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Respiratory Flashcards

1
Q

Treatment for tension pneumothorax

A

Large bore cannula in 2nd ICS at midclavicular

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2
Q

Triangle of safety

A

Ant axillary line
Mid axillary line
5th ICS

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3
Q

Tracheal deviation
Reduced air entry on affected side
Kinking of vessels
Inc resonance on affected side
Hemodynamic instability

A

Pneumothorax

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4
Q

Hypoxia
Cyanosis
Raised JVP
Peripheral edema
Pansystolic murmur
Pulsatile hepatomegaly
Third heart sound

A

Cor pulmonale

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5
Q

Diagnostic test for COPD

A

Pulmonary function test
Fev/fvc ratio <70

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6
Q

Severity of COPD

A

Fev1

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7
Q

Xray finding of COPD

A

Hyperinflated lungs

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8
Q

Persistent asthma with transient infiltrates

A

ABPA

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9
Q

Best diagnostic modality for COPD

A

CT chest

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10
Q

Treatment of COPD

A

SABA
LABA
INHALED CORTICOSTEROID

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11
Q

Video assissted thoracoscopic surgery is done when

A

In recurrent pnuemothorax

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12
Q

Causes of COPD
C4-GAS

A

Coal
Cadmium
Cement
Cotton
Grains
A1Atd
Smoking

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13
Q

Bacteria causing exacerbation of COPD

A

H. INFLUENZA
M. CATARRHALIS
S. PNEUMONIA

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14
Q

Virus causing exqcerbation of COPD

A

Rhinovirus

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15
Q

Copd with consolidation

A

Strepto

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16
Q

Copd with no consolidation

A

H. Influenza

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17
Q

Last treatment for Copd

A

NIV

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18
Q

Last treatment for asthma

A

Intubation

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19
Q
A
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20
Q
A
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21
Q
A
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22
Q

Why CPAP prreferred over BiPAP

A

CPAP is used first line in HF because it’s better than BiPAP at achieving oxygenation (it just continuosly keeps the airways patent) and it increases intrathoracic pressure (lowering preload

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23
Q

What nrt should be used with caution in patients with a history of depression or self-harm

A

varenicline

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24
Q

Nrt contraindicated in pregnancy and breastfeeding

A

Verinicline

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25
Q

Nrt contraindicated in epilepsy, pregnancy and breast feeding. Having an eating disorder is a relative contraindication

A

Bupropion

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26
Q

asthma
blood eosinophilia (e.g. > 10%)
paranasal sinusitis
mononeuritis multiplex
renal involvement occurs in around 20%
pANCA positive in 60%

A

Churg straus

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27
Q

asthma
blood eosinophilia (e.g. > 10%)
paranasal sinusitis
mononeuritis multiplex
renal involvement occurs in around 20%
pANCA positive in 60%

A

Churg straus

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28
Q

Non caseating granuloma with epitheloid cells

A

Sarcoidosis

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29
Q
A
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30
Q
A
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31
Q

Isocyanates associated with

A

Occupational asthma

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32
Q

Productive cough for more than 3 months in last 2 years

A

Chronic bronchitis

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33
Q

Alveoli lined by

A

pseudostratified ciliated columnar epithelium

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34
Q
A
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35
Q

Hypertrophy and hyperplasia of mucinous glands and goblets cells

A

Chronic bronchitis

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36
Q

located on chromosome 14
inherited in an autosomal recessive / co-dominant fashion*

A

A1at def

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37
Q

Type of emphysema in a1at def

A

Panacinar emphysema

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38
Q

Investigation for a1at

A

Serum a1at levels
Genotype
Cxr
Ct scan
Pft
Spirometry obstructive picture

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39
Q

Asbestosis typically affects which lobe

A

causes lower lobe fibrosis.

