Respiratory Flashcards
What is stony dull to percussion on the chest?
Pleural Effusion
What is the most likely diagnosis of right sided pleuritic chest pain?
Pneumonia
What can cause the following - alveolar bat’s wings, kerley B lines, cardiomegaly, dilated prominent upper lobe vessels and/or pleural effusion?
Pulmonary Oedema
What can cause a ground-glass appearance on an X-ray (2)?
Pulmonary Fibrosis
Respiratory Distress Syndrome of the Newborn
What cause a positive Ziehl-Neelsen stain for acid fact bacilli?
TB
What disease causes caseous necrosis?
TB
Name the most likely apical diseases?
Secondary TB (the apical lesion is called an Assmann Focus)
What disease involves the spread of organism into the blood stream? If spread via the pulmonary artery it disseminated into the lungs and if the organism spreads via the pulmonary vein their is systemic dissemination into the liver, spleen and/or kidneys?
Miliary Tuberculosis
What does a positive anti-glomerular basement membrane antibody indicate?
Goodpasture’s Syndrome
What is the likely bacterial cause of a chest infection of a patient who owns a parrot or pigeon?
Chlamydophila Psittaci
What disease (bacteria) presents with a dry cough, diarrhoea and an indication of water spread? Also what test would you do to confirm diagnosis?
Legionella Pneumophila which can be tested for by using for antigen
Who classically gets a spontaneous pneumothorax (2)?
Tall, thin, young men who indulge in marijuana Mardans Syndrome (connective tissue disorder)
Bilateral hilar lymphadenopathy, erythema nodosum, granuloma, fatigue, uveitis and wight loss are symptoms of what disease?
Sarcoidosis
What causes the signet ring sign on a CT scan when the bronchioles are wider (dilated) than neighbouring arterioles?
Bronchiectasis
What causes a D sign on an CXR?
Empyema
What causes a “steeple” sign on a CXR (2)?
Laryngotracheobronchitis
Croup
What is the likely diagnosis of a child with a barking cough?
Croup
Who normally gets pneumocystis pneumonia and how is it treated?
Patients with HIV and it is treated with Co-Tramoxazole and Prednisolone if severe
What 3 conditions make up Samter’s Triad?
Asthma
Nasal Polyps
Salicylate Sensitivity
What pneumonia (including bacteria) are alcoholics likely to get?
Aspiration pneumonia caused by Klebsiella Pneumonia
What causes (bacteria) red jelly sputum?
Klebsiella Pneumonia
What causes (bacteria) mucoid sputum?
Chlamydia Psittaci
What causes (bacteria) rusty sputum?
Pneumococcal Pneumonia
What classically causes cannonball metastases and also weight loss and haematuria?
Primary Renal Cell Carcinoma
What can cause a morning headache (2)?
Hypercapnia
Side effects of organic nitrates
What type of cancer has ACTH (Adrenocorticotropic Hormone) secreting lung tumours?
Small Cell Carcinoma of the Lung
What type of cancer has ACTH (Adrenocorticotropic Hormone) secreting lung tumours?
Small Cell Carcinoma of the lung
What type of cancer has PTH (Parathyroid Hormone) secreting lung tumour?
Squamous Cell Carcinoma of the lung
What lung cancer affects neuroendocrine cell, is highly malignant and may be associated with ectopic endocrine syndromes?
Small cell Carcinoma of the lungs
What causes and increase in serum ACE (Angiotensin Converting Enzyme) and Calcium levels?
Sarcoidosis
What causes eggshell calcification at the hillier regions of the lungs?
Silicosis
What is meant by “heart failure cells” seen in alveolar spaces?
Macrophages that have absorbed haemosiderin. This can be found in pulmonary oedema and is associated with sever left ventricular heart failure. It is also seen in long-standing pulmonary hypertension
What is a Ghon Focus and what happens if they rupture?
An area of infection and caseous necrosis at the periphery of the lung and beneath the pleura. They are found in TB. If the Ghon Focus ruptures (rare) through the visceral pleura and into the pleural cavity, this will produce tuberculosis pleurisy
What is an Assmann Focus?
An apical lesion of secondary tuberculosis infection
What is a “coin lesion” found on a chest radiograph and its causes (7)?
A round solitary lesion. the common lesions are primary bronchial or lung carcinoma, metazoic tumour (especially of the kidneys), bronchial hamartoma, carcinoid tumour, granulomatous inflammation and lung assesses
What is a “coin lesion” found on a chest radiograph and its causes (7)?
A round solitary lesion. the common lesions are primary bronchial or lung carcinoma, metazoic tumour (especially of the kidneys), bronchial hamartoma, carcinoid tumour, granulomatous inflammation and lung absesses
What is Horner’s Syndrome and the Signs?
Can occur when there is a local spread of cancer to the intrathoracic nodes or a Pancoast’s tumour. Signed include ptosis (drooping of the eyelid), exophthalmos (sunken eye), miosis (small pupil) and lack of sweating on the ipsilateral (same side as invasion) of the face. This is due to invasion of the cervical sympathetic chain
Describe the acute management of asthma?
OSHIT MAN: Oxygen 100% non-rebreather mask Salbutamol Nebulised Hydrocortisone IV or Prednisolone PO Ipatropium Bromide
Describe the acute management of asthma?
OSHIT MAN: Oxygen 100% non-rebreather mask Salbutamol Nebulised Hydrocortisone IV or Prednisolone PO Ipatropium Bromide Nebulised hourly Theophylline IV or Aminophylline IV Magnesium and Call an Anaesthetist
What does a Thumbprint sign on a head X-Ray indicate?
Epiglottitis
What has an inspiratory whooping or barking cough?
Pertussis
What causes a snowstorm appearance on an CXR (2)?
Baritosis
Silicosis
What is the management of infective exacerbation of COPD?
iSOAP: i for ipratropium S for Salbutamol O for Oxygen A for Amoxicillin P for Prednisolone
What cancer usually occurs in non-smokers (including location)?
(Peripheral) Adenocarcinoma
Where are squamous and small cell lung cancers located?
Central
What do you suspect if you find high d-dimers?
Suspect (but not diagnose) Pulmonary Embolism. Send for a CTPA (CT Pulmonary Angiogram) or V/Q scan
What does a low d-dimer result mean?
Exclude diagnosis of Pulmonary Embolism
What is the treatment for a large pulmonary embolism?
Thrombolysis
What is the treatment for a small pulmonary embolism?
Low Molecular Weight Heparin
