Respiratory Flashcards

1
Q

Stony Dull to percuss

A

Pleural Effusion

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2
Q

Right sided pleuritic chest pain

A

Most likely pneumonia

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3
Q
Alveolar bat wings 
Kerley B lines
Cardiomegaly 
Dilated prominent upper lobe vessels 
Pleural effusion
A

Pulmonary oedema

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4
Q

Ground glass appearance on Xray

A

Pulmonary fibrosis and respiratory distress syndrome of the newborn

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5
Q

Xiehl Neelsen stain positive for acid fast bacilli

A

TB

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6
Q

Caseous necrosis

A

TB

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7
Q

Apical disease

A
Most likely (secondary) TB 
Apical lesion is called an Assmann focus
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8
Q

Military TB

A

Spread of organism into bloodstream. If organism spread via pulmonary artery, military dissemination in to the lung occurs. If organism spread via pulmonary vein, there is systemic dissemination to the liver, spleen and kidneys

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9
Q

Positive anti-glomerular basement membrane antibodies

A

Goodpasture’s syndrome

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10
Q

Chest infection with a parrot / pigeon as pet

A

Caused by chlamoydophila psittaci

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11
Q

Dry cough and diarrhoea after holiday abroad, some indication of water spread

A

Legionella pneumophila (test urine for antigens)

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12
Q

Tall, thin young man who indulges in marijuana

A

Probably pneumothorax (Marfan’s)

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13
Q

Bilateral hilar lymphadenopathy, erythema nodosum, granulomas, fatigue, uveitis and weight loss

A

Sarcoidosis

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14
Q

Bronchiole wider than neighbouring arteriole (on CT) (signet ring sign)

A

Bronchiectasis

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15
Q

D sign on X Ray

A

Empyema

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16
Q

Steeple sign on X ray

A

Laryngotracheobronchitis / croup

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17
Q

Child with barking cough

A

Croup

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18
Q

Pneumocystis pneumonia

A

HIV (treat with Co-tramoxazole)

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19
Q

Asthma + nasal polyps + salicylate sensitivity

A

Samter’s triad

20
Q

Alcoholic (danger of aspiration pneumonia)

A

Klebstelle pneumoniae

21
Q

Red jelly sputum

A

Klebsiella Pneumoniae

22
Q

Mucoid sputum

A

Chlamydia psittaci

23
Q

Rusty sputum

A

Pneumococcal pneumonia

24
Q

Cannonball metastases (also weight loss and haematuria)

A

Classically from primary renal cell carcinoma

25
Q

Morning headache

A

Hypercapnia or side effects of organic nitrates

26
Q

ACTH secreting lung tumour

A

small cell carcinoma of the lung

27
Q

PTH secreting lung tumour

A

squamous cell carcinoma of the lung

28
Q

Small-cell carcinoma

A

Neuroendocrine, highly malignant and may be associated with ectopic endocrine syndromes

29
Q

Increased serum ACE and Ca2+

A

Sarcoid

30
Q

Eggshell calcification at hilar region

A

Silicosis

31
Q

Heart failure cells seen in alveolar spaces

A

Macrophages that have absorbed haemosiderin - found in chronic pulmonary oedema and associated (sever) left ventricular heart failure
Also seen in long standing pulmonary hypertension

32
Q

Hon focus

A

An area of infection and gaseous necrosis at the periphery of the lung, beneath the pleura - found in TB infection
Hon Focus rupture (rare) through the visceral pleura into the pleural cavity will produce tuberculous pleurisy

33
Q

Acumen Focus

A

Apical lesion of secondary TB infection

34
Q

Coin lesion found on chest radiographs

A

A rounded solitary lesion
The common lesions are: Primary bronchial or lung carcinoma
Metastatic tumour (esp. of kidney)
Bronchial haemartoma, Carcinoid tumour, Granulomatous inflammation, lung abscess

35
Q

Horner’s syndrome

A

Can occur when there is a local spread of cancer to the intrathoracic nodes for a pan coast’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. This is due to invasion, of the cervical sympathetic chain

36
Q

Thumbprint sign on head Xray

A

epiglottitis

37
Q

Inspiratory whoop/ barking cough

A

pertussis

38
Q

Snow storm appearance of X ray

A

Baritosis, silicosis

39
Q

Management of infective exacerbation of COPD

A
iSOAP 
Ipratropium
Salbutamol
Oxygen 
Amoxicillin
Prednisolone
40
Q

Non smoker + lung cancer

A

Peripheral - adenocarcinoma

41
Q

Squamous + small cell lung cancers

A

Central

42
Q

High d dimers

A

suspect (but not diagnose) Pulmonary Embolism (send for CTPA or V/Q scan)

43
Q

Low d dimers

A

Exclude PE

44
Q

Large PE

A

Thrombolysis.

45
Q

Small PE

A

Low molecular weight heparin