Respiratory Flashcards
Dry, non productive cough, type 1 respiratory failure, mild renal impairment, hypoatraemia
Atypical pneumonia (legionella)
fine inspiratory crepitations, type 1 respiratory failure, restrictive spirometry and finger clubbing
Idiopathic Pulmonary Fibrosis
Acute severe bilateral pulmonary oedema due to acute capillary leak in response to trauma or illness, persistent hypoxia despite given oxygen
Acute Respiratory Distress Syndrome
Respiratory alkalosis with no metabolic compensation
Acute Panic Attack
Young Afro Caribbean woman, pulmonary fibrosis in upper lobes, restrictive lung pattern, raised serum ACE, hypercalemia, bilateral hillier lymphadenopathy
Sarcoidosis
Sudden causes of reduction in lung function
asthma, pneumothorax, PE, pulmonary haemorrhage, removal or lung collapse
High KCO
Pulmonary Haemorrhage (acute) and Pneumonectomy (later)
Cavitating tumour
Squamous cell carcinoma
BREAST CA
Bleomycin Radiation Extrinsic allergic alveolitis Ankylosing spondylitis Sarcoidosis TB Cryptogenic Fibrosing alveolitis Asbestosis
Progressive massive fibrosis
Associated with emphysema, upper lobes are affected first, opacities > 10mm in diameter
Causes of transudate effusion
organ failure- heart, kidney, lung
Causes of exudate effusion
Maligancy, infection, pulmonary infarct, TB
What to do with tension pneumothorax, spontaneous+collapse, emergency, trauma
Emergency: immediate needle thoracocentesis
Spontaneous + lung collapse: needle aspiration
Trauma: 5th intercostal space, mid axillary line
deletion of chromosome 22q11, hypocalaemia, recurrent viral, bacterial and frequent fungal infections, absent or decreased T cells, normal/raised B cells. Developmental defect…
Di George Syndrome
Mutation of IL-2 receptor, very low or absent T cells, persistent diarrhoea, failure to thrive, graft host skin disease
SCID
Failure to produce mature B cells, selective IgA deficiency
Bruton’s hypogammaglobulinaemia
Low IgG, IgA and IgE, recurrent bacterial infections, autoimmune disease, granulomatous
CVID
Bronchiolitis in children
Respiratory Synctial Virus RSV
Rare autoimmune disease, muscle weakness, paraneoplastic syndrome
Eaton Lambert Syndrome
Failure to produce neutrophils
Reticular dysgenesis
autosomal recessive disorder with severe chronic neutropenia, recurrent bacterial infections after first 2 weeks of birth, failure to thrive, irritability, oral ulceration
Kostmann syndrome
Failure of neutrophil adhesion and migration
genetic defect in CD18 or defect in CD18
Failure of oxidative killing mechanism, deficient of p47 in NADPH oxidase, excessive inflammation and granuloma formation, NBT testing
Chronic Granulomatous Disease
Gel and Coombs IDID
Immediate hypersensitivity
Direct Cell Killing
Immune complex mediated
Delayed type hypersensitivity
Type 2 hypersensitivity, muscle weakness
Guillan Barre Syndrome
Type 2 hypersensitivity, overactive Thyroid and Bulging eyes
Grave’s disease
Immune complexes deposited in walks of alveoli and bronchioles, examination often normal but may have dry cough, pyrexia, wheeze and malaise
acute hypersensitivity pneumonitis
antibodies form against a person’s own protein
Systemic Lupus Erythematosus
Drug addict in type 1 respiratory distress, treatment and why?
Treat with IV antibiotics to prevent HIV
Pulmonary oedema with no cardiomegaly
acute left ventricular heart failure
level of right hilar
6th rib
Causes of numerous calcified nodules
TB, Histaplomosis, chronic renal failure, Varicella pneumonitis
double shadow heart border, prominent left atrial apendage, left main bronchus elevation
Advanced mitral stenosis
Ring shadows and tram lines on CXR
Bronchiectasis
Ground glass appearance on CXR
Cryptogenic fibrosing alveolitis and ARDS
A patient in type 2 respiratory failure who has responded poorly to medication should be given what next?
NIPPV so long as he is conscious and cooperative, next proceed to intubation
A mucus secreting cell found in respiratory epithelium
Goblet cell
A non ciliated cell found in terminal bronchioles. Acts as an immune modulator and stem cell and is able to produce surfactant
Clara cell
A polygonal cell that is able to release surfactant from lamellar bodies within cytoplasm
Type 2 pneumocyte
Non keratinised stratified squamous epithelium
Oropharynx
Keratinised stratified squamous epithelium
Nasal cavity
Olfactory
roof of nasal cavity
Side effects of RIPE
Rimfampicin: hepatitis, discolouration of the urine/tears, orange/red
Isoniazide: Neuropathy, agranulocytosis, allergic reaction
Pyrazinamide: Hepatic toxicity (rare), reduced excretion of rate, gout,
Ethambutol: colour blindness, developing into blindness
Positive result for cANCA
Granulomatous with positive for polyangitis
Bacterial causes of epiglottitis
Haemophilus Influenza B, Streptococcol or Staphylcoccal
Complication of Cystic Fibrosis
Pancreatic insufficiency
Chronic sinusitis, dextrocardia and infertility
Kartanger’s syndrome
Cannon ball metastases
Renal cell carcinoma
What organism is likely to cause infection excerbations of COPD and what antibiotics should be given?
Haemophillus Influenza and treated with amoxicillin or trimethoprim
When should an IV bronchodilator be given to a patient which an acute exacerbation of asthma?
Only if the patient has failed to respond to REPEATED nebulised treatment
Small cell carcinoma
oat cell- arises from endocrine cells which secrete polypeptide hormones. Highly malignant and rapid growing but response well to chemotherapy.
Squamous cell carcinoma
40% of lung carcinomas, cavitates, metastases late
Large cell carcinoma
25% of all tumours, metastases early
Adenocarinoma
10% of all tumours. Arises in scar tissue and is associated with asbestos. More common in non smokers, women and elderly
Alveolar cell carcinoma
1-2% of patients. The patients produce large amounts of mucoid sputum.
In COPD patients, non smokers with baseline O2 <7.3kPa consider…
Long term oxygen therapy for more than 15hrs a day to increase survival
Egg shell calcification of hilar nodes
Silicosis
Rheumatoid arthritis and rounded fibrotic nodules 0.5-5cm
Caplan’s Syndrome
double shadow heart border, prominent left atrial apendage, left main bronchus elevation, widening of carina
Advanced mitral stenosis
