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5th year countdown > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Differentials for pyrexia + productive cough

A

Pneumonia (bacterial - typical bc atypical), viral, fungal
TB
PE

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2
Q

Inv pyrexia + productive cough

A 
Bloods
Cultures
ABG
CXR
Sputum culture 
Urine - legionella antigen
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3
Q

Mgmt pyrexia + productive cough

A

Paracetamol
Oxygen
Broad spec antibiotics - co-amoxiclav + clarithromycin

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4
Q

Common atypicals

A

Mycoplasma pneumonia
Chlamydophila pneumonia
Legionella pneumonia

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5
Q

How does Mycoplasma pneumonia

present

A 
Person to person
↑ young peopl
Slow onset 
Resolves in a few week 
Interstitial reticular pattern on CXR
Extrapulmonary picture

test PCR

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6
Q

How does Chlamydophila pneumonia

present

A 
Slow onset 
Hoarse voice (laryngitis)

CXR: pleural effusion in 15%

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7
Q

How does Legionella pneumonia present

A

Air conditioning - been on holiday - water
Prodrome cough, fever
SOB pleuritic chest pain, haemopysis, GI symptoms
Relative bradycardia (wouldn’t expect with fever)
CXR: bibasal consolidation, pleural effusion in 50%

Investigate for severe CAP

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8
Q

Who should you test legionella for, how to test

A

Investigate for severe CAP

Urine

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9
Q

Q fever

A

Spread by farm animals
Coxiella burnett
Acute - non specific
risk endocarditis

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10
Q

Psittaci

A

Spread by birds
Horders spots
splenomegaly

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11
Q

Viral pneumonia

A

RSV most common

risk secondary bacterial

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12
Q

Recent chicken pox which pneumonia to consider?

A

Varicella pneumonias - 3-4 days after rash

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13
Q

Describe Peumocystis pneumnoa

A

pneumocystis jirovecii
immunocompromosed
ground glass
HIV pt

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14
Q

Desbribe Fungal

A

endemic vs opportunistic
Risk factor - travel (e) or immunocompromised
Fever + dry cough
Tx antifungals

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15
Q

Aspergillosis

A

Allergic bronco pulmonary aspergillosis - hypersensitivity to colonisation, common in asthma/CF?bronchiectasis

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16
Q

Dry cough, multiple painful joints, erythema nods DD

A

Sarcoidosis
Rheumatoid
TB

17
Q

Inv

A

Bloods

CXR

18
Q

Mgmt

A

Lifestyle mgmt
NSAIDs
Consider oral steroids

19
Q

Sarcoidosis

A

Granulomatous disorder
Adults ages 20-30
F>M
Afro-carribeam

20
Q

Sarcoidosis how does present

A

often incidentally finding
constutyak symptoms
inflammation of parotid glands, facial nerve plays

21
Q

Inv results

A

↑ESR
CXR- bilateral hilar lymphadenopathy
Tissue biopsy

22
Q

DD bilateral hilar lymphadenopathy

A

Sarcoidosis
TB
Malignancy (e.g. lymphoma)

23
Q

Mgmt sarcoid

A

Lifestyle, NSAIDS

24
Q

Gold standard investigation for bronchiectasis + other investigation
What see on XR

A 
High resolution CT → signet ring sign 
XR- tramlines 
Sputum cultue 
Immune function test
If < 40 years - CF?
25
Q

Mgmt bronchiectasis

A

Chest physio, consider bronchodilators
Antibiotics according to sensitivities - for 14 days (ciprofloxacin or IV abx for pseudomonas)
Refer to resp

26
Q

Describe bronchiectasis

A

Permanent dailation of bronchi and bronchioles
Causes: post-infective, immunocompromised
Persistent cough, lots of sputum

27
Q

pneumoconiosis

A

Caused by inhalation of dusts
> 10 years exposure and onset
Coal workers pneumoconiosis = asymptomatic or chronic bronchitis
CXR - round opociates in upper zones
Can process to fibrosis
Silicosis - fibrosis - diffuse nodules
Abestosis - ↑ lung cancer risk + mesothelioma

28
Q

Extrinsic allergic alveolitis

A

Inlahed allergens causing hypersensitivity
Bird-fanciers lung, farmers lung

Acute- fever, malaise
Chronic - fibrosis - Tx - avoid allergen and steroids

29
Q

Pleural effusions

Transudate - describe features, cause

A

Protein level < 30
HF, cirrhosis, low albumin, peritoneal dialysis
Tx cause

30
Q

Exudate describe features, cause. mgmt

A 
Protein level > 30 
pneumonia, malignancy 
plural aspiration → send for culture and cytology 
Tx cause 
Tap/drain for symptomatic relief
31
Q

What is lights criteria

A

Pleural fluid 25-35

Pleural fluid houd be consider an execute is some criteria are met (looks at LDH)

5th year countdown (17 decks)

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