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Daisy Finals Revision > Respiratory > Flashcards

Respiratory Flashcards

1
Q

What is the most common organism in bronchiectasis?

A

H. Influenzae

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2
Q

What are the causes of upper lobe fibrosis?

A

CHARTS
Coal workers ppeumoconiosis
Histiocytosis
Ankylosing spondylitis/allergic bronchopulmonary aspergillosis
Radiation
Tuberculosis
Silicosis, sarcoidosis

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3
Q

What are the spirometry findings in pulmonary fibrosis?

A

Reduced FVC, normal fev1/fvc

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4
Q

What is the second line investigation for asthma if spirometry is normal?

A

Fraction of exhaled nitrous oxide testing
FeNO

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5
Q

What medication causes lower zone lung fibrosis?

A

Amiodarone (and bleomycin, methotrexate)

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6
Q

What are the features of acute sarcoidosis?

A

Erythema nodosum
Bilateral hilar lymphadenopathy
Swinging fever
Polyarthralgia

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7
Q

What investigations are required before starting azithromycin?

A

ECG (and LFTs)

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8
Q

What is first line mgt of COPD?

A

SABA or SAMA PRN

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9
Q

What is the second line mgt of COPD?

A

Asthmatic features/steroid responsiveness: LABA and ICS
NO asthmatic features - LABA and LAMA (if on SAMA switch to SABA)

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10
Q

what is the investigation of choice for idiopathic pulmonary fibrosis?

A

high res CT

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11
Q

what are the features of kartagener’s syndrome?

A

dextrocardia
bronchiectasis
recurrrent sinusitis
subfertility

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12
Q

in step down tx of asthma, what reduction of corticosteroid tx are you aiming for?

A

25-50%

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13
Q

most common pathogens causing IECOPD?

A

haemophilus influenzae
strep pneumoniae
moraxella catarrhalis

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14
Q

investigation of pleural effusion?

A

PA CXR
US guided pleural aspiration (sent for pH, protein, LDH, cytology and microbiology)
contrast CT to investigate underlying cause

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15
Q

how to differentiate transudate and exudate in pleural effusion?

A

exudate if: pleural fluid protein/serum protein >0.5
pleural fluid LDH / serum LDH >0.6
pleural fluid LDH more than two thirds the upper limits of normal serum LDH

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16
Q

when should a chest drain be placed in pleural effusion?

A

if fluid is purulent or turbid/cloudy chest tube should be placed
if fluid is clear but pH less than 7.2 in patients with suspected pleural infection chest tube should be placed

17
Q

mgt of recurrent pleural effusion?

A
  • recurrent aspiration
  • pleurodesis
  • indwelling pleural catheter
  • drug mgt to alleviate sx eg opioids to relieve dyspnoea
18
Q

acute asthma management escalation?

A
  1. oxygen
  2. salbutamol nebs
  3. ipratropium bromide nebs
  4. hydrocort IV or oral pred
  5. mag sulf IV
  6. aminophylline/IV salbutamol
19
Q

fev1/fvc ratio <0.7?

A

obstructive

20
Q

fev1/fvc ratio >0.7?

A

restrictive

21
Q

restrictive spirometry picture and impaired gas exchange?

A

pulmonary fibrosis

22
Q

features of silicosis?

A

upper zone fibrosing lung disease
‘egg-shell’ calcification of the hilar lymph node

23
Q

ABG measurements indicating LTOT in COPD?

A

two ABG measurements with pO2 <7.3kPa
(while stable on optimal med mgt)

24
Q

mnemonic for upper lobe fibrosis?

A

CHARTS
Coal workers pneumoconiosis
Histiocytosis
Ankylosing spondylitis
Radiation
TB
Sarcoidosis/silicosis

25
Q

mnemonic for lower lobe fibrosis?

A

DIAL at the base of the lungs
Drugs
Idiopathic
Asbestosis
Lupus

26
Q

COPD - still breathless despite using SABA/SAMA and asthma/steroid responsive features?

A

add LABA and ICS

27
Q

bronchiectasis features?

A

persistent productive cough
dyspnoea
haemoptysis

28
Q

key sign on HRCT in bronchiectasis?

A

signet ring sign

29
Q

gold standard investigation for mesothelioma?

A

thoracoscopic biopsy

30
Q

what is the safe triangle for chest drain insertion>

A

Bounded by latissimus dorsi,
pectoralis major,
line superior to the nipple
and apex at the axilla

31
Q

features of acute sarcoidosis?

A

erythema nodosum
bilateral hilar lymphadenopathy
swinging fever
polyarthralgia

32
Q

investigation for occupational asthma?

A

serial peak flow measurements at work and at home

33
Q

deficiency of what protein is a risk factor for hepatocellular carcinoma?

A

alpha-1 antitrypsin

34
Q

causes of acute respiratory distress syndrome?

A

infection: sepsis, pneumonia
massive blood transfusion
trauma
smoke inhalation
pancreatitis
covid 19
cardio-pulmonary bypass

35
Q

what is acute respiratory distress syndrome?

A

inc permeability of alveolar capillaries
-> leading to fluid accumulation in alveoli ie non-cardiogenic pulmonary oedema

36
Q

smoking cessation in pregnancy?

A

NRT patches
-»> bupropion and varenicline CI’d

37
Q

score used for sleep problems?

A

epworth sleepiness scale

38
Q
A

Daisy Finals Revision (25 decks)

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