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Year 1 MBChB > Respiratory > Flashcards

Respiratory Flashcards

1
Q

How is a massive PE (hypotensive) managed?

A

Alteplase (thrombolysis)

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2
Q

What organism causes pneumonia in COPD?

A

H. influenzae

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3
Q

When should you use NIV in an acute exacerbation of COPD?

A

Resp acidosis, Type 2 resp failure

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4
Q

Who gets Klebsiella pneumonia?

A

Alcoholic and diabetics

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5
Q

Who gets pneumocystis jiroveci pneumonia?

A

HIV/AIDS

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6
Q

What are the parameters of CURB-65?

A

Confusion, Urea > 7 RR > 30 BP systolic <90, diastolic < 60, Age over 65

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7
Q

How do you treat CAP with a CURB of 0-2?

A

amoxicillin

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8
Q

Which organisms causes rusty sputum?

A

Strep pneumoniae

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9
Q

What is the buzzword for silicosis?

A

Stonemasons, Pottery

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10
Q

What is seen on the CXR in ILD?

A

Diffuse infiltrates

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11
Q

What are the common causes of exudate?

A

PE Lung infections Cancers CTDs

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12
Q

What is the management of acute asthma?

A

Nebs: salbutamol & ipratropium, Steroids: oral pred/IV hydrocortisone

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13
Q

What should be given for an acute exacerbation of COPD if there is no response?

A

Iv aminophylline

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14
Q

What pH of a pleural effusion suggests an epyema?

A

< 7.2

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15
Q

What is the buzzword for byssinosis?

A

Cotton

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16
Q

What does this CXR show?

A

Left lower lobe consolidation

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17
Q

What pneumonia organisms causes haemolytic anaemia + erythema multiforme/nodosum?

A

Mycoplasma

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18
Q

How is an exacerbation of ILD managed?

A

Steroids

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19
Q

What are the features of a life threatening asthma attack?

A

Silent chest, Exhaustion Hypoxaemia PEFR < 33% Features of shock

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20
Q

What is the step 2 in the treatment of chronic COPD?

A

SABA or SAMA (salbutamol or ipratropium)

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21
Q

Asthma + eosinophilia + mono neuritis complex?

A

Churg Strauss Vasculitis

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22
Q

What is the management of a secondary spontaneous pneumothorax if 0-1cm + asymptomatic?

A

Oxygen + admit for 24hr obs

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23
Q

What is the management of a primary spontaneous pneumothorax if <2cm + asymptomatic?

A

Discharge

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24
Q

What is seen on ABG in COPD?

A

Compensated type 2 resp failure

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25
Q

How does ILD present?

A

Dry cough, SOBOE, myalgia, fine inspiratory crackles

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26
Q

How do you treat HAP/aspiration pneumonia?

A

IV amox, met and gent

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27
Q

What is step 4 in the management of chronic asthma?

A

SABA + ICS + LABA +/- LTRA (salbutamol + beclametasone + salmeterol +/- montelukast)

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28
Q

What is seen on CXR in COPD?

A

Hyperinflation, flattened hemidiaphragms

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29
Q

How is asthma investigated?

A

Peak flow Spirometry

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30
Q

When does staph aureus pneumonia usually occur?

A

After influenza A

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31
Q

What investigations are done in a PE?

A

Bloods incl D dimer, ABG, ECG, CXR (exclusion) CTPA / V/Q

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32
Q

What is seen on ABG in PE?

A

Resp alkalosis

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33
Q

What is the step 3 in the treatment of chronic COPD if FEV1 < 50%?

A

LABA + ICS (folmeterol + beclometasone) or LAMA (tiotropium)

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34
Q

What treatment does small cell lung cancer respond well to?

A

Chemo

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35
Q

What is the buzzword for hypersensitivity pneumonitis?

A

Farmers, Bird fanciers

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36
Q

What is the presentation os asthma?

A

Recurrent episodes of cough, wheeze, SOB Worse in morning and at night

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37
Q

How is ILD investigated?

A

CXR, Spirometry, ABG

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38
Q

What does this CXR show?

A

Pulmonary oedema

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39
Q

What is the typical presentation of pneumonia?

A

SOB, productive cough, chest pain, fever, confusion, myalgia

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40
Q

What biopsy is done in a central lung cancer?

A

Bronchoscopy

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41
Q

What is the management of a secondary spontaneous pneumothorax if >2cm or symptomatic?

A

Chest drain

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42
Q

What is the management of a primary spontaneous pneumothorax if >2cm or symptomatic?

A

Admit for aspiration If this fails > chest drain

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43
Q

What are the risk factors for a PE?

A

Immobility, post-op, malignancy, pregnancy, COCP, HRT

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44
Q

What investigation is done for a PE in pregnancy?

A

perfusion only V/Q scan

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45
Q

What are the features of a pneumothorax?

A

Asymptomatic, SOB, chest pain Young, thin tall male

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46
Q

What is step 3 in the management of chronic asthma?

A

SABA + ICS + LTRA (salbutamol + beclametasone + montelukast)

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47
Q

Who gets legionella?

A

Travel/water

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48
Q

What is the pathophysiology of cor pulmonale in COPD?

A

Chronic cascade > hypoxia > pulm vasoconstriction > pulm hypertension > cor pulmonale

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49
Q

What is seen on the ABG in ILD?

A

Type 1 resp failure

50
Q

What does this CXR show?

A

Right upper lobe consolidation

51
Q

What is FVC?

A

Total volume of gas expired on forced expiration from maximal inspiration

52
Q

What does this CXR show?

A

Right pneumothorax

53
Q

What is seen on spirometry in ILD?