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40
Q

Management of asbestosis

A

Conservative management

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41
Q

Most dangerous form of mesothelioma

A

Crocidolite(blue) asbestosis

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42
Q

dyspnoea and reduced exercise tolerance
clubbing
bilateral end-inspiratory crackles
lung function tests show a restrictive pattern with reduced gas transfer

A

Asbestos

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43
Q

Extrapulmonary causes of restrictive gaseous exchange

A

Obesity
Pleural effusion
Pleural thickening
Neuromuscular weakness
Kyphoscoliosis

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44
Q

Gold standard for ILD

A

HRCT without lung biopsy

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45
Q

Causes of digital clubbing

A

Diffused lung disease
Cystic fibrosis
Cyanotic heart disease

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46
Q

function of IL5

A

Attract and activate eosinophills

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47
Q

helper cells involved in asthma

A

helper T calls 2

48
Q

cytokines involved in asthma

A

IL5 AND IL8(from neutrophils)

49
Q

Curshman spirals in sputum

50
Q

Charcot leyden crystals

51
Q

worsening dyspnoea, wheeze and cough that is not responding to salbutamol
maybe triggered by a respiratory tract infection

A

Acute attack of asthma

52
Q

ipratropium bromide:

A

in patients with severe or life-threatening asthma, or in patients who have not responded to beta‚‚-agonist and corticosteroid treatment, nebulised ipratropium bromide, a short-acting muscarinic antagonist

53
Q

Most common organism in ARDS

54
Q

Definitive management for ARDS

55
Q

Prevention of acute mountain sickness

A

Acetazolamide

56
Q

Why there is saline nebulization

A

For mucus production

57
Q

Causes of b/l hilar lymphadenopathy

A

Tb
Sarcoidosis

58
Q

Causes of bronchiestasis

A

Tb
Cystic fibrosis

59
Q

Causes of COPD

A

Smoking
A1AT deficiency

60
Q

Long term control of patients with b/l bronchiectasis

A

postural drainage

61
Q

Normal vital capacities

A

M 4500ml
F 3500ml

62
Q

Vital capacity decreases with age (True or False)

63
Q

CI for lung transplantation in pt with CF

A

Colonisation with Burkholderia capacia

64
Q

Antibiotics for acute exacerbation of COPD

A

oral antibiotics first-line: amoxicillin or clarithromycin or doxycycline.

65
Q

Central bronchiectasis is particularly characteristic of

66
Q

ABGs of salicylate poisoning

A

Mixed resp alkalosis and metabolic acidosis

67
Q

severity of COPD categorised by

68
Q

Drug to be avoided in CSS

A

LTRA (montelukast)

69
Q

widely used to prevent AMS and has a supporting evidence base

A

acetazolamide (carbonic anhydrase inhibitor)

70
Q

HAPE

A

pulmonary vasoconstriction

71
Q

HACE

A

cerebral vasodilation

72
Q

Management of HACE

A

descent
dexamethasone

73
Q

Management of HAPE

A

descent
nifedipine, dexamethasone, acetazolamide, phosphodiesterase type V inhibitors*
oxygen if available

74
Q

asthma, eosinophilia, presence of mono-/polyneuropathy, flitting pulmonary infiltrates, paranasal sinus abnormalities and histological evidence of extravascular eosinophils.

75
Q

pulmonary and renal symptoms with cANCA positive and epistaxis and hemoptysis no asthma with no raised eosinophil

76
Q

pANCA positive and focal segmental glomerulosclerosis and weight loss, lethargy and low-grade fever, though in advanced disease it can progress to haemoptysis and renal failure.

A

Microscopic polyangiitis

77
Q

Samter’s triad.

A

asthma, nasal polyposis and salicylate sensitivity

78
Q

What is the most appropriate test prior to starting azithromycin?

A

ECG (to rule out QT prolongation) and LFT (as it is hepatotoxic)

79
Q

radiological findings such as bilateral symmetric hilar lymphadenopathies with the presence of non-caseating granulomas

A

sarcoidosis

80
Q

Radiological findings can include lobar consolidation, cavitation, caseating granulomas (tuberculomas)which eventually calcify.

81
Q

treatment for extrinsic allergic alveolitis

A

avoid precipitating factors
oral glucocorticoids

82
Q

Silent chest, normalisation of pCO2 and fall in pH are all indicators of

A

life-threatening asthma.

83
Q

A rising pCO2 is indicative of

A

type 2 respiratory failure.

84
Q

Rising CO2 and silent chest

A

INTUBATEEE!

85
Q

responsible for malt workers’ lung?

A

Aspergillus clavatus

86
Q

Radiologically, it presents with diffuse interstitial infiltrates, and histologically with granulomatous inflammation

A

malt workers lung (aspergillus clavatus)

87
Q

primarily linked to humidifier lung or air conditioner lung

A

Thermoactinomyces candidus

88
Q

Treatment for ABPA

A

Oral glucocorticoids

89
Q

progressive exertional dyspnoea
bibasal fine end-inspiratory crepitations on auscultation
dry cough
clubbing

90
Q

investigation of choice and required to make a diagnosis of IPF

91
Q

non caseating granulomas

A

sarcoidosis
berryliosis
hypersensitivity pneumonitis

92
Q

drugs for dpression and anxiety

93
Q

Drugs used for smoking cessation

A

Bupropion
Verinacline

94
Q

erythema nodosum with cough

A

Sarcoidosis

95
Q

most specific autoantibody used in diagnosis of sarcoidosis

A

ACE levels

96
Q

Confirmatory for sarcoidosis

97
Q

erythema nodosum, bilateral hilar lymphadenopathy, swinging fever, polyarthralgia, hypercalcemia

A

acute onset sarcoidosis

98
Q

bilateral hilar lymphadenopathy (BHL), erythema nodosum, fever and polyarthralgia.

A

Lofgren’s syndrome

99
Q

parotid enlargement, fever and uveitis secondary to sarcoidosis

A

Heerfordt’s syndrome (uveoparotid fever)

100
Q

anti depressant contraindicated in patients with epilepsy

101
Q

COPD infective exacerbation organism

A

H.influenza

102
Q

COPD common organism

A

Haemophillus (most common)
Strep pneu
Moraxella

103
Q

Mesothelioma treatment

A

palliative chemotherapy

104
Q

best or predicted is considered as a sign of a life-threatening asthma attack

A

peak expiratory flow rate (PEFR) of less than 33%

105
Q

Hypercalcaemia + bilateral hilar lymphadenopathy → ?

A

sarcoidosis

106
Q

rash, photosensitivity, ulcers and arthritis.

A

systemic lupus erythematosus,

107
Q

SLE diagnostic antibody

A

Anti-dsDNA antibodies

108
Q

Over rapid aspiration/drainage of pneumothorax can result in

A

re-expansion pulmonary oedema

109
Q

Heroin overdose ABGs show

A

Respiratory acidosis

110
Q

treatment of choice for allergic bronchopulmonary aspergillosis

A

oral glucocorticoids

111
Q

investigation of choice for upper airway compression

A

flow volume loop

112
Q

fever, joint pain, erythema nodosum, lymphadenopathy and bilateral hilar lymphadenopathy.

A

Lofgren’s syndrome
(sarcoidosis)

113
Q

‘red-currant jelly’ sputum

A

Klebsiella

114
Q

Causes of bilateral hilar lymphadenopathy

A

Fully LOST

Fungi, Lymphoma, Other Malignancy, Occupational dust (berryliosis), Sarcoidosis, TB

115
Q

Dyspnoea, obstructive pattern on spirometry in patient with rheumatoid → ?

A

bronchiolitis obliterans

116
Q

Chronic sinusitis + nephritic syndrome → ?

A

granulomatosis with polyangiitis

RCP (4 decks)

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