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AKT > Respiratory 2 > Flashcards

Respiratory 2 Flashcards

1
Q

Idiopathic pulmonary fibrosis
Age
Gender

A

50-70yo
M>F

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2
Q

IPF spirometry findings
FEV1 =
FVC =
Ratio =
TLCO

A

Restrictive picture
FEV1 normal/ decreased, FVC decreased
Ratio increased
TLCO - reduced transfer factor

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3
Q

CXR IPF (3)

A

Bilateral interstitial shadowing
Ground glass
Honeycombing

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4
Q

IPF gold standard test

A

high resolution CT

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5
Q

What is Kartagener’s syndrome?

A

Primary ciliary dyskinesia

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6
Q

Kartagener’s syndrome features (4)

A

Dextrocardia
Bronchiectasis
Recurrent sinusitis
Subfertility

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7
Q

Name the bacteria:
Typically after aspiration or UTIs
Common in ETOH excess and diabetics
Red currant jelly sputum
Often affects upper lobes
Can cause lung abscess formation and empyema

A

Klebsiella pneumonia

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8
Q

First line investigation lung cancer
Investigation of choice

A

CXR
CT

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9
Q

PET scans are offered in patients with which type of lung cancer?
Why?

A

Non small cell lung cancer
To establish eligibility for curative treatment

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10
Q

Small cell lung cancer paraneoplastic features (2)

A

SIADH
Lambert Eaton syndrome

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11
Q

Squamous cell lung cancer paraneoplastic features (4)

A

PTH secretion causing raised calcium
Clubbing
Hypertrophic pulmonary osteoarthropathy
Hyperthyroidism due to ectopic TSH

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12
Q

Adenocarcinoma lung ca paraneoplastic syndrome (2)

A

Gynaecomastia
HPOA

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13
Q

Lung cancer 2ww pathway referral (2)

A

CXR findings with lung ca
40 and above with unexplained haemoptysis

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14
Q

RF for obstructive sleep apnoea (6)

A

Obesity
Acromegaly
Hypothyroidism
Amyloidosis
Large tonsils
Marfan’s syndrome

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15
Q

Gas OSA

A

Respiratory acidosis

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16
Q

Mx OSA (2)

A

Weight loss
CPAP

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17
Q

Point of care CRP test for abx for pneumonia interpretation

A

CRP <20 - no abx
20-100 delayed prescription
>100 abx

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18
Q

CURB65

A

Confusion AMTS 8/10
Urea >7mmol
RR >30
BP 90/60
65 or more

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19
Q

CURB65 interpretation

A

0 -1 home based care
2 - consider hospital
3 or more = admission

0 - rx at home
1/2 - hospital assessment
3/4 high urgent admission

20
Q

Ix pneumonia in intermediate and high risk patients (4)

A

Blood and sputum cultures
Pneumococcal and legionella urinary antigen tests

21
Q

Rx pneumonia
low risk
medium risk
high risk

A

Low risk amoxi
Medium risk double amoxi and clarthro
High risk co-amox or cef or taz

22
Q

Primary pneumothorax mx

A

<2cm and no SOB –> discharge
>2cm –> aspiration, if still >2cm or SOB still then for drain

23
Q

Secondary pneumothorax mx

A

All patients should be admitted for at least 24 hours
>50yo and >2cm/ SOB –> chest drain
1-2cm –> aspiration, if fails then chest drain
<1cm –> oxygen

24
Q

Iatrogenic pneumothorax mx

A

Majority should resolve with observation, if rx is needed then to aspirate unless COPD or requiring ventilation

25
Q

Obstructive or restrictive
Pulmonary fibrosis
COPD
Asthma
Asbestosis
Sarcoidosis
ARDS
Bronchiectasis
Kyphoscoliosis
Bronchiolitis obliterans
Neuromuscular disorders

A

R Pulmonary fibrosis
O COPD
O Asthma
R Asbestosis
R Sarcoidosis
R ARDS
O Bronchiectasis
R Kyphoscoliosis
O Bronchiolitis obliterans
R Neuromuscular disorders

26
Q

Pulmonary function tests
Obstructive
Restrictive

A

FEV1 sig reduced
FVC reduced or normal
Ratio reduced

FEV1 reduced
FVC sig reduced
Ratio normal or increased

27
Q

Who may be considered for an immediate abx prescribing approach? (resp infections) (3)
(x2 children cases and centor criteria)

A

Children <2yo with bilateral acute otitis media
Children with otorrhoea with otitis media
3 or more centor criteria

28
Q

CENTOR criteria

A

Cough absent
Exudate
Nodes
Temperature
OR young or old (<15yo +1, >44 -1)

29
Q

Adult immediate prescribing indications with respiratory infections
>65 with:
>80 with:

(4)

A

acute cough + 2 (>65yo) or +1 (>80yo) of the following

  • hospitalisation in the last year
  • on steroids
  • diabetic
  • CCF hx
30
Q

Length of symptoms for respiratory infections
Otitis media
Sore throat/ tonsilitis
Cold
Rhinosinusitis
Bronchitis

A

acute otitis media: 4 days
acute sore throat/acute pharyngitis/acute tonsillitis: 1 week
common cold: 1 1/2 weeks
acute rhinosinusitis: 2 1/2 weeks
acute cough/acute bronchitis: 3 weeks

31
Q

If centor 3 or more then which bacteria is likely to have caused the sore throat?

A

Group A beta haemolytic Strep

32
Q

RA respiratory manifestations (7)
Hint: 6 P’s

A

Pulmonary fibrosis
Pleural effusion
Pulmonary nodules
Pleurisy
CaPlan’s syndrome
Pneumonitis
Bronchiolitis obliterans

33
Q

Non caseating granulomas = which condition?

A

Sarcoidosis

34
Q

Sarcoidosis is common in:
Age
Ethnicity

A

Young adults
African descent

35
Q

Sarcoidosis features
Acute (4)

A

Swinging fever
Erythema nodosum
Bilateral hilar lymphadenopathy
Polyarthralgia

36
Q

mining
slate works
foundries
potteries
Occupations that are at risk of which condition

A

Silicosis

37
Q

fibrosing lung disease
‘egg-shell’ calcification of the hilar lymph nodes
on CXR = which condition?

A

Silicosis

38
Q

CXR findings for silicosis

A

fibrosing lung disease
‘egg-shell’ calcification of the hilar lymph nodes

39
Q

Smoking cessation options (3)

A

NRT
Varenicline
Bupropion

40
Q

NRT adverse effects (3)

A

N&V
Headaches
Flu like symptoms

40
Q

NRT prescribing if high level of dependence

A

combination of patches and one other form

41
Q

Varenicline
MOA
When should it be started?
Length of treatment

A

Nicotinic receptor partial agonist
1 week prior to STOP date
12 weeks

42
Q

Varenicline adverse effects (3)

A

Nausea
Abnormal dreams
Insomnia

43
Q

Bupropion
MOA
Start date

A

Norepinephrine and dopamine reuptake inhibitor
1-2 weeks before STOP date

44
Q

Bupropion SE (1)

A

Increased risk of seizures

45
Q

Smoking cessation mx in pregnancy (4)
If on NRT - advice that needs to be given

A
  1. CBT
  2. Motivational interviewing
  3. Structure self help
  4. NRT

Take off patches prior to bed

AKT (52 decks)

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