Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 4 Final > Respiratory > Flashcards

Respiratory Flashcards

1
Q

First line for acute bronchitis

A

Doxycyline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is pneumoconiosis?

A

Accumulation of dust in the lungs and the response of the bodily tissue to its presence, most commonly used in relation to coal worker’s pneumoconiosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What do you hear in lung auscultation in pulmonary oedema?

A

Fine crackles as a result of fluid in the alveolar space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Features of pulmonary oedema on a chest X-ray

A

Interstital oedema
Bat wing appearance
Upper lobe diversion
Kerley B line
PE
Cardiomegaly may be seen if cardiogenic cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When should you consider azithromycin in people with COPD?

A

Do not smoke and
have optimised non-pharmacological management and inhaled therapies, relevant vaccinations and (if appropriate) have been referred for pulmonary rehabilitation and continue to have 1 or more of the following, particularly if they have significant daily sputum production:
frequent (typically 4 or more per year) exacerbations with sputum production
prolonged exacerbations with sputum production
exacerbations resulting in hospitalisation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the parneoplastic manifestations of small cell lung cancer?

A

Ectopic production of ACTH and ADH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the parneoplastic manifestations of squamous cell lung cancer?

A

Parathyroid hormone related proteins are produced leading to hypercalcaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Most common organism causing infective exacerbation of COPD

A

Haemophilus influenza

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is a pack year

A

20 cigarettes per day for 1 year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

NICE guidelines recommend prescribing what for patients with COPD who have had >3 exacerbations requiring steroid therapy and at least one exacerbation requiring hospital admission in the previous year

A

Azithromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is A1AT deficiency?

A

Common inherited condition caused by a lack of a protease inhibitor (Pi) normally produced by the liver. The role of A1AT is to protect cells from enzymes such as neutrophil elastase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What can transudates indicate?

A

heart failure (most common transudate cause)
hypoalbuminaemia (liver disease, nephrotic syndrome, malabsorption)
hypothyroidism
Meigs’ syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What can exudates indicate?

A

infection: pneumonia (most common exudate cause), TB, subphrenic abscess
connective tissue disease: RA, SLE
neoplasia: lung cancer, mesothelioma, metastases
pancreatitis
pulmonary embolism
Dressler’s syndrome
yellow nail syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Parneoplastic syndromes most associated with adenocarcinoma?

A

Gynaecomastia
Hypertrophic pulmonary osteoarthropahy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Mneumonic for LTOT

A

The 4 Bs
Blue (cyanosis, sp02 <92%)
Breathing (severe airway obstruction, FEV1 <30%)
Blood (secondary polycythaemia)
Ballooning (peripheral oedema, raised JVP, hepatomegaly)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Triangle of safety for chest drain insertion

A

base of the axilla, lateral edge pectoralis major, 5th intercostal space and the anterior border of latissimus dorsi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

NICE only recommend giving oral antibiotics in an acute exacerbation of COPD in the presence of

A

Purulent sputum or signs of pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Most common sites of aspiration pneumonia?

A

Right middle and lower lung lobes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

First line after weight loss in sleep apnoea treatment?

A

CPAP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Why does polycythemia occur in COPD?

A

Secondary polycythemia can be caused by a high secretion of erythropoietin (EPO) in response to chronic hypoxia or as a consequence of an EPO-secreting tumor [3]. Theoretically, secondary polycythemia can be attributed to chronic obstructive pulmonary disease (COPD) in response to chronic hypoxia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are canon ball metastasis?

A

Refer to well-defined spherical nodules scattered over both lungs, being a classical presentation of hematogenous tumor spreading.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How much protein points to an exudate?

A

More than 30g/L protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Most common causes of bilateral hilar lymphadenopahty?

A

Sarcoidosis
TB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What test can help make chug strauss diagnosis?

A

ANCA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How can small vessel vasculitis be divided?

A

ANCA associated vasculitis
Immune complex mediated vasculitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

ANCA associated vasculitis types?

A

Microscpic polyangiitis
Granulomatosis with polyangitis
Eosinophilic granulomatosis with polyangitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is atelectasis?

A

Common postoperative complication in which basal alveolar collapse can lead to respiratory difficulty. It is caused when airways become obstructed by bronchial secretions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Management of atelectasis?

A

Positioning the patient upright
chest physiotherapy: breathing exercises

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Parneoplastic features of SCC LC>

A

parathyroid hormone-related protein (PTH-rp) secretion causing hypercalcaemia
clubbing
hypertrophic pulmonary osteoarthropathy (HPOA)
hyperthyroidism due to ectopic TSH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Fibrosis predominately affecting the upper zones

A

hypersensitivity pneumonitis (also known as extrinsic allergic alveolitis)
coal worker’s pneumoconiosis/progressive massive fibrosis
silicosis
sarcoidosis
ankylosing spondylitis (rare)
histiocytosis
tuberculosis
radiation-induced pulmonary fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Fibrosis predominately affecting the lower zones

A

idiopathic pulmonary fibrosis
most connective tissue disorders (except ankylosing spondylitis) e.g. SLE
drug-induced: amiodarone, bleomycin, methotrexate
asbestosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Features of idiopathic pulmonary fibrosis?

