Respiratory Flashcards
1) What are the histological types of lung cancer are there?
2) which one is the most common one?
1) Small-cell lung cancer (SCLC) (around 20%)
Non-small-cell lung cancer (around 80%)\
2) Adenocarcinoma (around 40% of total lung cancers)
Squamous cell carcinoma (around 20% of total lung cancers)
Large-cell carcinoma (around 10% of total lung cancers)
1) what is extrapulmonary manifestations
2) what are Paraneoplastic syndromes
3) causes of paraneoplastic syndromes
1) symptoms or conditions that occur outside of the lungs
2) group of rare disorders that occur in some people with cancer, they’re not caused directly by the tumour itself but rather by the body’s immune response to the cancer
3) immune system reaction & substances produced by tumours
1) what are the referral criteria for suspected lung cancer
2) NICE guidelines recommend offering a chest x-ray when pt >40yrs with _____________
3) What other unexplained symptoms can lung cancer present?
1) Pt over 40
clubbing
lymphadenopathy
recurrent/persistent chest infection
raised platelet count (thrombocytosis)
chest signs of lung cancer
2)
Two or more unexplained symptoms who never smoked
One or more unexplained symptoms who smoked/had asbestos exposure
3)
cough
SOB
chest pain
fatigue
Weight loss
Loss of appetite
1) What is the first line of investigation for suspected lung cancer?
2) name other investigations that would help with diagnosing lung cancer
1) CXR
2) Staging CT scan
PET-CT
Bronchoscopy
Histological diagnosis - biopsy
1) What are the treatment options and management plan for lung cancer?
2) What is the first line of management for non-small-cell lung cancer?
1) Discussed with MDT about possible surgery, radio, chemo, endobronchial treatment
2) surgery
What are the normal values for the following markers?
1) pH
2) PaO2
3) PaCO2
4) HCO3
5) Base excess
6) Lactate
1) 7.35 – 7.45
2) 10.7 – 13.3 kPa
3) 4.7 – 6.0 kPa
4) 22 – 26 mmol/L
5) -2 – +2
6) 0.5 – 1 mmol/L
1) What indicates type 1 respiratory failure?
2) What indicates type 2 respiratory failure?
1) Normal PaCO2 with low PaO2 (only 1 is affected)
2) Raised PaCO2 with low PaO2 (2 are affected)
1) cause of respiratory acidosis
2) cause of respiratory alkalosis
3) cause of metabolic acidosis
4) cause of metabolic alkalosis
1) COPD, asthma, chest wall disorder (reduce lung expansion), pneumonia
2) hyperventilation syndrome (anxiety / PE)
3) raised lactate (tissue hypoxia), raised ketones (DKA), increased H ions (renal failure, rhabdomyolysis), reduced bicarbonate (diarrhoea, renal failure/ type 2 renal tubular acidosis)
4) reduced / loss of hydrogen ions, increased aldosterone (conn’s syndrome/liver cirrhosis)
1) What conditions are classified as lower respiratory tract infections?
2) examples of upper respiratory tract infection
3) Is it true that URTIs are more prone to bacterial infection?
1) Acute bronchitis & pneumonia
2) Common cold
3) NOT TRUE, The lower down the respiratory tract, the higher the probability of bacterial infection, Higher the tract, more viral
1) What is Aspiration pneumonia
2) what is aspiration pneumonia commonly associated with?
1) When the infection develops due to the aspiration of food or fluids, usually in patients with impaired swallowing
2) anaerobic bacteria
Presentation with pneumonia
cough
sputum production
SOB
fever
feeling generally unwell
haemoptysis
pleuritic chest pain (sharp chest pain, worse on inspiration)
Delirium
What are the clinical chest sign for pneumonia?
*explain the cause of signs
1) bronchial breath sounds (harsh inspiratory and expiratory breath sounds)
–> cause by consolidation around the airways
2) Focal coarse crackles
–> caused by air passing through sputum in the airways
3) Dullness to percussion
–> due to lung tissue filled with sputum / collapsed
What are the signs of sepsis secondary to pneumonia?
Raise RR
Raise HP
Low O2
Hypotension (shock) low bp
Fever
Confusion
1) What is the assessment scoring system for pneumonia?
2) what are the scores grading categories?
3) common cause of pneumonia
4) causes of pneumonia in hospital
1) CURB-65
C - confusion
U - urea > 7mmol/L
R - RR >30
B -BP <90 or <60
65 - Age over 65
2)
0-1 –> treatment at home
2 or more –> hospital admission
3 or more –> ICU
3)Streptococcus pneumoniae (most common)
Haemophilus influenzae
4) Methicillin-resistant Staphylococcus aureus (MRSA)
1) Definition of Atypical pneumonia
2) What are the 5 causes of atypical pneumonia
3) treatment for atypical pneumonia
1) caused by organisms that cannot be cultured in the normal way or detected using a gram stain
2) Legions of psittaci MCQs
Legions - Legionella pneumophila (infected water; hyponatraemia + pneumonia symptoms)
*urine antigen test for initial screening
psittaci - Chlamydia psittaci (parrot owner / infected bird)
M - Mycoplasma pneumonia (pneu + erythema multiforme)
C - Chlamydophila pneumonia (chronic-moderate pneu + wheezing in school-age children)
Qs - Q fever /coxiella burnetii (exposure of bodily fluid of animals, farmer with flu-like ilness)
3) clarithromycin, levofloxacin, doxycycline
