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
Small cell carcinoma
Neuroendocrine, highly malignant and may be associated with ectopic endocrine syndromes
26
Increased serum ACE and Ca2+
Sarcoid
27
Eggshell calcification at hilar region
Silicosis
28
'Heart failure' cells seen in alveolar spaces
Macrophages that have absorbed haemosiderin: found in **chronic pulmonary oedema** and associated (severe) LV heart failure Also seen in long-standing hypertension
29
Ghon Focus
- Area of infection and caseous necrosis at the periphery of the lung beneath the pleura (found in TB)
30
Assman Focus
Apical lesion of secondary tuberculosis infection
31
Coin lesion found on chest radiographs
A rounded solitary lesions Common: primary bronchial or lung carcinoma, metastatic tumour, bronchial hamartoma, carcinoid tumour, granulomatous inflammation, lung abscess
32
Horner's Syndrome
- 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
Acute Management of Asthma
**O**xygen **S**albutamol (nebulised back to back) **H**ydrocortisone IV or Prednisalone PO **I**pratropium Bromide (nebulised hourly) **T**heophylline IV or aminophylline IV **M**agnesium and call an **A**naesthetist **OH SHIT MAN**
34
Thumbprint sign on head X ray
Epiglottitis
35
Inspiratory whoop/barking cough
Pertussis
36
Snow storm appearance on X ray
Baritosis Silicosis
37
Management of infective exacerbation of COPD
**i** - ipratropium **S** - Salbutamol **O** - Oxygen **A** - Amoxicillin **P** - Prednisalone
38
Non-smoker + Lung Cancer
(peripheral) adenocarcinoma
39
Squamous + Small Cell Lung Cancers
Central
40
High D Dimers
Suspect; Pulmonary Embolism (send for CTPA or V/Q scan)
41
Low D Dimers
Exclude Pulmonary Embolism
42
Large PE
Thrombolysis
43
Small PE
Low Molecular Weight Heparin
44
Honeycomb lung
Fibrosing alveolitis
45
TB Drugs 2 RIPE 4 RI
2 months = Rifampicin, Isoniazid, Pyrazinamide, Ethambutol 4 months = Rifampicin, Isoniazid Side effects = orange tear, hepatic and renal toxicity
46
Respiratory causes of Clubbing
**A**BSCESS **B**RONCHIECTASIS **C**ARCINOMA OF THE LUNG **D**ECREASED PaO2 **E**MPYEMA **F**IBROTIC LUNG DISEASE
47
PE risk factors
**H**eridatary risk factors **H**istory **H**ypomobility **H**ypovolaemia **H**ypercoaguability **H**ormones **H**yperviscosity states
48
Causes of Pulmonary Fibrosis
**B**leomycin **R**adiation **E**xtrinsic allergic alveolitis **A**ankylosing spondylitis **S**arcoidosis **T**uberculosis
49
Causes of BHL (Bilateral Hilar Lymphadenopathy)
Sarcoidosis Infection (TB, Mycoplasma) Malignancy (lymphoma, carcinoma, mediastinal tumours) Organic Dust Disease (silicosis, berylliosis) Extrinsic Allergic Alveolitis
50
Pink Frothy Sputum
Pulmonary Oedema
51
Increased vocal resonance
Fibrosis = the thickened parenchyma conducts transmitted sounds better
52
Wedge shaped infarct on CXR
PE - Unusual presentation
53