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Respiratory Flashcards

1
Q

Paroxysmal and reversible obstruction of the airways

History of recurrent episodes of wheezes, chest tightness, breathlessness, and/or cough, particularly at

night/early morning

Symptoms may be triggered by specific triggers (e.g. pollens, pets, cold air or perfumes)

Symptoms may worsen after taking beta-blockers, aspirin or NSAIDs (BAN) — Paracetamol is safe

Evidence of variable airflow obstruction seen on tests such as peak expiratory flow measurement

A

Asthma

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2
Q

Bronchospasm (smooth muscle spasm narrowing airways)

Excessive production of secretions (plugging airways)

A

Acute asthma

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3
Q

Risk Factors for Asthma

A

A combination of genetic & environmental factors

Personal history of atopy (genetic tendency to develop allergic diseases) such as eczema

Family history of asthma or atopy

Inner city environment

Prematurity and low birth weight

Smoking

Maternal smoking

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4
Q

Presentation of Acute Asthma

A

Cough

SOB

Wheezes

Chest tightness

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5
Q

Slight tachypnea, tachycardia

Classically, expiratory wheeze is
heard (widespread wheeze)

A

Mild Attack

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6
Q

o Use of accessory muscles of
respiration

o Inability to complete a sentence
in one breath

o Intercostal retractions

A

Acute Severe Attack

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7
Q

Silent chest (no wheeze at all)
Exhaustion

Altered consciousness
Cyanosis

Arrythmia

hypotension

Poor respiratory effort

PEF <33% best or predicted
RR >26

Sp02 <92%

Pa02 <8 kPa

Normal PaCO2 (4.6-6 kPa)

A

Life-threatening Attack

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8
Q

SE of Atenolol

A

wheezing

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9
Q

SE of Ramipril

A

cough

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10
Q

Initial diagnostic tool — Reversible obstructive pattern

A

Pulmonary function tests (SPIROMETRY)

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11
Q

Day-to-day peak flow variability showing diurnal cycle

A

Treatment monitoring and adjustment

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12
Q

Diagnostic for Asthma

A

Symptoms of Asthma

Post-dilator improvement of >12% in FEV1/FVC

Unexplained peripheral blood eosinophilia

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13
Q
  1. Low dose inhaled steroid (preventer) + SABA when needed (reliever)
A

Asthma in adults

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14
Q
  1. Very low dose inhaled steroid + SABA when needed (reliever)
A

Asthma in children

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15
Q

Add LTRA (e.g. Montelukast)

A

Asthma in adults

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16
Q

> 5 years — LABA or LTRA // <5 years — LTRA

A

Asthma in children

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17
Q

Increase the dose of inhaled steroids OR add
LABA (Salmeterol)

A

Asthma in adults

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18
Q

Increase the dose of inhaled steroid

A

Asthma in children

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19
Q

In severe cases — Short-term oral steroid

A

Asthma in adults

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20
Q

In severe cases — SR Theophylline

A

Asthma in children

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21
Q

Immediate treatment [OSTHP]

A
  1. Start O, if saturation < 92%, aim for 94-98%
  2. Salbutamol 5mg (or terbutaline 10mg) nebulized with 02
  3. IV Hydrocortisone 100mg OR oral prednisolone 40-50 mg
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22
Q

Where diagnosis is uncertain but with
demonstration of airway obstruction [EEV1/FVC « 0.7),

A

reversibility testing and trial of assessment are suggested

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23
Q

Chest X-ray is not a routine assessment
but it’s useful for

A

Exclusion

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24
Q

Only benefit for IV hydrocortisone over
oral prednisolone if patient is vomiting or having severe dyspnea where they cannot consume oral medication

A

True

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25
Q

If immediate TTT is not working, add

A

ipratropium - MgS04 — IV aminophylline + IV salbutamal (ICU)

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26
Q

In children, tx pf acute exacerbation

A

OSIPH
IV Salbutamol or IV Aminophylline
Mgs04 comes last

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27
Q

Side effect of B2 agonist

A

Palpitation and Tachycardia

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28
Q

If life threatening features are present (SIM)

