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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
ipratropium drug class
SAMA
26
tiotropium
LAMA
27
formoterol
LABA
28
salmeterol
LABA
29
obstructive spirometry vs restrictive
obstructive --> FEV1/FVC <0.7 restrictive --> FEV1/FVC >0.7
30
lung cancer Ix of choice
Contrast enhanced CT scan
31
trachea pulled towards white out lung
Pneumonectomy Complete lung collapse e.g. endobronchial intubation Pulmonary hypoplasia
31
trachea central with white out lung
Consolidation Pulmonary oedema (usually bilateral) Mesothelioma
32
trachea pushed away from white out lung
Pleural effusion Diaphragmatic hernia Large thoracic mass
33
bupropion Mechanism of action
Norepinephrine and dopamine reuptake inhibitor, and nicotinic antagonist.
34
varenicline mechanism of action
Nicotinic receptor partial agonist
35
Pregnant women who have a severe asthma attack
should be admitted to hospital, even if they initially improve with treatment
36
mesothelioma gold standard investigation
thoracoscopic biopsy
37
Kartageners
dextrocardia or complete situs inversus bronchiectasis recurrent sinusitis subfertility
37
loss of the left heart border is a classic sign of
left lingula consolidation
38
hypertrophic pulmonary osteoarthropathy- associated lung cancer
adenocarcinoma and squamous cell
38
pleural effusion immediate management
pleural aspirate
39
COPD vaccinations
annual influenza, one off pneumococcal
40
bronchiectasis High resolution CT findings
'signet-ring' sign- dilated airways
41
NIV should be considered in all patients with an acute exacerbation of COPD in whom:
a respiratory acidosis persists despite immediate maximum standard medical treatment PaCO2>6kPa pH <7.35 ≥7.26
42
gynaecomastia - which lung cancer
adenocarcinoma
43
ABPA treatment
steroids
44
Fostair
LABA + ICS
45
Trimbow
LABA + LAMA + ICS inhaler
46
ARDS clinical features
typically of an acute onset and severe: dyspnoea elevated respiratory rate bilateral lung crackles low oxygen saturations
47
sudden deterioration with ventilation
tension pneumothorax
48
causes of restrictive lung disease
Pulmonary fibrosis Asbestosis Sarcoidosis Acute respiratory distress syndrome Infant respiratory distress syndrome Kyphoscoliosis e.g. ankylosing spondylitis Neuromuscular disorders Severe obesity
49
first line Tx for HAP
co-amoxiclav
50
high risk characteristics of pneumothorax warranting need for chest drain
Haemodynamic compromise (suggesting a tension pneumothorax) Significant hypoxia Bilateral pneumothorax Underlying lung disease ≥ 50 years of age with significant smoking history Haemothorax
51
diagnostic Ix for lung cancer
CT chest
52
empyema
ph<7.2 high LDH low glucose
53
lung cancer platelets
raised
54
dark indurated plaques that can involve the face and extremities
lupus pernio --> sarcoidosis
55
indications for steroid treatment for sarcoidosis
parenchymal lung disease uveitis hypercalcaemia neurological or cardiac involvement
56
Adults with asthma who are poorly controlled on SABA prn + regularly ICS →
regular low-dose regular ICS/formoterol combination inhaler (MART therapy)

Passmed wrong (21 decks)

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