Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y3 > Respiratory 2 > Flashcards

Respiratory 2 Flashcards

1
Q

What are the 2 main types of lung cancer?

A

small cell lung cancer (SCLC) - 20%
non-small cell lung cancer (NSCLC) - 80%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the different types of non-small cell lung cancer?

A

adenocarcinoma (40%) - peripheral lesions
squamous cell carcinoma (20%) - cavitating lesions
large cell carcinoma (10%) - peripheral lesions
other types (10%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which type of lung cancer can lead to development of paraneoplastic syndromes?

A

small cell lung cancer - contain neurosecretory granules - release neuroendocrine hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is mesothelioma?

A

lung malignancy affecting mesothelial cells of pleura
linked to inhalation of asbestos
latent period between asbestos exposure and development of mesothelioma ~ 45 years
poor prognosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How does lung cancer typically present?

A

SoB
cough
haemoptysis
finger clubbing
supraclavicular lymphadenopathy
weight loss
recurrent chest infections
hoarseness - Pancoast tumours
SVC syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the CXR referral criteria for suspected lung cancer?

A

CXR within 2 weeks for patients 40+ y.o. with:
- clubbing
- supraclavicular lymphadenopathy
- thrombocytosis
- recurrent / persistent chest infections
- chest signs of lung cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When should you offer CXR when suspecting lung cancer?

A

patient over 40 with 1+ (if smoked/asbestos exposure) or 2+ (if non-smoker) of the following: (non-specific symptoms)
- cough
- SoB
- chest pain
- fatigue
- weight loss
- loss of appetite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When should patients be referred for suspected (lung) cancer pathway?

A

CXR findings consistent with lung cancer
40+ y.o. with unexplained haemoptysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What examination findings can be found in lung cancer?

A

fixed, monophonic wheeze
supraclavicular lymphadenopathy / persistent cervical lymphadenopathy
finger clubbing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What paraneoplastic features are associated with small cell lung cancer?

A

SIADH - syndrome of inappropriate ADH -> ectopic ADH produced -> hyponatraemia
Cushing’s syndrome - ectopic ACTH secretion
Lambert Eaton syndrome - caused by antibodies to SCLC cells
Limbic encephalitis - antibodies to brain tissue (esp. limbic system)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is SIADH? What type of lung cancer is it associated with?

A

syndrome of inappropriate ADH
associated with SCLC
production of ectopic ADH
presents with hyponatraemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How does Cushing’s syndrome present in lung cancer? What type of lung cancer is it associated with?

A

associated with SCLC
ectopic secretion of ACTH
atypical presentation
HTN, hyperglycaemia
hypokalaemia
alkalosis
muscle weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is Lambert Eaton syndrome? Which type of lung cancer is it associated with?

A

antibodies against SCLC cells
antibodies also damage voltage gated Ca channels on presynaptic terminals in motor neurons
causes weakness of proximal muscles
can also affect:
- intraocular muscles - diplopia
- levator muscles - ptosis
- pharyngeal muscles - slurred speech, dysphagia
can also lead to autonomic dysfunction:
- dry mouth
- blurred vision
- dizziness
- impotence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is limbic encephalitis? What type of lung cancer is it associated with?

A

SCLC
production of antibodies to the limbic system -> inflammation
presents with
- short-term memory loss
- hallucinations
- confusion
- seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What paraneoplastic features are associated with squamous cell lung cancer?

A

parathyroid hormone-related protein secretion -> causes hypercalcaemia
finger clubbing
HPOA - hypertrophic pulmonary osteoarthropathy
ectopic TSH -> hyperthyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is HPOA? What types of lung cancer is it associated with?

A

squamous cell and adenocarcinoma
hypertrophic pulmonary osteoarthropathy
clubbing
proliferative periostisis involving that typically involves the long bones
causes pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What paraneoplastic features are associated with lung adenocarcinoma?

A

gynecomastia
HPOA (hypertrophic pulmonary osteoarthropathy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What complications can result from lung cancer?

A

recurrent laryngeal nerve palsy - hoarseness, caused by tumour compression of the nerve
phrenic nerve palsy - diaphragm weakness - SoB
SVC obstruction - facial swelling, SoB, distended neck and upper chest veins; Pemberton’s sign (facial congestion and cyanosis when arms raised)
Horner’s syndrome - associated with Pancoast tumour pressing on sympathetic ganglion; ptosis, anhydrosis, miosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What investigations are used to diagnose lung cancer?

A

bloods - thrombocytosis
CXR
staging CT scan
bronchoscopy with endobronchial ultrasound - with biopsy
PET CT -

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What findings can be found on CXR in lung cancer?

A

hilar enlargement
peripheral opacity - visible lesion
pleural effusion (usually unilateral)
lung collapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the management options for lung cancer?

A

MDT meeting
surgery - first line for NSCLC (SCLC usually already metastatic)
radiotherapy - can be curative in NSCLC
chemotherapy - adjuvant to other treatments, palliative
endobronchial treatment - stents, debulking - to improve QoL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the treatment options for SCLC?

A

usually palliative chemo+radiotherapy
tends to present later and already metastatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the surgical options for lung cancer?

A

segmentectomy / wedge resection - removing a section of a lobe
lobectomy - removing the entire lobe
pneumonectomy - removing the entire lung

24
Q

What are the surgical methods available for lung cancer?

A

thoracotomy - open surgery
VATS (video-assisted thoracoscopic surgery) - keyhole surgery
robotic

25
Q

What are the main thoracotomy incisions used in lung cancer surgery?

A

anterolateral
axillary
posterolateral - most common

26
Q

What are some potential features of pulmonary embolism?

A

pleuritic chest pain
SoB
haemoptysis
tachycardia
tachypnoea

27
Q

What are the PERC (PE Rule-out Criteria)?

A

Age >50
HR >100
O2 sats <94
Previous DVT / PE
Recent trauma / surgery (past 4 weeks)
Haemoptysis
Unilateral leg swelling
Oestrogen use

28
Q

When is PERC negative?

A

when all criteria are absent
chance of PE is then < 2%

29
Q

What are some risk factors for DVT / PE?

A

immobility
recent surgery (past 4 weeks)
long haul travel
pregnancy
malignancy
oestrogen use
polycythaemia
SLE
thrombophilia

30
Q

What is the Wells score? When is it used?

A

Wells score predicts the probability of a patient having a PE
performed when PE is suspected
PE likely - more than 4 points

31
Q

What investigations are performed when PE is likely (Wells score > 4)?

A
  1. CXR - to rule out other pathologies
  2. CTPA (CT pulmonary angiogram)
    - if delayed - give anticoagulation before CTPA can be performed
    - if positive = PE
    - if negative = proximal leg vein USD if DVT suspected
32
Q

What investigations are performed when PE is unlikely (Wells score < 4)?

A

D-dimer
1. if positive -> CTPA (anticoagulation if delay)
2. if negative -> PE unlikely, consider other Dx

33
Q

What are some possible ECG findings in PE?

A

S1Q3T3
- large S in lead 1
- large Q in lead 3
- inverted T in in lead 3
RBBB
R axis deviation
sinus tachycardia

34
Q

What conditions (other than PE) can create a high D dimer?

A

pregnancy
pneumonia
malignancy
HF
surgery

35
Q

What is the first line management of PE?

A

anticoagulation
1. apixaban / rivaroxaban - first line
2. LMWH if DOACs not suitable

36
Q

How long should patients with PE be anticoagulated for?

A

at least 3 months
if DVT provoked (obvious precipitating event) - 3 months
if DVT unprovoked - 6 months

37
Q

How are haemodynamically unstable patients with PE managed?

A

thrombolysis - e.g. alteplase

38
Q

How are patients with PE assessed regarding outpatient/inpatient treatment?

A

PESI (PE severity index)

39
Q

When is pleural effusion transudate?

A

when < 30g/L protein

40
Q

What are some causes of transudative pleural effusion?

A

secodary causes of lung pathologies / systemic:
HF
hypoalbuminaemia
hypothyroidism
Meig’s syndrome

41
Q

When is pleural effusion exudative?

A

when > 30g/L protein
EXudative - EXtra protein

42
Q

What are some causes of exudative pleural effusion?

A

primary lung pathologies:
infection - pneumonia, TB
connective tissue disease
neoplasia
pancreatitis
PE
yellow nail syndrome
Dressler’s syndrome

43
Q

What are some features of pleural effusion?

A

SoB
non-productive cough
chest pain

44
Q

What are some examination findings in pleural effusion?

A

dullness to percussion
reduced breath sounds
reduced chest expansion

45
Q

What imaging is used in pleural effusion?

A

PA CXR
USD
contrast CT

46
Q

What is the typical management of bronchitis?

A

analgesia
high fluid intake
ATB only if:
- systematically unwell
- pre-existing co-morbidities
- elevated CRP (above 20)

47
Q

What is the first line ATB in bronchitis?

A

doxycycline

48
Q

What is lung abscess?

A

well-circumscribed infection within the lung parenchyma

49
Q

What are the potential causes of lung abscess?

A

most commonly secondary to aspiration pneumonia
poor dental hygiene
previous stroke
haematogenous spread
bronchial obstruction secondary to lung tumour

50
Q

What are the most common causative organisms of monomicrobial lung abscess?

A

Staph aureus
Klebsiella pneumonia
Pseudomonas aeruginosa

51
Q

What are the features of lung abscess?

A

similar to pneumonia but subacute
- symptoms develop over weeks
- systemic features - night sweats, weight loss
fever
productive cough with foul smelling sputum
chest pain
SoB

52
Q

What are some examination signs of lung abscess?

A

dullness to percussion
bronchial breathing
clubbin

53
Q

What investigations can be used in lung abscess>

A

CXR
- fluid-filled space within area of consolidation
- air-fluid level can be seen
sputum cultures
blood cultures

54
Q

What is the management of lung abscess?

A

IV ATB
percutaneous drainage - if not resolving

55
Q

When is pleural effusion exudative, according to Light’s criteria?

A

any 1 of:
pleural fluid protein / serum protein > 0.5
pleural fluid LDL / serum LDL > 0.6
pleural fluid LDL more than 2/3 the upper limits of normal serum LDH

56
Q
A

Y3 (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions