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Sam Clin Path > Respiratory > Flashcards

Respiratory Flashcards

1
Q

proportion of children diagnosed with asthma in UK?

A

1/10

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2
Q

Type 1 pneumocyte =?

A

Gas exhange

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3
Q

Type 2 pneumocyte =?

A

Surfactant

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4
Q

Type 1 respiratory failure =?

A

Low CO2

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5
Q

Type 2 respiratory failure =?

A

High CO2 >6.3 hypercapnic drive

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6
Q

Interstitial lung diseases examples?

A

ARDS, Fibrosisng alveolitits and sarcoidosis.

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7
Q

Mesothelioma is a disease of what?

A

Pleura

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8
Q

% lung tumours malignant?

A

90%

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9
Q

% lung tumours due to smoking ?

A

80%

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10
Q

Risk factors for Lung CA

A

Cigarettes naturally, asbestos, radon, tar, arsenic chromates.

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11
Q

Primary lung tumours are….

A

Rare

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12
Q

Most dangerous asbestos?

A

Blue

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13
Q

High levels of asbestos causes what?

A

Pulmonary fibrosis

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14
Q

% of lung cancer that are non small cell?

A

85% with 52% squamous

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15
Q

All small cell carcinomas are of what origin?

A

Neuroendocrine

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16
Q

small cell carcinoma accounts for what % of lung cancer?

A

15%

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17
Q

Cytokeratin positive lung tumours are from where?

A

Upper GI, but also small cell and adeno

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18
Q

Cytokeratin 7 -ve and 20 +ve possibly from where/

A

Colorectal

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19
Q

Squamous carcinoma of lung can cause what blood abnormality?

A

Hypercal due to parathyroid peptide

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20
Q

approx 90% of people with this lung cancer are smokers?

A

Squamous

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21
Q

Normal bronchus lining?

A

Pseudostrat colum epi

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22
Q

Irritants in smoke cause what change in the epithelium of bronchus?

A

Metaplastic change to stratified squamous

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23
Q

define: One metaplastic cell undergoes irreversible genetic changes (a series of sequential somatic mutations of oncogenes & anti-oncogenes) producing the first neoplastic cell
{squamous}

A

Dysplasia

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24
Q

Neoplastic cells proliferate [squamous]….

A

more successfully than metaplastic and replace these = dysplasia and carcinoma insitu

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25
Q

neoplastic cells invade basement membrane to produce …

A

Invasive squamous carcinoma

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26
Q

Bronchioalveolar carcinoma also known as?

A

Adenomcarcinoma in situ

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27
Q

Adenocarcinoma in situ mimics what disease?

A

Pneumonia

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28
Q

what is a kulchitsky cell?

A

Neuroendocrine cell

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29
Q

Typical lung carcinoid tumours are not associated with?

A

Smoking

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30
Q

Atypical lung carcinoid tumours … talk to me?

A

not good, necrosis, aggressive grrrr

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31
Q

Large cell lung neuroendocrine tumours associated with?

A

Smoking

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32
Q

Smokers account for what % of lung small cell tumours?

A

99%

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33
Q

Hormones such as acth present in what lung carcinomas?

A

Small cell

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34
Q

approx 50% of large cell carcinomas express what factor?

A

Thyroid transcription

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35
Q

Lambert Eaton myasthenic syndrome caused by what lung problerm?

A

anti-neuromuscular junction autoantibodies in small cell carcinoma

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36
Q
A

T1

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37
Q

T2 =

A

3-7cm

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38
Q

> 7cm =

A

T3

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39
Q

New drugs used in lung cancer?

A

EGFR-TK imhibitor non curative but stabilises

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40
Q

Transudate pleural effusion seen in?

A

Your mum … CCF

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41
Q

Malignant mesothelioma is a tumour of what?

A

Pleura

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42
Q

what % of mesothelioma asbestos responsible ?

A

> 90 blue especially and brown

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43
Q

What is often seen on radiographs to indicate exposure to asbestos?

A

fibrous pleaural plaques

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44
Q

Are fibrous pleural plaques malignant

A

no

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45
Q

Definition of chronic bronchitis?

A

Cough and sputum 3 months in each of 2 consecutive years

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46
Q

Define emphysema?

A

Abnormal permanent dilation of airspace distal to terminal bronchiole destruction of airspace wall. no fibrosis

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47
Q

Classicifcation of emphysema?

A

centrilobular or panlobular (>80% alpha anti trypsin deficient)

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48
Q

often adult onset asthma is associated with what?

A

Occupation

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49
Q

restrictive lung diseases often what type?

A

interstitial

50
Q

inflammation and fibrosis of lung tissue causes waht?

A

Increased diffusion distance restrictive disease

51
Q

Lobes affected first in idiopathic pulmonary fibrosis?

A

Sub pleural lower lobes

52
Q

Characteristic appearance of idiopathic pulmonary fibrosis on lung?

A

cobblestone

53
Q

What is sarcoidosis?

A

Non-caseating perilymphatic pulmonary granulomas, then fibrosis

54
Q

What size must inhaled particles be in order to reach alveoli?

A
55
Q

What does silicosis do to the lungs?

A

Kills phagocytosing macrophages

56
Q

Silicosis can cause reactivation of what?

A

TB

57
Q

pigeon fanciers lung is what type of reaction?

A

Type III super pigeon antigen

58
Q

cftr gene on which chromosome?

A

7

59
Q

Normal flora of urt?

