masks used

A

Emergency
10-15 l min

42
Q

Adverse reactions of beta 2 agonists

A

Sinus tachycardia, fine tremor

43
Q

Adverse reactions of muscarinic antagonists

A

Dry mouth
Blurred vision
Urinary retention
Constipation

44
Q

two symptoms that are highly suggestive of sarcoidosis

A

bi hilar lymphadenopathy
erythema nodosum

45
Q

symptoms of moderate asthma exacerbation

A

PEF 50-75% of expected

46
Q

symptoms of acute severe exacerbation

A

PEF 33-50% of expected
can’t speak full sentences
sats 92%
accessory muscle use

47
Q

symptoms of life threatening asthma

A

PEF < 33%
exhaustion
confusion
altered consciousness
silent chest

48
Q

what is the CURB65 score

A

confusion
urea >7
resp rate >30
blood pressure <90/60
age > 65

49
Q

management of curb score 0-1

A

5 days of amoxicillin

50
Q

management of curb score 2

A

oral amoxicillin and clarithromycin

51
Q

Mx of curb score 3-5

A

in hospital
IV co amoxiclav

52
Q

what to give for pseudomonas bronchiectasis

A

ciprofloxacin

53
Q

klebsiella pneumonia is found where and what is the Tx

A

upper lobe pneumonia
meropenem

54
Q

What is meigs syndrome

A

Benign ovarian tumour
Transudative pleural effusion
Ascites

55
Q

Smoker presents with cough, eyelid drooping, dryness on one side of face

A

Could be pancoast tumour (apical region) causing compression of sympathetic nerves
Chest x ray !

56
Q

Bronchoscopy vs cxr for lung cancer

A

Bronchoscopy for central lesions
Cxr for general / peripheral lesions

57
Q

wheeze sounds like ..? and indicates..?

A

noisy exhalation
issue inside the thoracic cavity

58
Q

stridor sounds like..? and indicates..?

A

noisy inhalation
issue outside thoracic cavityq

59
Q

cause of unequal air entry

A

foreign object aspiration

60
Q

4 drugs for TB + 2 continuation drugs

A

RIPE
rifampicin
isoniazid (add B6 pyroxidine to prevent peripheral neuropathy)
pyrazinamide
ethambutol

continue: rifampicin + isoniazid

61
Q

wheezing, shortness of breath after exposure to irritant fumes
what is it
Ix
Mx

A

reactive airway dysfunction syndrome (RADS)
positive methacholine challenge test
inhaled bronchodilators

62
Q

Mx of reactive airway dysfunction syndrome

A

inhaled bronchodilators

cromolyn sodium

63
Q

pneumonia

very bad breath
cause???

A

mixed anaerobes

64
Q

most common cause of pneumonia
gram stain
catalase

A

strep pneumonia
gram +
catalase -

65
Q

staphylococcus aureus gram? coagulase?

A

gram +
coagulase +

66
Q

Mx of acute COPD exacerbation

A

nebulised bronchodilators + O2
aminophylline if no response

67
Q

feverish
cough
clear sputum

A

bronchitis

68
Q

white out of the hemithorax after aspiration of foreign body…

A

atelectasis due to bronchial obstruction

69
Q

mediastinal shift towards the CXR opacification is…

A

atelectasis

70
Q

mediastinal shift away from the CXR opacification is…

A

pleural effusion or tension pneumo

71
Q

what is plastic bronchitis

A

accumulations of fluid and mucus in the shape of the airways
when the patient coughs they cough up gelatinous tubular structures

72
Q

most common causative agent of common cold

A

rhinovirus