A

progressive exertional dyspnoea
bibasal fine end-inspiratory crepitations on auscultation
dry cough
clubbing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Criteria for discharge after an asthma attack?

A

been stable on their discharge medication (i.e. no nebulisers or oxygen) for 12–24 hours
inhaler technique checked and recorded
PEF >75% of best or predicted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Why can elevated calcium occur in sarcoidosis?

A

sarcoidosis can lead to hypercalcaemia due to the increased production of 1,25-dihydroxy vitamin D3 by activated macrophages and granulomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Features of acute sarcoidosis?

A

erythema nodosum, bilateral hilar lymphadenopathy, swinging fever, polyarthralgia
insidious: dyspnoea, non-productive cough, malaise, weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Features of primary ciliary dyskinesia?

A

dextrocardia or complete situs inversus
bronchiectasis
recurrent sinusitis
subfertility (secondary to diminished sperm motility and defective ciliary action in the fallopian tubes)

q

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

CXR features in COPD?

A

hyperinflation
flattened hemidiaphragms
hyperlucent lung fields

38
Q

LTOT in COPD mneuomic

A

lungS POP
Secondary polycythaemia
Peripheral oedema
Oxygen 7.3-8
Pulmonary hypertension

39
Q

Which Oral prophylactic antibiotic therapy is used for COPD patients

A

Azithromycin

40
Q

An increase in the FEV1 of what after inhalation of a short-acting bronchodilator is indicative of asthma

A

12% or more

41
Q

Features of kartenger’s syndrome?

A

dextrocardia or complete situs inversus
bronchiectasis
recurrent sinusitis
subfertility (secondary to diminished sperm motility and defective ciliary action in the fallopian tubes)

42
Q

Causes of actual mediastinal widening include:

A

vascular problems: thoracic aortic aneurysm
lymphoma
retrosternal goitre
teratoma
tumours of the thymus

43
Q

What is acute respiratory distress syndrome?

A

acute condition characterized by bilateral pulmonary infiltrates and severe hypoxemia (PaO2/FiO2 ratio < 200) in the absence of evidence for cardiogenic pulmonary oedema (clinically or pulmonary capillary wedge pressure of less than 18 mm Hg).

44
Q

Causes of adult respiratory distress syndrome?

A

Sepsis
Direct lung injury
Trauma
Acute pancreatitis
Long bone fracture or multiple fractures (through fat embolism)
Head injury (causes sympathetic nervous stimulation which leads to acute pulmonary hypertension)

45
Q

How is a diagnosis of mesothelioma made?

A

histology, following a thoracoscopy

46
Q

First line bronchodilator therapy for asthma?

A

a short-acting beta2-agonist (SABA) or short-acting muscarinic antagonist (SAMA) is first-line treatment

47
Q

A number of conditions predominantly cause fibrosis of the upper lobes. They can be summarised with the mnemonic CHARTS:

A

C- Coal worker’s pneumoconiosis
H - Histiocytosis/ hypersensitivity pneumonitis
A - Ankylosing spondylitis
R - Radiation
T - Tuberculosis
S - Silicosis/sarcoidosis

48
Q

NSCLC surgery contraindications?

A

assess general health
stage IIIb or IV (i.e. metastases present)
FEV1 < 1.5 litres is considered a general cut-off point*
malignant pleural effusion
tumour near hilum
vocal cord paralysis
SVC obstruction

49
Q

Indications for steroids in sarcoidosis?

A

patients with chest x-ray stage 2 or 3 disease who are symptomatic. Patients with asymptomatic and stable stage 2 or 3 disease who have only mildly abnormal lung function do not require treatment
hypercalcaemia
eye, heart or neuro involvement

50
Q

What is TLCO?

A

overall measure of gas transfer for the lungs from the alveoli into the capillaries and reflects how much oxygen is taken up into the red cells

51
Q

What is KCO?

A

TLCO divided by the alveolar volume, which makes it a measure of how efficient gas exchange is in relation to the alveolar-capillary surface to volume ratio.

52
Q

What is klebsiella pneumonia?

A

Gram-negative rod that is part of the normal gut flora. It can cause a number of infections in humans including pneumonia (typically following aspiration) and urinary tract infections.

53
Q

Features of Klebsiella pneumonia

A

more common in alcoholic and diabetics
may occur following aspiration
‘red-currant jelly’ sputum
often affects upper lobes

54
Q

Complications that may occur and which the patient should be advised of in the process of obtaining consent:

A

Failure of insertion - the drain may be abutting the apical pleura, in which case it should be pulled back, or may be subcutaneous or in rare cases could enter the abdominal cavity. In both latter cases, the drain should be removed and re-sited.
Bleeding - around the site of the drain or into the pleural space
Infection
Penetration of the lung
Re-expansion pulmonary oedema

55
Q

Mneumonic for asthma management?

A

‘Oh Shit, I Hate My Asthma’
oxygen, salbutamol, hydrocortisone, ipratropium, magnesium, aminophylline

56
Q

Pathophysiology of lung abscesses?

A

Polymycrobial in nature

57
Q

Commonest causes of an anterior mediastinum mass can be remembered by the 4 T’s:

A

teratoma, terrible lymphadenopathy, thymic mass and thyroid mass

58
Q

conditions that cause an increased KCO with a normal or reduced TLCO

A

pneumonectomy/lobectomy
scoliosis/kyphosis
neuromuscular weakness
ankylosis of costovertebral joints e.g. ankylosing spondylitis

59
Q

Best pH for NIV?

A

7.25-7.35

60
Q

COPD staging criteria

A
61
Q

What is ipraprotium?

A

SAMA

62
Q

What is Eosinophilic granulomatosis with polyangiitis?

A

ANCA associated small-medium vessel vasculitis.

63
Q

Light’s criteria state that a pleural effusion is an exudate if:

A

Effusion lactate dehydrogenase (LDH) level greater than 2/3 the upper limit of serum LDH
Pleural fluid LDH divided by serum LDH >0.6
Pleural fluid protein divided by serum protein >0.5

64
Q

Hospital acquired pneumonia first line management?

A

co-amoxiclav

65
Q

Signs of a lung abscess?

A

dull percussion and bronchial breathing
clubbing may be seen

66
Q

Bloods in lung cancer?

A

raised platelets may be seen

67
Q

What is bupropion?

A

norepinephrine and dopamine reuptake inhibitor, and nicotinic antagonist

68
Q

COPD symptoms in a young person - think what?

A

alpha-1 antitrypsin (A1AT) deficiency

69
Q

Liver features in alpha 1 anti tirpsin deficinecy?

A

cirrhosis and hepatocellular carcinoma in adults, cholestasis in children

70
Q

Why would opu prescribe LABA and LAMA over LABA and ICS?

A

If patient has no asthma/steroi responsiveneness

71
Q

Squamous cell cancer features?

A

parathyroid hormone-related protein (PTH-rp) secretion causing hypercalcaemia
clubbing
hypertrophic pulmonary osteoarthropathy (HPOA)
hyperthyroidism due to ectopic TSH

72
Q

A normal PCO2 in an acute ashtma attack indicates what?

A

exhaustion and should, therefore, be classified as life-threatening.

73
Q

What type of lung cancer is gynaecomastia associated with?

A

Adenocarcinoma

74
Q

Mnemonic: assessing for LTOT - The 4 Bs

A

Blue (cyanosis, sp02 <92%)
Breathing (severe airway obstruction, FEV1 <30%)
Blood (secondary polycythaemia)
Ballooning (peripheral oedema, raised JVP, hepatomegaly)

75
Q

Management of a primary pneumothorax?

A

aspiration should be attempted
if this fails (defined as > 2 cm or still short of breath) then a chest drain should be inserted

76
Q

What is varenicline?

A

nicotinic receptor partial agonist

77
Q

What does a hyperexpaned middle and lower lobe look like?

A

hyperlucent- Blacker

78
Q

Acute features of sarcoidosis?

A

erythema nodosum, bilateral hilar lymphadenopathy, swinging fever, polyarthralgia

79
Q

Chest drain swinging

A

Rises in inspiration, falls in expiration

80
Q

Management of alpha 1 antitrypsin deificiency?

A

no smoking
supportive: bronchodilators, physiotherapy
intravenous alpha1-antitrypsin protein concentrates
surgery: lung volume reduction surgery, lung transplantation

81
Q

Pack per year equation?

A

1 pack/day X1 year

82
Q

What is Legionnaire’s disease?

A

Lung infection you can get from inhaling droplets of water from things like air conditioning or hot tubs. It’s uncommon but it can be very serious.

83
Q

Symptoms of legionnaires disease?

A

Symptoms of Legionnaires’ disease include:a cough
difficulty breathing
chest pain
a high temperature
flu-like symptoms

84
Q

If insufficient air expansion despite chest drain insertion what is next?

A

video-assisted thoracoscopic surgery (VATS) should be considered to allow for mechanical/chemical pleurodesis +/- bullectomy.

85
Q

What does the pleural effusion fluid proein/serum protein ratio have to be for PE fluid to be an exudate?

A

More than 0.5

86
Q

What is the henderson hasselbach equation

A
87
Q

What is lactate?

A

Source of hydrogen ions

88
Q

What does high lactate indicate?

A

Tissue ischaemia

89
Q

Why can you stil clear CO2 in pneumonia?

A

More soluble so unless you have ventilation problem can still clear it

90
Q

What is usual cut off to give blood transfusion?

A

70

91
Q

How long does bicarbonate take to get chronically raised?

A

Days to weeks so important to think is this chronic when looking at COPD patient

92
Q

If give oxygen what is important to think about with CO2

A

CO2 bind to haemoglobin if given oxygen knocks it off so then more CO2 in the body

Year 4 Final (39 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions