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YEAR 4 > Respiratory > Flashcards

Respiratory Flashcards

1
Q

CNs supplying phrenic nerve?

A

C3,4,5

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2
Q

Where do sympathetic pre-ganglionic neurones arise from?

A

T1 - L2

Thoracolumbar outflow

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3
Q

What nerves carry parasmpathetic neurones?

A 
Cranio sacral outflow
Occulomotor
Facial
Glossopharyngeal
Vagus
S2-S4
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4
Q

Definition of restrictive lung disease?

A

harder to get air into the lungs
decreased FEV1
decreased FVC
FEV1/FVC ratio >80% (FEV1 decreases less than FVC)

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5
Q

2 main causes of restrictive lung disease?

A

interstitial lung disease

chest wall abnormalities (e.g. obesity)

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6
Q

What is interstitial lung disease and what impact does this have?

A

fibrosis of the interstitium (tissue around the air sacs)

Thickening of the barrier for gas exchange and decreased lung filling ability

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7
Q

What are the 3 main types of interstitial lung disease?

A

Idiopathic pulmonary fibrosis
Pneumoconioses (occupational interstitial lung disease)
Sarcoidosis

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8
Q

Secondary causes of idiopathic pulmonary fibrosis?

A

bleomycin, amioderone, radiation therapy

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9
Q

Does idiopathic pulmonary fibrosis increase your risk of lung cancer?

A

yes

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10
Q

What is honeycombing a sign of?

A

advanced diffuse pulmonary fibrosis seen in idiopathic pulmonary fibrosis

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11
Q

How do interstitial lung diseases present?

A

progressive dyspnoea, cough

cyanosis, fine end inspiratory crackles

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12
Q

Pathology of pneumoconioses?

A

small particles are inhaled into small airways and picked up by macrophages that activate fibroblasts to deposit connective tissue. Chronic local immune activation and inflammation.

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13
Q

4 main pneumoconioses?

A

asbestosis
berylliosis
silicosis
coal workers pneumoncoises

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14
Q

What is asbestos and who was at risk?

A

insulation material used until 70s

construction workers, plumbers, shipyard workers

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15
Q

What is more harmful chrysotile (white) or crocidolite (blue) asbestos?

A

blue

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16
Q

What does asbestosis increase your risk of?

A 
pleural plaques (fibrosis of the pleura)
lung cancer (non small cell)
mesothelioma
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17
Q

Who is at risk for beryllium inhalation?

A

miners

workers in aerospace

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18
Q

Does berylliosis increase your risk of lung cancer?

A

yes

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19
Q

What is the pathological feature of berylliosis?

A

non caseating granulomas

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20
Q

What is anthracosis and who gets it?

A

carbon laden macrophages, clinically insignificant exposure to carbon e.g. living in a city

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21
Q

Pathology of coal worker’s pneumoconiosis?

A

black shrunken lung with massive fibrosis

round nodules on CXR

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22
Q

What is caplan’s syndrome?

A

RA and pneumoconiosis

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23
Q

Who is at risk of silicosis?

A

sand blasters, silica miners

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24
Q

Why does silicosis increase risk of TB?

A

impairs the formation of phygolysosome in macrophages

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25
Q

Pathology in sarcoidosis?

A

non caseating granulomas in multiple organs

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26
Q

What is sarcoidosis?

A

systemic disease with formation of granulomas

body in overdrive attacking own tissues

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27
Q

What substances are raised in sarcoidosis?

A

hypercalcemia (granulomas have 1 alpha hydroxalase activity that activates vit D)
raised serum ACE

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28
Q

Common presentation of sarcoidosis?

A 
pulmonary fibrosis (dyspnoea, cough)
bilateral hilar lymphadenopathy
erythema nodosum, conjunctivitis
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29
Q

How is sarcoidosis definitively diagnosed?

A

bronchial or lymph node biopsy

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30
Q

Pharyngitis organism?

A

adenovirus

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31
Q

Epiglottitis organisms?

A

HIB

strep pyogenes

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32
Q

Thumbprint sign?

A

epiglottitis

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33
Q

Management of epiglottitis?

A

ITU with endotracheal intubation

IV ceftriaxone

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34
Q

Croup organism?

A

parainfluenza

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35
Q

Management of croup?

A

dexamethasone

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36
Q

Assman focus

A

reactivated foci of TB in the apex of lungs

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37
Q

most common location for aspirated pneumonia

A

lower right lobe

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38
Q

Pulmonary oedema CXR signs

A 
Alveolar bat wings
kerley b lines
cardiomegaly
dilated upper lobe vessels
pleural effusion
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39
Q

ground glass appearance on XRY

A

respiratory distress of the newborn

pulmonary fibrosis

40
Q

TB identification

A

ZN stain positive for acid fast bacilli

41
Q

caseated granulomas

A

Caseated means necrosis is present

TB

42
Q

Antiglomerular basement membrane antibodies (against type 4 collagen)

A

good pastures (pulmonary haemorrhage and rapidly progressive glomerulonephritis)

43
Q

chlamydophilia psittaci

A

pigeons/parrots chest infection

44
Q

dry cough and diarrhoea after holiday abroad

A

legionella (urine antigen test)

45
Q

afrocaribean, bilateral hilar lymphadenopathy, erythema nodosum, non-caseating granulomas, uveitis, weight loss

A

sarcoidosis

46
Q

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

A

bronchiectasis (widening of the airways usually due to chronic inflammation and infection)

47
Q

obesity hypoventillation syndrome

A

pickwickians (restrictive lung disease due to difficulty expanding chest wall)

48
Q

what is an empyema

A

pus in the pleural space

49
Q

D sign on CXR

A

empyema

50
Q

steeple sign on CXR

A

croup (laryngotracheal narrowing)

51
Q

Pneumocytis pneumonia

A

HIV treat with co-trimoxazole

52
Q

sameters triad

A

asthma, nasal polyps, NSAID sensitivity

53
Q

pneumonia in alcoholic

A

klebsiella

54
Q

red jelly sputum

A

klebsiella

55
Q

mucoid sputum

A

chamydia psittaci

56
Q

rusty sputum

A

pneumococcal

57
Q

canonnball mets

A

from primary renal cell carcinoma

58
Q

ACTH secreting tumour

A

small cell lung ca (causes hypernatremia and hypokalemia)

59
Q

PTH secreting tumour

A

Squamous cell ca (causes hyperparathyroidisim)

60
Q

Increased serum ACE and Ca

A

sarcoidosis

61
Q

Eggshell calcification at hilar regions

A

silicosis

62
Q

pancoast tumour

A

a tumour in the upper apex of the lung (can cause horners syndrome)

63
Q

thumbprint sign on XRAY

A

epidlottitis

64
Q

where are squamous and small cell lung cancers commonly found

A

centrally

65
Q

what kind of lung cancer so non smokers get and where are they found

A

adenocarcinoma

periperal

66
Q

coxiella burnetti

A

sheep/farm

67
Q

pleaural plaques

A

asbestosiss

68
Q

Using SABA and ICS step up

A

ICS + LABA (beclamethasone + formoterol)

69
Q

ABGs in heroin overdose

A

heroin is diamorphine
overdose causes pinpoint pupils and respiratory depression
respiratory acidosis

70
Q

ABGs in COPD stable and infective exacerbation

A

respiratory acidosis with complete compensation
respiratory acidosis with partial compensation
(T2 resp failure happening in both, hypoxic drive)

71
Q

ABGS in hyperventillation

A

respiratory alkalosis

72
Q

ABGs in acute asthma

A

respiratory alkalosis initially then progresses to respiratory acidosis and T2 failure as exhaustion kicks in

73
Q

ABGs and resp failure in pulmonary fibrosis

A

ABGs normal

T1 resp failure

74
Q

ABGs in PE

A

resp alkalosis and t1 resp failure

75
Q

ABGs in vomitting

A

metabolic alkalosis

76
Q

stony dull to percuss

A

pleural effusion

77
Q

sever CAP

A

IV co-amox and clarithromycin (CURB65 3-5)

78
Q

bronchus inhaled foreing object likely to pass into

A

right main bronchus

79
Q

what cells produce surfactant

A

type 2 pneumocytes

80
Q

croup virus

A

parainfluenza

81
Q

bronchiolitis virus

A

RSV

82
Q

pneumonia in CF

A

psudomonnas

staph aurus

83
Q

4 cs of idiopathic pulmonary fibrosisq

A

clubbin, cough, cyanosis, crackles

84
Q

obstructive disease with raised eosinophils or neutrophils

A

asthma

COPD

85
Q

horners triad

A

ptosis
miosis
anhydrosis

86
Q

most common pneumonia

A

strep pneumonia

87
Q

TB treatment

A

RIPE for 2 months then RI for 4 months

88
Q

middle aged Asian presents with weight loss, night sweats and productive cough. CXR shows multiple small discrete nodules throughout both lung fields

A

TB

89
Q

Side effects of TB drugs

A

r - orange tears, rash, hepatotoxicity
i - tingling and parathesia of extremities
p - joint pain rash, gout
e- vision changes, optic neuritis

90
Q

CAP 0-2 curb65

A

amoxicillin

91
Q

wilsons disease

A

excess copper

92
Q

signet ring cells

A

andeocarcinoma (mucin producing)

93
Q

why is a combo of drugs used in tb

A

to prevent resistence

94
Q

CAP 0 pen allergic

A

doxy

95
Q

purpose of balloon on endotracheal tube

A

secure it in place, to prevent leakage of respiratory gases, and to protect the tracheobronchial tree from receiving undesirable material

96
Q

clara cells

A

found in terminale bronchioles

YEAR 4 (27 decks)

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