A
  1. Give salbutamol nebulizers every 15 minutes, or 10 mg continuously
  2. Add in ipratropium 0.5mg to nebulizers
  3. Give single dose of Mg504 (1.2-2g IV) over 20 minutes
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29
Q

If improving within 15-30 minutes (SP)

A
  1. Nebulized Salbutamol every 4 hrs
  2. Prednisolone 40-50 mg PO OD for 5-7 days
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30
Q

» It’s a sign of poorly controlled asthma

» Choice of medication: Short acting beta 2 agonist (used before exercise)

» Review of the regimen including inhaled corticosteroids should be done

A

Exercise-induced asthma

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31
Q
  • Patients who are well controlled on inhaled corticosteroids but complains of exercise being the specific problem,
    then consider ADDING either:
A
  • Leukotriene receptor antagonist (LTRA) = Montelukast
  • Along-acting beta 2 agonist (LABA) = Salmeterol
  • Sodium cromoglicate
  • An oral beta 2 agonist
  • Theophylline
  • This would be taken 2h before an exercise and will prevent symptoms for approximately 12h
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32
Q

» History of smoking and progressive dyspnea

» Evidence of irreversible airflow obstruction on spirometry
- FEV1 < 80% predicted
- FEV1/FVC < 0.7 (Post-dilator)

» All spirometry findings are increased (TLC, RV) except for DLCO & VC

A

COPD

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33
Q

Presentation of COPD

A
  • Cough + sputum production
  • Dyspnea
  • low-grade fever (mostly afebrile)
  • Wheezes
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34
Q

Investigations of COPD

A

Raised hematocrit

Chest X-ray is not recommended but if ordered
- Hyperinflated lung fields
- Flattened diaphragm
- Prominent posterior ribs markings (>7 posterior ribs seen)
- Small heart
- May see bullae

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35
Q

Productive cough (TABLESPOON of mucus)
that lasts for three months or more per year
for at least two years

A

Chronic Bronchitis

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36
Q

is now the preferred term for patients
with airflow obstruction who were
previously diagnosed with chronic bronchitis
or emphysema

A

COPD

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37
Q

Asthma Vs COPD

A

Reversibility distinguishes asthma from
COPD

COPD is almost refractory to medication
Almost all COPD patients do smoke or have
smoked in the past

COPD tend to be in old age (>35 years)

» Asthma patients can develop COPD later in life
» Venturi mask doesn’t create +ve pressure
unlike non-invasive ventilation

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38
Q

MAanagement of COPD

A
  • Antibiotics — If sputum is purulent or clinical signs of pneumonia
  • Prednisolone 30mg/day for 7-14 days
  • Nebulized normal saline — to clear out mucus
  • Inhaled or nebulized bronchodilators
  • Controlled 02 therapy 24% via Venturi face mask, with oximetry Maintain saturations between 88% and 92%
  • |V aminophylline Beneficial if the patient is wheezy and has not improved with nebulizers alone
  • Non-invasive ventilation — RR> 30, pH< 7.34, falling Pa02 or rising PaC0O2 despite medical treatment
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39
Q

Invasive mechanical ventilation

Indications

A
  • Failed NIV
  • Contraindicated NIV in scenarios such as: respiratory arrest, high aspiration risk or impaired mental status
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40
Q

