Respiratory Flashcards
stony dull to percuss
pleural effusion
right sided pleuritic chest pain
likely pneumonia
alveolar bat wings, kerley B lines, cardiomegaly, dilated prominent upper lobe vessels
pulmonary oedema
ground-glass appearance on CXR
pulmonary fibrosis and respiratory distress syndrome of the newborn
Zeihl-Neelson stain positive for acid fast bacilli
TB
Caseous necrosis
TB
apical disease
most likely (secondary) TB; apical lesion is called an Assman focus
positive anti-glomerular basement membrane antibodies
Goodpasture’s syndrome
chest infection with parrot/pigeon as a pet
caused by chlamoydophila psittaci - psittacosis
dry cough and diarrhoea after holiday abroad, some indication of water spread, air conditioning
Legionella pneumophila (test for urine antigens)
tall thin young man who indulges in marijuana
probably pneumothorax (Marfan’s)
bilateral hilar lymphadenopathy, erythema nodosum, granulomas, fatigue, uveitis, weight loss
sarcoidosis
bronchiole wider than neighbouring arteriole (on CT) signet ring sign
bronchiectasis
D sign on X ray
empyema
‘steeple’ sign on x-ray
laryngotracheobronchitis/croup
child with barking cough
croup
pneumocystis pneumonia
HIV - treat with co-tramoxazole (plus 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 (weight loss and haematuria)
classically from primary renal cell carcinoma
morning headache
hypercapnia or side effects from organic nitrates
ACTH secreting lung tumour
small cell carcinoma of the lung
PTH secreting lung tumour
squamous cell carcinoma of the lung
small cell carcinoma
neuroendocrine, highly malignant, may be associated with ectopic endocrine syndromes
increased serum ACE and Ca2+
sarcoidosis
eggshell calcification at hilar region
silicosis
‘heart failure cells’ seen in alveolar spaces
macrophages that have absorbed haemosiderin - found in chronic pulmonary oedema and associated with LHF and long standing pulmonary hypertension
Ghon focus
area of infection and caseous necrosis at the periphery of the lung, beneath the pleura - found in TB
note: Ghon focus rupture (rare) through the visceral pleura into the pleural cavity will produce tuberculous pleurisy
Assman focus
apical lesion of secondary TB infection
Horner’s syndrome
can occur when there is a local spread of cancer to the intrathoracic nodes or a Pancoast’s tumour
signs include: ptosis (drooping of the eyelid), enophthalmos (sunken eye), miosis (small pupil), and lack of sweating on the ipsilateral (same side as invasion) side of the face due to invasion of the cervical sympathetic chain
Acute management of asthma
OSHIT MAN:
- Oxygen 100% through a non-rebreather mask
- Salbutamol nebuliser back-to-back
- Hydrocortisone IV or Prednisolone PO
- Ipratropium Bromide nebulised hourly
- Theophylline IV or aminophylline IV
- Magnesium
- ANaesthetist
thumbprint sign on head xray
epiglottitis
inspiratory whoop/barking cough
perfussis
snow storm appearance on CXR
baritosis, silicosis
management of infective exacerbation of COPD:
iSOAP: ipratropium Salbutamol Oxygen Amoxicillin Prednisolone
non-smoker with lung cancer
(peripheral) adenocarcinoma
squamous and small cell lung cancers
central
high d-dimers
suspect (not diagnose) pulmonary embolism (send for CTPA or V/Q scan)
low d-dimers
exclude PE
treatment for large PE
thrombolysis
treatment for small PE
low molecular weight heparin
