Respiratory Flashcards
Stony dull to percuss
Pleural effusion
Right sided pleuritic chest pain
Most likely pneumonia
Alveolar bat’s wings, Kerley B lines, cardiomegaly, dilated prominent upper lobe vessels, pleural effusion
Pulmonary oedema
Ground-glass appearance on X-ray
Pulmonary fibrosis and Respiratory distress syndrome of the new born
Zeil-Neelsen stain positive for acid fast bacilli
TB
Caseous necrosis
TB
Apical disease
Most likely (secondary) TB
Miliary Tuberculosis
Spread of organism into bloodstream
Positive anti-glomerular basement membrane antibodies
Goodpasture’s syndrome
Chest infection with a parrot/pigeon as pet
Caused by chlamydophila psittaci
Dry cough and diarrhoea after holiday abroad, some indication of water spread
Legionella pneumophila (test urine for antigens)
“tall thin man who indulges in marijuana” (Mr. Snoop Dogg)
Probable pneumothorax
Bilateral hilar lymphadenopathy, erythema nodosum, granulomas, fatigue, uveitis and weight loss
Sarcoidosis
Bronchiole wider than neighbouring arteriole (on CT) (signet ring sign)
Bronchiectasis
“D sign on CXR”
Empyema
“Steeple” sign on CXR
laryngotracheobronchitis/croup
Child with barking cough
Croup
Pneumocystis pneumonia
HIV (treat with Co-trimoxazole [± prednisolone if severe])
Asthma + Nasal polyps + Salicylate sensitivity
Samter’s Triad
Alcoholic (danger of aspiration pneumonia)
Klebsiella Pneumoniae
Red jelly sputum
Klebsiella Pneumoniae
Mucoid sputum
Chlamydia psittaci
Rusty sputum
Pneumococcal pneumonia
Cannonball metastases (also weight loss and haematuria)
Classically from primary renal cell carcinoma
Morning headache
Hypercapnia
ACTH secreting lung tumour
Small cell carcinoma of the lung
PTH secreting lung tumour
Squamous cell carcinoma of the lung
Small-cell carcinoma
Neuroendocrine
Increased serum ACE and Ca2+
Sarcoidosis
Eggshell calcification at hilar region
Silicosis
‘Heart-failure cells’ seen in alveolar spaces
Macrophages that have absorbed haemosiderin
Ghon focus
An area of infection and caseous necrosis at the periphery of the lung, beneath pleura
Assmann focus
Apical lesion of secondary tuberculosis infection
‘Coin lesion’ found on chest radiographs
A rounded solitary lesion e.g. primary bronchial or lung carcinoma, metastatic tumour
Horner’s syndrome
Can occur when there is a local spread of cancer to the intrathoracic nodes
Acute management of asthma
OHSHIT MAN Oxygen 100% through non-rebreather mask Salbutamol nebuliser back-to-back Hydrocortisone IV or Prednisolone PO Ipratropium IV or aminophylline IV Magnesium and call an Anaesthetist
Thumbprint sign on head X-ray
Epiglottitis
Inspiratory whoop/barking cough
Pertussis
Snow storm appearance on X-ray
Baritosis, silicosis
Management of infective exacerbation of COPD
iSOAP Ipratropium Salbutamol Oxygen Amoxicillin Prednisolone
Non-smoker + lung cancer
(peripheral) Adenocarcinoma
Squamous + small-cell lung cancers
CENTRAL
High d-dimers
Suspect pulmonary embolism
Low d-dimers
Exclude pulmonary embolism
Large PE
Thrombolysis
Honey-combing + pleural plaques
Asbestosis
Breathless after transplant
Bronchiolitis obliterans
Respiratory alkalosis
PE
Hyperventilation
Stroke
Altitude
Respiratory acidosis
COPD
Asthma
Obesity hypoventilation syndrome