Complications
Invasive mechanical ventilation

A

¢ Pneumonia
* Barotrauma
* Failure to wean to spontaneous ventilation

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41
Q

A respiratory stimulant, given IV

Used to drive respiratory rate if >20 breaths/minute

Been replaced by NIV

A

Doxapram

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42
Q

amount of air in the lungs after maximal inspiration

A

TLC

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43
Q

amount of air that remains in the lungs after maximal expiration

A

RV

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44
Q

amount of air that is pushed out of the lungs after maximal inspiration

A

VC

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45
Q

amount of air pushed out of the lungs after forced maximal expiration

A

FVC

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46
Q

amount of air pushed out of the lungs in 1sec during maximal expiration

A

FEV1

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47
Q

FEV1 - decreased
Less than 80% of predicted

A

Obstructive

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48
Q

FEV1 - decreased
Less than 80% of predicted

A

Restrictive

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49
Q

FvC N
More than 80% of predicted

A

Obstructive

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50
Q

FvC - decreased
Less than 80% of predicted

A

Restrictive

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51
Q

FEV1/FVC decreased
Less than 0.7

A

Obstructive

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52
Q

FEV1/FVC - N
0.7-0.8
OR
increased
More than 0.8

A

Restrictive

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53
Q

Obstructive Lung Disease
vs
Restrictive Lung Disease

A
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54
Q

Long-term oxygen therapy (LTOT)

A

Prescribed to patients with COPD and severe chronic hypoxemia

7 Once started, it’s likely to be life-long
# Usually given over a minimum of 15h a day

Add-ons to improve breathlessness = Prednisolone or Nebulized normal saline

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55
Q

Possible candidates

A
  • Very severe airflow obstruction — FEV] < 30% predicted
  • Polycythemia
  • (Cyanosis
  • Peripheral swelling
  • Raised JVP
  • Oxygen saturation 92% or less on room air
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56
Q

Conditions for assessment

A

® Patient should be stable and >5 weeks have passed since last exacerbation of COPD

® (On a fully optimized treatment for COPD

  • 2 sets of ABG are taken 3 weeks apart to ensure the patient is sufficiently hypoxic
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57
Q

Indications

A
  • p02<7.3kPa
  • p02 =7.3kPa+ one of the following:
  • 2ry polycythemia (raised hematocrit)
  • Peripheral edema
  • Pulmonary hypertension
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58
Q

Non-invasive ventilation
Indications

A
  1. Acidosis (pH <7.35)
  2. Rising PaCO2
  3. Falling Pa02
  4. RR=30

All of these despite medical management (steroids, nebulized bronchodilators & standard 02 therapy) is an

indication of non-invasive ventilation

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59
Q

Risk Factors for Pulmonary Embolism

A
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60
Q

is suspected with normal X-ray & normal chest examination

A

Pulmonary embolism

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61
Q

Respiratory alkalosis + Hypoxia =

A

Pulmonary embolism

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62
Q

Respiratory alkalosis + NO hypoxia =

A

Panic attack

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63
Q

Symptoms of PE

A

Dyspnea
Pleuritic chest pain or retrosternal chest pain
Cough and hemoptysis

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64
Q

Signs of PE

A
  • Tachypnea, tachycardia
  • Hypoxia, anxiety, restlessness, agitation and impaired consciousness
    ® Pyrexia
  • Elevated JVP
  • Gallop heart rhythm, a widely split-second heart sound, tricuspid regurgitant murmur
  • Pleural rub
  • Systemic hypotension and cardiogenic shock
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65
Q

Diagnosis of Pulmonary Embolism

A

CTPA (CT pulmonary angiogram) — Gold standard

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66
Q

Management of Pulmonary Embolism

A

Immediate administration of LMWH once PE is suspected (even prior to CTPA)

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67
Q

Results in hyperventilation which causes a respiratory alkalosis

There would be no metabolic compensation as panic attacks resolve rapidly

We would not expect any metabolic compensation as it takes the kidneys days to conserve acid

Pa02 would be normal

A

Panic attacks

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68
Q

Pulmonary embolism in pregnancy

A

Chest X-ray should be requested first before deciding whether a V/Q scan or CTPA should be done, in order to
exclude other pulmonary diseases such as pneumonia, pneumothorax or lobar collapse

Abnormal X-ray + clinical suspension of PE = CTPA

Normal X-ray + clinical suspicion of PE = V/Q sean

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69
Q

Pulmonary embolism in pregnancy

A
70
Q

Pulmonary embolism in pregnancy

A
71
Q

Pulmonary embolism in pregnancy

A
72
Q

Pneumocystis carinii pneumonia (PCP) (Pneumocystis jiroveci pneumonia)

