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Passmed wrong > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Klebsiella associated with

A

aspiration
lung abscess formation and empyema

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2
Q

pneumothorax mimic

A

emphysematous bullae

bullae appear as lucency without a visible wall

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3
Q

NGT aspirate pH

A

Nasogastric tubes are safe to use if pH <5.5 on aspirate

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4
Q

chest drain relative contraindications

A

INR > 1.3
Platelet count < 75
Pulmonary bullae
Pleural adhesions

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5
Q

Infective exacerbation of COPD: first-line antibiotics

A

are amoxicillin or clarithromycin or doxycycline

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6
Q

acute bronchitis Antibiotic therapy

A

are systemically very unwell
have pre-existing co-morbidities
have a CRP of 20-100mg/L (offer delayed prescription) or a CRP >100mg/L (offer antibiotics immediately)

doxycycline
amoxicillin in children/pregnancy

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7
Q

first line Ix for asthma in children

A

FeNO

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8
Q

cavitating lesions lung cancer

A

squamous cell carcinoma

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9
Q

Minimally symptomatic primary pneumothorax, regardless of size Tx:

A

conservative treatment / regular follow-up

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10
Q

severe obesity- lung function test

A

restrictive defect

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11
Q

FEV1/FVC and TLCO

emphysema and pulmonary fibrosis

A

emphysema: FEV1/FVC reduced, TLCO reduced

pulmonary fibrosis: FEV1/FVC raised, TLCO reduced

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12
Q

Chest drain swinging

A

Rises in inspiration, falls in expiration

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13
Q

Symptom control in non-CF bronchiectasis

A

inspiratory muscle training + postural drainage

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14
Q

Pulmonary capillary wedge pressure

A

Raised = cardiac pulmonary oedema
not raised = ARDS

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15
Q

COPD severity

A

Moderate has an FEV1 50-70%, severe is 30-49%,
very severe is <30%.

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16
Q

anterior mediastinum mass

A

4Ts:
teratoma,
terrible lymphadenopathy
thymic mass
thyroid mass

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17
Q

Bronchiectasis: most common organism =

A

Haemophilus influenzae

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18
Q

contraindications to lung cancer surgery

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

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19
Q

The triangle of safety for chest drain insertion involves

A

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

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20
Q

Acute exacerbation of COPD GP

A

5-day course of prednisolone (typically 30mg daily)

Antibiotics if purulent sputum or any clinical signs of pneumonia

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21
Q

mesothelioma CXR

A

pleural thickening

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22
Q

radiation pneumonitis

A

upper lobe fibrosis from previous radiotherapy

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23
Q

small cell lung cancer management

A

combination of chemotherapy and radiotherapy
surgery for very early disease e.g. T1

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24
Q

tension pneumothorax type of shock

A

obstructive shock as a result of cardiac outflow obstruction

25
Q

ipratropium drug class

A

SAMA

26
Q

tiotropium

A

LAMA

27
Q

formoterol

A

LABA

28
Q

salmeterol

A

LABA

29
Q

obstructive spirometry
vs restrictive

A

obstructive –> FEV1/FVC <0.7
restrictive –> FEV1/FVC >0.7

30
Q

lung cancer Ix of choice

A

Contrast enhanced CT scan

31
Q

trachea pulled towards white out lung

A

Pneumonectomy
Complete lung collapse e.g. endobronchial intubation
Pulmonary hypoplasia

31
Q

trachea central with white out lung

A

Consolidation
Pulmonary oedema (usually bilateral)
Mesothelioma

32
Q

trachea pushed away from white out lung

A

Pleural effusion
Diaphragmatic hernia
Large thoracic mass

33
Q

bupropion Mechanism of action

A

Norepinephrine and dopamine reuptake inhibitor, and nicotinic antagonist.

34
Q

varenicline mechanism of action

A

Nicotinic receptor partial agonist

35
Q

Pregnant women who have a severe asthma attack

A

should be admitted to hospital, even if they initially improve with treatment

36
Q

mesothelioma gold standard investigation

A

thoracoscopic biopsy

37
Q

Kartageners

A

dextrocardia or complete situs inversus
bronchiectasis
recurrent sinusitis
subfertility

37
Q

loss of the left heart border is a classic sign of

A

left lingula consolidation

38
Q

hypertrophic pulmonary osteoarthropathy- associated lung cancer

A

adenocarcinoma and squamous cell

38
Q

pleural effusion immediate management

A

pleural aspirate

39
Q

COPD vaccinations

A

annual influenza, one off pneumococcal

40
Q

bronchiectasis High resolution CT findings

A

‘signet-ring’ sign- dilated airways

41
Q

NIV should be considered in all patients with an acute exacerbation of COPD in whom:

A

a respiratory acidosis persists despite immediate maximum standard medical treatment

PaCO2>6kPa
pH <7.35 ≥7.26

42
Q

gynaecomastia - which lung cancer

A

adenocarcinoma

43
Q

ABPA treatment

A

steroids

44
Q

Fostair

A

LABA + ICS

45
Q

Trimbow

A

LABA + LAMA + ICS inhaler

46
Q

ARDS clinical features

A

typically of an acute onset and severe:
dyspnoea
elevated respiratory rate
bilateral lung crackles
low oxygen saturations

47
Q

sudden deterioration with ventilation

A

tension pneumothorax

48
Q

causes of restrictive lung disease

A

Pulmonary fibrosis
Asbestosis
Sarcoidosis
Acute respiratory distress syndrome
Infant respiratory distress syndrome
Kyphoscoliosis e.g. ankylosing spondylitis
Neuromuscular disorders
Severe obesity

49
Q

first line Tx for HAP

A

co-amoxiclav

50
Q

high risk characteristics of pneumothorax warranting need for chest drain

A

Haemodynamic compromise (suggesting a tension pneumothorax)
Significant hypoxia
Bilateral pneumothorax
Underlying lung disease
≥ 50 years of age with significant smoking history
Haemothorax

51
Q

diagnostic Ix for lung cancer

A

CT chest

52
Q

empyema

A

ph<7.2
high LDH
low glucose

53
Q

lung cancer platelets

A

raised

54
Q

dark indurated plaques that can involve the face and extremities

A

lupus pernio –> sarcoidosis

55
Q

indications for steroid treatment for sarcoidosis

A

parenchymal lung disease
uveitis
hypercalcaemia
neurological or cardiac involvement

56
Q

Adults with asthma who are poorly controlled on SABA prn + regularly ICS →

A

regular low-dose regular ICS/formoterol combination inhaler (MART therapy)

Passmed wrong (21 decks)

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