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Medicine AS > Respiratory > Flashcards

Respiratory Flashcards

0
Q

Complications of COPD

A 
Cor pulmonale
Lung cancer
IHD
Recurrent pneumonia
Pneumothorax 
Respiratory failure
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1
Q

COPD Definition

A

Preventable and treatable disease characterised by progressive airflow limitation that is not fully reversible and is associated with an abnormal inflammatory response to noxious particles or gases. Both emphysema and chronic bronchitis.

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2
Q

COPD BODE index

A

BMI (<19 high risk)
Obstruction FEV1
Dyspnoea MRC score
Exercise capacity 6min walk test

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3
Q

COPD investigations

A 
Spirometry 
Pulse oximetry 
ABG
CXR
FBC
ECG
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4
Q

Causes of upper lobe fibrosis

A 
Aspergillosis ABPA
Pneumoconiosis: coal, silica
Extrinsic allergic alveolitis
Negative, sero-arthropathy
TB
Previous radiotherapy
Ank spon
Sarcoidosis
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5
Q

Causes of lower pulmonary fibrosis

A 
Sarcoidosis
Toxins (amiodarone, methotrexate)
Asbestosis 
Idiopathic pulmonary fibrosis 
Rheum: RA, SLE, SS, Sjögrens, PM/DM
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6
Q

Pulmonary fibrosis investigations

A 
PEFR, ECG
FBC, ABG, ESR, CRP, ANA, RF, C3/C4, ACE, Ca
CXR, HRCT
Spirometry
Echo
BAL, lung biopsy
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8
Q

Bronchiectasis causes

A 
Congenital: CF, PCD, Young's, Low Abs
Chronic lung disease (COPD)
Post-infectious: pertussis, TB, measles
Obstruction: tumour, foreign body
Chemical damage (acid reflux aspiration)
Associated: RA, IBD, ABPA
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9
Q

Bronchiectasis treatment

A

MDT: GP, resp, physio, dietician, immunologist
Medical: Abx (prophylactic), bronchodilators
Treat underlying cause: CF (DNAase, Creon, ADEK vits), ABPA (Steroids), Immune deficiency (IVIg)
Vaccination: flu, pneumococcus
Surgical: severe localised disease or obstruction

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10
Q

Kartagener’s Syndrome

A

Situs inversus
Chronic sinusitis
Bonchiectasis

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11
Q

Young’s Syndrome

A

Bronchiectasis
Rhinosinusitis
Azoospermia

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12
Q

Hypogammaglobulinaemia causes

A

Bruton’s X-linked Agammablobulinaemia (no B cells)
Common Variable Immunodeficiency (only IgM)
Specific Antibody Deficiency

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13
Q

Yellow Nail Syndrome

A 
Very rare
Yellow dystrophic nails
Pleural effusions
Lymphoedema: lymphatic hypoplasia
Bronchiectasis
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14
Q

Pleural Effusion causes

A
  • Transudate: CCF, CLD, Nephrotic syn, hypothyroidism, peritoneal dialysis
  • Exudate: Infection, Malignancy, PE, AI (RA, SLE), pancreatitis, drugs, post CABG, trauma, oesophageal rupture!
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15
Q

Pleural Effusion investigations

A 
Sputum
Bloods: FBC, U+Es, LFTs, TFTs, ESR, Ca
Imaging: CXR, US, CT
Diagnostic pleurocentesis: MC+S, cytology, chemistry
Pleural biopsy
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16
Q

Indications for lobectomy

A 
Lung cancer (90%)
Brochiectasis
COPD lung reduction surgery
Chronic lung abscess
TB
Benign tumours
Fungal infections (Aspergillus)
Congenital abnormalities
17
Q

Thoracotomy scar causes

A 
Pneumonectomy
Lobectomy
Oesophageal surgery
Diaphragmatic repair
Heart valve replacement
Thoracic aortic aneurysm repair
Anterior spinal tumour excision
Latissimus dorsi flaps
18
Q

Lung cancer complications

A

Local: nerve palsies, Horner’s, SVCO
Paraneoplastic: Endo (ADH, ACTH, PRHrP, 5-HT), DM/PM, Neuro (cerebellar, peripheral neuropathy), Derm (acanthosis nigricans)
Metastatic: #’s, liver failure, neurology, Addisons

19
Q

SIRS

A

Inflam response to a variety of insults manifest by ≥ 2 of:
Temperature: >38°C or 90
Respiratory rate: >20 or PaCO2 12x109/L or 10% bands

20
Q

Complications of pneumonia

A 
Parapneumonic effusion
Empyema
Lung abscess
Respiratory failure
Severe sepsis/septic shock
21
Q

TB treatment and side effects

A

Rifampicin: hepatitis, orange urine, enzyme induction
Isoniazid: peripheral sensory neuropathy
Pyrazinamide: hepatitis, arthralgia (CI: gout, porphyria)
Ethambutol: optic neuritis → loss of colour vision first

22
Q

TB surgery

A 
Artificial pneumothorax
Phrenic nerve crush
Thoracoplasty (rib removal)
Plombage (insertion of polystyrene balls)
Lobectomy/pneumonectomy
23
Q

Cor pulmonale

A

Cardiovascular consequence of chronic respiratory failure:
- pulmonary hypertension
- peripheral vasodilation and oedma from hypercapnia
- salt and water retention from renal hypoxia
Does not = RVF but can lead to it. RVF has low output state from dilated ventricle, CorP has normal output from hypertrophied ventricle

Medicine AS (16 decks)

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