A

» HIV patient + desaturation on exercise while normal during rest

» HIV is an important risk factors especially if CD4 <200/mm? — should receive PCP prophylaxis (co-trimoxazole)

73
Q

Pneumocystis carinii pneumonia (PCP) (Pneumocystis jiroveci pneumonia)

Features

A
  • Exertional dyspnea
  • Gradual onset of dry cough
  • Fever
  • Tachypnea
  • May be signs of AIDS (e.g. Thrush)
  • Chest examination is typically normal
  • Could present with Herpes labialis
74
Q

Pneumocystis carinii pneumonia (PCP) (Pneumocystis jiroveci pneumonia)

Investigation

A
  • Sputum
  • Bronchoscopy with bronchoalveolar lavage
75
Q

Pneumocystis carinii pneumonia (PCP) (Pneumocystis jiroveci pneumonia)

Management

A

Co-trimoxazole (trimethoprim-sulfa) in severe cases

Atovaquone in mild to moderate cases

76
Q

HIV + dry cough

A

PCP

77
Q

HIV + productive cough

A

TB

78
Q

Prophylaxis in HIV with mycobacterium avium & CD4<50

A

Azithromycin

79
Q

Think of flu like symptoms in an

A

Immunocompromised patients

80
Q

Caused by Legionella pneumophila

Acquired by droplet inhalation of contaminated water

Severe, potentially fatal acute pneumonia

A

Legionnaires disease

  • they often mention hints like travelling, hotel spas or hot tubs [millionaire]
81
Q

Features of
Legionnaires disease

A

Flu-like symptoms

Cough: dry — productive

Fever, diarrhea, vomiting, confusion, coma

82
Q

Investigations of
Legionnaires disease

A

Sputum — Black currant jelly

Chest X-ray (should be arranged as a follow uo around 6 weeks after discharge — Bi-basal consolidation

Specific blood results:
Low sodium
Lymphocytopenia (low WBCs)
Low albumin
Elevated Liver enzymes

83
Q

Management of
Legionnaires disease

A

Clarithromycin/Azithromycin +/- rifampicin or fluoroquinolone

Clarithromycin + statin may lead — rhabdomyolysis = pause/decrease statins OR give Doxycycline

instead

Clarithromycin + salbutamol can cause — hypokalemia
 

84
Q

Features of
Mycoplasma (atypical pneumonia)

A
  • Young adults (living in dorms)
  • Dry cough
  • NoSOB
  • Joint pain + rash (erythema multiform — target lesions on the back of the hand)
  • low grade fever + flu-like symptoms
85
Q

Chest X-ray of
Mycoplasma (atypical pneumonia)

A

perihilar shadowing + bilateral patchy consolidation

86
Q

Management of
Mycoplasma (atypical pneumonia)

A

Erythromycin

87
Q

Commonest causative organisms — Staph, Strept, H. influenza

A

Aspiration pneumonia

88
Q

risk factors for predicting mortality

A

CURB-65

89
Q

CURB-65

A
  • Confusion
  • Urea >7mmol/L (>19 mg/dl)
  • Respiratory rate >30/min
  • BP <90/60mmHg

® Age265

Score is also used in case of community acquired pneumonia

90
Q
  • A complication of pneumonia as well as invasive procedures of the thorax
  • Pneumonia — Parapneumonic effusion — Pleural empyema
  • Suspected when pneumonia does NOT improve with antibiotics
  • Empyema usually starts in the lower lobe where sound would be absent
  • Pneumonia and empyema share similar symptoms
A

Pleural empyema

91
Q

Pleural empyema
Other features

A
  • Swinging fever, night sweats
  • Weight loss
  • Chest pain
92
Q

Pleural empyema
Investigation

A
  • Pleural aspiration
  • Blood and sputum culture
    ® HIV test
93
Q

Pleural empyema
Management

A

® Chest drain, if:
- pH of the pleural aspirate is <7.2
- Effusion is causing respiratory compromise

94
Q

Pneumothorax

Risk factors

A

Smoking

95
Q

Types
Pneumothorax

A
  1. Primary spontaneous
    - Occurs without apparent cause
    - Most commonly in tall, athletic, thin men aged 20-40 years
    - 90% unilateral (commonly at right side)
    - Usually caused by rupture of a small subpleural blebs (collection of air < 2cm)
    - Presented with dyspnea, chest pain, cough & tachypnea
  • lpsilateral decreased chest wall movement, hyper-resonant hemithorax to percussion
  1. Secondary spontaneous
    - Occurs in presence of existing lung pathology (e.g. Asthma, COPD)
  2. Simple pneumothorax
    - Non-expanding collection of air around the lung

4, Tension pneumothorax [one-way valve]
- Expanding collection of air around the lung
Investigation

96
Q

Pneumothorax
Investigation

A

» Chest X-ray — Diagnostic
- Visible lung edge and absent lung markings peripherally

» ABG — if patient is dyspneic, cyanosed or there’s an underlying condition

97
Q

NO distended neck veins
NO tracheal deviation
Usually caused by stabbing injuries

A

Hemothorax

98
Q

Management of 2ry spontaneous pneumothorax

A

> 2cm (50%) OR Hypoxic — Chest drain
<2cm (50%) — Cannula insertion

99
Q
  • Acute respiratory distress * NO tracheal deviation
  • Hypotension * Usually caused by stabbing injuries
  • Raised JVP Management of 2ry spontaneous pneumothorax
  • Tracheal deviation away from the pneumothorax side
  • Reduced air entry on affected side
A

Tension pneumothorax

100
Q

Non Tension Pneumothorax

A
101
Q

Management of Tension Pneumothorax

A
  1. Initial = High flow 02
  2. Insert large-bore cannula into 2” intercostal space in midclavicular line (just above 3™ rib) on side of pneumothorax — hiss sound is from the air escaping and confirms the diagnosis
  3. Do NOT wait for chest X-ray if the patient is seriously compromised or cardiac arrest has occurred or if the
    diagnosis is clinically certain
  4. Air should be aspirated until the patient is less distressed, then insert a chest drain in mid-axillary line
    leaving the cannula in place until you’ve finished and the underwater seal is bubbling satisfactorily
  5. Always perform a chest X-ray post chest drain insertion to ensure the drain is appropriately placed
102
Q

Seen in both tension pneumothorax and
cardiac tamponade

A

Engorged neck veins indicate high pressure in the right ventricle

103
Q

Beck’s triad for cardiac tamponade

A
  1. Engorged neck veins
  2. Hypotension
  3. Muffled heart sounds (Vs. reduced air entry and tracheal deviation in tension pneumothorax)
103
Q

Non Tension Pneumothorax

A
104
Q

Causes of post-operative breathlessness

A

Infection/atelectasis
- Occurs early (within hours)
- Common in smokers

Pulmonary embolism
- Occurs early (within hours/days)

Left ventricular failure (LVF) (fluid overload)

Exacerbation of underlying disease such as COPD

Tension pneumothorax

105
Q

» The collapse or closure of a lung resulting in reduced or absent gas exchange (Reduced air entry)

» History of smoking

A

Atelectasis

106
Q

Alveoli either deflated or filled with alveolar fluid

A
  • Atelectasis
107
Q

may happen in about 3 days if atelectasis is not resolved. If this happens, fever will persist and X-ray will show infiltrates.

A

Pneumonia

108
Q

Management of Atelectasis

A

Analgesia — To encourage expectoration
Nebulized saline
Chest physiotherapy
Deep breathing and coughing
Postural drainage
Incentive spirometry
If lung doesn’t re-inflate = Bronchoscopy to suction out secretions
 

109
Q

Non Tension Pneumothorax

A
109
Q

Irreversible dilatation of small and medium sized bronchi, with chronic airway inflammation destroying their elastic and muscular structure

It’s associated with chronic sputum production, chronic cough, recurrent acute chest infections and airflow
obstruction

A

Bronchiectasis

110
Q

Etiology
Bronchiectasis

A

Infection — Most common
- Childhood respiratory viral infections (e.g. measles, pertussis, influenza, respiratory syncytial virus)
- TB
- Bacterial pneumonia — Look out for history of recurrent pneumonia