A

Strep viridans, neisseria, diptheroid and anerobes

60
Q

asymptomatic pathogen carry?

A

Strep pneumoniae, moraxella, and strep pyogenes, haemophillus influenza

61
Q

Rhino sinusitis aetiology?

A

Post viral inflammation

62
Q

Rhinosinusitis organism is bacterial?

A

Strep pneumoniae, haemophillus

63
Q

Rhinosinusitis abx if needed?

A

Amoxicillin

64
Q

what should you avoid giving to people with EBV?

A

Ampicillin (rash and may say allergic)

65
Q

Ebv diagnosis?

A

serology IgM igG

66
Q

Diptheria causative organism?

A

Corynebacterium diptheriae

67
Q

Diptheria treatment?

A

Erythromycin/penicillin and antitioxin severe

68
Q

Epiglottitis what should you not do?

A

Touch throat, unless ET tube to hand

69
Q

Lateral neck XRAY can diagnose what?

A

Epiglottitis

70
Q

Hot potato speech?

A

Epiglottitis

71
Q

Treatment of epiglottitis?

A

cefotaxime

72
Q

Croup aka?

A

Laryngotracheobronchitis.

73
Q

incubation of whooping cough?

A

1-3 weeks

74
Q

otitis externa -acute possible organism?

A

Pseudomonas, s.aureus

75
Q

What to avoid in chronic otitis externa?

A

gentamicin

76
Q

Malignant otitis externa ?

A

lots of pus and pain often pseudomonas

77
Q

otitis media common cause?

A

Most viral

78
Q

Co-amoxiclav first line for treating what in the ear?

A

Mastoiditis

79
Q

3 usual suspects

A

strep pneumoniae, moraxella, and haemophilus influenzae

80
Q

pseudomonal antibiotics examples c,c,g

A

ciprofloxacin, ceftazadine, gentamicin

81
Q

what is unusual about the cell wall of mycobacteria?

A

Unusually waxy

82
Q

Comment on the growth of mycobacterium?

A

slow growing

83
Q

What is a classic stain for mycobacteria?

A

Acid fast, Ziehl Neelsen

84
Q

Important skin infection caused by mycobacterium?

A

M.leprae

85
Q

one third of worlds population infected with what?

A

TB

86
Q

> 50% of TB is what?

A

Pulmonary

87
Q

Most common sone for TB in lungs?

A

Midzone

88
Q

There is often a focus of what on a chest radiographs?

A

Ghon focus of the hilar lymph node

89
Q

Granuloma in TB are what?

A

Epitheloid cells, and giant cells

90
Q

What type of nbecrosis in TB possibly?

A

Casseous

91
Q

Risks for TB re-activation?

A 
>50
Men
alcoholism
HIV
INFLIXIMAB!
Chronic disease
92
Q

TB often reactivated where in lungs?

A

Apices, obligate aerobe

93
Q

Miliary tb is what affects who?

A

Very young, old, immunocompromised

94
Q

TB meningitis presentation?

A

Insidious, persoonality change, fever, focal defects, mild headache

95
Q

TB blood test?

A

Interferon gamma release

96
Q

How many specimins of sputum and when TB?

A

3 early morning

97
Q

> how many oprganism per ml is smear positive in TB?

A

5000

98
Q

Tb meningitis high what white cell count in CSF?

A

Lympho

99
Q

2 months of tb treatment how many drugs?

A

4 drugs

100
Q

4 months tb how many drugs?

A

2 drugs

101
Q

Main drugs for TB?

A

Isoniazid, rifampicin, pyrazinamide, streptomycin(ethamutol)

102
Q

secondline TB drug (a)

A

Amikacin

103
Q

Leprosy also know as what?

A

Hansens disease

104
Q

4 groups of pneumonia?

A

ventilator, community, hospital, aspiration

105
Q

Predisposing factors for LRTI?

A

Swallowing issues, no cough reflex, ciliary defect, pulmonary oedema, smoking and congenital immunodeficiency

106
Q

LRTI includes what?

A

Below larynx

107
Q

4 viral causes of bronchitis?

A

coronavirus, rhinovirus, adenovirus and influenza

108
Q

Bronchiolitis msot common in?

A

Kids (2-10mnths)

109
Q

Most common cause of bronchiolitis?

A

RSV (75%)

110
Q

Pneumonia affects where?

A

most distal airways

111
Q

two anatomical pneumonias?

A

Bronchial and lobar

112
Q

Lobar pneumonia >90% caused by what?

A

S.pneumoniae

113
Q

Hospital acquired pneumonia classified if acquired when ?

A

> 48hrs after hospital

114
Q

organisms with hospital pneumoniae?

A

Enterobacteria and pseudopmonas

115
Q

Community acquired pneumonia incidnce?

A

1%

116
Q

Atypical pneumonia organism?

A

Mycoplasma, legionella, chlamydia and coxiella

117
Q

Typical pneumonia organism?

A

strep pneumo, moraxella, haemophillus, staph, kleb

118
Q

Classical pneumonia symptoms?

A

Quick onset, chest pain, fever, rigors, malaise and fatigue

119
Q

Legionealla associated with what symptom most?

A

High High fever, vomiting, lfts deranged

120
Q

Guillain barre and peripheral neuropathy = possibility what pneumonia?

A

Mycoplasma

121
Q

Bird handlers pneumonia type + symptom?

A

Chlamydia psittaci and splenomegaly

122
Q

score for pneumonia ? greater than what for doing stuff?

A

CURB65 >2

Sam Clin Path (9 decks)

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