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’s wings

Kerley B lines

Cardiomegaly

Dilated prominent upper lobe vessels

Pulmonary Effusion

A

Pulmonary Oedema

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4
Q

Ground-glass appearance on X-ray

A

Pulmonary Fibrosis and RDS of the newborn

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5
Q

Ziehl-Neeson stain +VE for acid fast bacilli

Caseous Necrosis

A

TB

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6
Q

Miliary Tuberculosis

A
  • Spread of organism into bloodstream
  • If organism spreads via pulmonary artery, miliary dissemination into the lungs occurs
  • If organism spread via pulmonary vein, there is systemic dissemination to the liver, spleen and kidneys
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7
Q

Positive anti-glomerular basement membrane antibodies

A

Goodpasture’s syndrome

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8
Q

Chest Infection with a parrot/pigeon as a pet

A

Caused by chlamydophila psittaci

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9
Q

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

A

Legionella Pneumonia

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10
Q

Tall, thin young man who indulges in marijuana

A

Pneumothorax (Marfan’s)

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11
Q

Bilateral hilar lymphadenopathy

Erythema nodosum

Granulomas

Fatigue

Uveitis

Weight loss

A

Sarcoidosis

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12
Q

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

A

Bronchiectasis

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13
Q

D sign on X ray

A

Empyema

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14
Q

‘Steeple’ sign on X ray

A

laryngotracheobronchitis/croup

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15
Q

Child with a barking cough

A

Croup

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16
Q

Pneumocystis Pneumonia

A

HIV

Treat with Co-trimoxazole +/- prednisalone if severe

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17
Q

Asthma

Nasal polyps

Salicylate sensitivity

A

Samter’s Triad

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18
Q

Alcoholic (danger of aspiration pneumonia)

Red Jelly Sputum

A

Klebsiella pneumoniae

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19
Q

Mucoid sputum

A

Chlamydia psittaci

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20
Q

Rusty sputum

A

Pneumococcal pneumonia

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21
Q

Cannonball metastases (also weight loss and haematuria)

A

Classically from primary renal cell carcinoma

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22
Q

Morning Headache

A

Hypercapnia

Side effects of organic nitrates

23
Q

ACTH secreting lung tumour

A

Small cell carcinoma of the lung

24
Q

PTH secreting lung tumour

A

Squamous cell carcinoma of the lung

25
Q

Small cell carcinoma

A

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

26
Q

Increased serum ACE and Ca2+

A

Sarcoid

27
Q

Eggshell calcification at hilar region

A

Silicosis

28
Q

‘Heart failure’ cells seen in alveolar spaces

A

Macrophages that have absorbed haemosiderin: found in chronic pulmonary oedema and associated (severe) LV heart failure

Also seen in long-standing hypertension

29
Q

Ghon Focus

A
  • Area of infection and caseous necrosis at the periphery of the lung beneath the pleura (found in TB)
30
Q

Assman Focus

A

Apical lesion of secondary tuberculosis infection

31
Q

Coin lesion found on chest radiographs

A

A rounded solitary lesions

Common: primary bronchial or lung carcinoma, metastatic tumour, bronchial hamartoma, carcinoid tumour, granulomatous inflammation, lung abscess

32
Q

Horner’s Syndrome

A
  • Can occur when there is a local spread of cancer to the intrathoracic nodes or a Pancoast’s tumour

Signs: ptosis (drooping of the eyelid), enophthalmos (sunken eye), miosis (small pupil) and lack of sweating on the ipsilateral (same side as the invasion) side of face,

Due to invasion of the cervical sympathetic chain

33
Q

Acute Management of Asthma

A

Oxygen

Salbutamol (nebulised back to back)

Hydrocortisone IV or Prednisalone PO

Ipratropium Bromide (nebulised hourly)

Theophylline IV or aminophylline IV

Magnesium and call an

Anaesthetist

OH SHIT MAN

34
Q

Thumbprint sign on head X ray

A

Epiglottitis

35
Q

Inspiratory whoop/barking cough

A

Pertussis

36
Q

Snow storm appearance on X ray

A

Baritosis

Silicosis

37
Q

Management of infective exacerbation of COPD

A

i - ipratropium

S - Salbutamol

O - Oxygen

A - Amoxicillin

P - Prednisalone

38
Q

Non-smoker + Lung Cancer

A

(peripheral) adenocarcinoma

39
Q

Squamous + Small Cell Lung Cancers

A

Central

40
Q

High D Dimers

A

Suspect;

Pulmonary Embolism (send for CTPA or V/Q scan)

41
Q

Low D Dimers

A

Exclude Pulmonary Embolism

42
Q

Large PE

A

Thrombolysis

43
Q

Small PE

A

Low Molecular Weight Heparin

44
Q

Honeycomb lung

A

Fibrosing alveolitis

45
Q

TB Drugs

2 RIPE 4 RI

A

2 months = Rifampicin, Isoniazid, Pyrazinamide, Ethambutol

4 months = Rifampicin, Isoniazid

Side effects = orange tear, hepatic and renal toxicity

46
Q

Respiratory causes of Clubbing

A

ABSCESS

BRONCHIECTASIS

CARCINOMA OF THE LUNG

DECREASED PaO2

EMPYEMA

FIBROTIC LUNG DISEASE

47
Q

PE risk factors

A

Heridatary risk factors

History

Hypomobility

Hypovolaemia

Hypercoaguability

Hormones

Hyperviscosity states

48
Q

Causes of Pulmonary Fibrosis

A

Bleomycin

Radiation

Extrinsic allergic alveolitis

Aankylosing spondylitis

Sarcoidosis

Tuberculosis

49
Q

Causes of BHL (Bilateral Hilar Lymphadenopathy)

A

Sarcoidosis

Infection (TB, Mycoplasma)

Malignancy (lymphoma, carcinoma, mediastinal tumours)

Organic Dust Disease (silicosis, berylliosis)

Extrinsic Allergic Alveolitis

50
Q

Pink Frothy Sputum

A

Pulmonary Oedema

51
Q

Increased vocal resonance

A

Fibrosis

= the thickened parenchyma conducts transmitted sounds better

52
Q

Wedge shaped infarct on CXR

A

PE

  • Unusual presentation
53
Q
A