  • Immunodeficiency
  • HIV — Serious, persistent or recurrent infections

+ Connective tissue diseases
- RA
- Sjogren’s $
- Systemic sclerosis
= SLE PR
- Ehlers-Danlos $
- Marfan’s §
* Toxic insults
- Gastric aspiration
- Inhalation of toxic gases

  • Congenital defects
  • Cystic fibrosis = Most important to exclude
111
Q

Bronchiectasis

A
112
Q

» Malignant mesothelioma is a tumor of mesothelial cells that usually occurs in the pleura, rarely in peritoneum

» Associated with occupational exposures to asbestos (history of being a builder)

» Latent period between exposure and development of the tumor may be up to 45 years

» Deaths are reported to the coroner as it’s an industrial disease

A

Mesothelioma

113
Q

Mesothelioma
Features

A
  • SOB, chest pain, weight loss = Most common symptoms
  • Finger clubbing
  • Recurrent pleural effusion admission
114
Q

Signs of metastasis
Mesothelioma

A
  • Lymphadenopathy
    *Hepatomegaly
  • Bone pain and tenderness
  • Abdominal pain or obstruction (peritoneal malignant mesothelioma
115
Q

Investigation
Mesothelioma

A
  • Chest X-ray — Pleural thickening or effusion
  • Thoracoscopy under local anesthetic:
  • Pleural fluid aspiration and cytological analysis — very sensitive
  • Pleural biopsy = Most definitive
  • lt also enables drainage of pleural fluid, and pleurodesi
  • The diagnosis is often made post-mortem
116
Q

Management
Mesothelioma

A
  • Usually symptomatic
  • Cure is only possible with surgery for localized (stage I)
117
Q
  • When cancer-fighting antibodies (WBCs) mistakenly attack normal cells in the nervous system
  • Often associated with SCLC

® SCLC — Lambert-Eaton 5 (proximal muscle weakness, depressed tendon reflexes & autonomic changes) +
Hyponatremia due to SIADH + Hypokalemia (increased mineralocorticoid activity)

  • Sq. cell = Hypercalcemia due to PTH like action
A

Paraneoplastic syndromes

118
Q

Extrinsic allergic alveolitis/Hypersensitivity pneumonitis

A
  • Due to repeated inhalation of organic antigens in dusts (e.g. from dairy or grain products, animal dander and
    protein and water reservoir vaporizers)
  • Occupational risk: farmers, vets, bakers and people dealing with chemicals
119
Q
  • Chest X-ray —
    Extrinsic allergic alveolitis/Hypersensitivity pneumonitis
A

Diffuse micronodular interstitial shadowing

120
Q

There are 3 forms of extrinsic allergic alveolitis

A
  1. Acute
  • Symptoms start 4-8h after exposure to the sensitizing antigen and resolve quickly, within days
  • Flu-like illness with fever, chest tightness, dry cough, dyspnea
  • Associated symptoms: malaise, chills, headache, generalized aches and pains. Sometimes wheezes
  • Signs: fever, tachypnea and bi-basal fine respiratory crackles

2.Subacute

3.Chronic

121
Q

A systemic disease of unknown cause

Characterized histologically by the presence of non-specific non-caseating granulomas in the lungs and other

A

Sarcoidosis

122
Q

Sarcoidosis
Presentation

A
  • Up to 50% are asymptomatic (discovered accidently by chest X-ray — Hilar adenopathy)

+ Involves almost any organ system but pulmonary is the most common

+ Fever, Fatigue

  • Skin: erythema nodosum
  • Eyes: Uveitis

+ Kidneys: Stones

  • Lymphadenopathy
123
Q

Heerfordt-Waldenstrom

A
124
Q

Lofgren

A
125
Q

Lung + kidney

A

Goodpasture

126
Q

Lung + GIT

A

Cystic Fibrosis

127
Q

Lung + eye

A

Pancoast Tumor

128
Q

Investigations of Sarcoidosis

A
129
Q

Treatment of Sarcoidosis

A

Steroids

130
Q

A tumor of the pulmonary apex

Defined primarily by its location situated on top of end of
either right or left lung

A

Pancoast Tumor

131
Q

Presentation of
Pancoast Tumor

A
  • Ipsilateral invasion of cervical sympathetic plexus — Horner’s $
    (ptosis, myosis, anhidrosis + enophthalmos)
  • Brachial plexus invasion — Muscle wasting of the intrinsic
    hand muscles and paresthesia in the medial side of the arm
    along with shoulder and arm pain
  • RLN compression — HOV
132
Q

Patient works as a farmer or a baker

A

Extrinsic allergic alveolitis/hypersensitivity pneumonitis

133
Q

Pt works at a pet shop —

A

[Ch]lamydiophilia pisittaci — Rx with [Cl]arithromycin

134
Q

Pt was in anything starts with [H] like Hospital, hostel, hotel, hot tub — Legionella

A

Legionella

135
Q

Bilateral cavitation in the lung (for any reason) + pneumatoceles

A

Staph

136
Q

Upper lobe cavitation on CXR —

A

Klebsiella — Rx with Cephalosporin (Keflex)

137
Q

Bilateral Patchy consolidation, Myalgia + peri-hilar shadowing on CXR, dry cough, target lesions on back of the
hands (erythema multiform)

A

Mycoplasma

138
Q
  • lobar consolidation on CXR —
    Most common cause of community-acquired
    pneumonia
A

Strept (G +ve cocci)

139
Q
  • lobar consolidation on CXR —
    Most common cause of community-acquired
    pneumonia
A

Strept (G +ve cocci)

140
Q

Bi-basal consolidation —

A

Legionella

141
Q

Peri-hilar interstitial shadowing —

A

Carinii

142
Q

Diffuse micronodular interstitial shadowing

A

Extrinsic allergic alveolitis

143
Q

Rusty-colored sputum

A

Strept

144
Q

Currant jelly

A

Klebsiella

145
Q

Green

A

Pseudomonas

146
Q

Purulent

A

Staph

147
Q

Pneumonia + neurological signs

A

Legionella

148
Q

Fever + murmur + pneumonia

A

Coxiella burentti

149
Q

Pneumonia + herpes labialis

A

Strept or Carinii

150
Q

Reticular infiltrations + ground-glass appearance

A

Viral/Atypical pneumonia [mycoplasma/legionella)

151
Q

Pneumatoceles

A

Staph

152
Q

Ashestoses

A

Mesothelioma

153
Q

Coal mining — Coal worker’s pneumoconiosis (CWP)

A

Progressive massive fibrosis

154
Q

Central lung cancers

A

Sq. cell + Small cell

155
Q

Peripheral lung cancers

A

Adenocarcinoma + Large cell

156
Q

Keratin pearls + intercellular bridges

A

Sq. cell

157
Q

Oat cell + neuroendocrine involvement

A

Small cell

158
Q

Glandular + mucin producing

A

Adenocarcinoma

159
Q

Anaplastic + undifferentiated sheets/nests of polygonal/multinuclear cells

A

Large cell

160
Q

Most common lung cancer in non-smokers

A

Adenocarcinoma

161
Q

A lung cancer with a strong smoking history

A

Sq. cell

162
Q

One side of the chest

A

Hemithorax

163
Q

Erythema nodosum

A

Sarcoidosis

164
Q

Erythema multiforme (target lesions at the back of the hand)

A

Mycoplasma pneumonia

165
Q

Post-flu illness

A

Staph

166
Q

Hyponatremia

A

Legionella

167
Q

Terminal case with noisy breathing — Terminal respiratory secretions (death rattle]

A

Hyoscine SC

168
Q

a procedure that uses medicine to adhere lungs to the chest wall

A

Pleurodesis

169
Q

Corticosteroid inhalers can lead to oral thrush =

A

Spacers help steroids to get straight to the lungs as opposed
to the oral cavity

170
Q

Non-caseating granulomas

A

Sarcoidosis, Caseating granulomas -> TB

PlusM (6 decks)

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