A

Restrictive pattern, FEV1:FVC ratio > 0.7

54
Q

How is an unprovoked PE managed?

A

6 months of rivaroxaban

55
Q

What level of protein in a pleural effusion indicates an exudate?

A

> 30g/L

56
Q

How is a provoked PE managed?

A

3 months of rivaroxaban

57
Q

What is the normal FEV1:FVC ration?

A

0.7-0.8

58
Q

What investigations are done in lung cancer?

A

CXR, CT staging scan

59
Q

What are the features of COPD for diagnosis?

A

Sputum production and cough for most days for 3 months of 2 consecutive years

60
Q

What are features of an acute severe asthma attack?

A

Speech impairment (can’t complete sentences), Tachy Resp rate > 25 PEFR 33-50%

61
Q

What are the specific features in small cell carcinoma?

A

SIADH, Cushing’s + Lambert Eaton

62
Q

What are common causes of transudates?

A

LVF liver cirrhosis Nephrotic syndrome Acute GN

63
Q

What does this CXR show?

A

Air under diaphragm - perforation

64
Q

What causes a reduction in FVC and FEV1?

A

Restriction - pulmonary fibrosis, neuromuscular disorders, obesity, pleural disease

65
Q

What is the management of a secondary spontaneous pneumothorax if 1 - 2cm + asymptomatic?

A

Aspiration

66
Q

How is legionella diagnosed?

A

Urinary antigen

67
Q

What is given if there is no improvement or if the asthma attack is life threatening?

A

IV mag sulph

68
Q

What is seen on spirometry in asthma?

A

Reduced FEV1, normal FVC

69
Q

What is step 2 in the management of chronic asthma?

A

SABA + ICS (salbutamol + beclametasone)

70
Q

What are the features of lung cancer?

A

SOB, cough, haemoptysis, chest pain, hoarseness, stridor, weight loss, recurrent pneumonia, Horner’s, pain and weakness in arms and hands

71
Q

What is the step 4 in the treatment of chronic COPD?

A

Combo of LABA + ICS + LAMA

72
Q

What are common precipitants for asthma?

A

Cold air, Dust mites, Exercise, NSAIDs, Beta blockers

73
Q

When should you use intubation in an acute exacerbation of COPD?

A

pH < 7.26

74
Q

What electrolyte imbalance does legionella cause?

A

Hyponatraemia

75
Q

What is the commonest type of lung cancer?

A

Adenocarcinoma

76
Q

What is the step 1 in the treatment of chronic COPD?

A

STOP SMOKING

77
Q

What biopsy is done in peripheral lung cancer?

A

Percutaneous transthoracic needle biopsy

78
Q

What is seen on peak flow in asthma?

A

> 20% diurnal variation for at least 3 days for 2 weeks

79
Q

What is FEV1?

A

Volume of gas expired in the first second of forced expiration

80
Q

What is the most common organism that causes pneumonia?

A

Strep pneumoniae

81
Q

What are the specific features of squamous cell carcinoma?

A

PTH related protein > hypercalcaemia

82
Q

What is the gold standard investigation for a PE?

A

CTPA

83
Q

How is ILD managed?

A

Conservative, O2, Pulmonary rehab

84
Q

What pH in a pleural effusion indicates an exudate?

A

< 7.1

85
Q

What is seen on spirometry in COPD?

A

Obstructive pattern: FEV1:FVC ratio < 0.7

86
Q

What is the step 3 in the treatment of chronic COPD if FEV1 > 50%?

A

LABA or LAMA (salmeterol or tiotropium)

87
Q

How do you investigate pneumonia?

A

CXR, Bloods, Blood cultures

88
Q

What is the buzzword for idiopathic pulmonary fibrosis?

A

Honey combing on CT

89
Q

What causes a reduction in FEV1?

A

Obstruction: COPD, asthma

90
Q

How do you treat CAP with a CURB of 3+?

A

IV co-amoxiclav + IV clarithromycin

91
Q

How is mycoplasma pneumonia treated/?

A

Clarithromycin

92
Q

What is the atypical presentation of pneumonia?

A

dry cough, SOB, flu like symptoms

93
Q

What ABG sign is VERY worrying in acute asthma?

A

Normal/high CO2 - they are getting tired and starting to retain CO2

94
Q

What are the ECG changes seen in cor pulmonale?

A

Peaked P waves and RVH

95
Q

What follow up is needed in pneumonia and in whom?

A

CXR in 6 weeks for those at risk of lung cancer

96
Q

How does a PE present?

A

SOB, pleuritic chest pain, dizziness, syncope, haemoptysis

97
Q

How is COPD investigated?

A

CXR, ABG, Spirometry

98
Q

How is pneumocystis jiroveci treated?

A

Cotrimoxazole

99
Q

What is step 1 in the management of chronic asthma?

A

SABA (salbutamol)

100
Q

What is the management of an acute exacerbation of COPD?

A

nebulisers: salbutamol and ipratropium, steroids: oral red/IV hydrocortisone, Antibiotics (amoxicillin/doxuy)

101
Q

Asthma + nasal polyps + aspirin sensitivity?

A

Samter’s triad

102
Q

What is the buzzword for asbestosis?

A

Ship builders, dock workers

103
Q

What is lupus pernio?

A

Raised plaque of purple indurated skin

104
Q

In which condition is lupus pernio a feature?

A

Sarcoidosis

105
Q

When is pulmonary rehab recommended in COPD?

A

As soon as patients become short of breath with regular activties

106
Q

How can asthma be diagnosed with spirometry?

A

> 12% improvement in FEV1 after SABA

107
Q

What metabolic abnormality does sarcoidosis cause?

A

Hypercalcaemia

108
Q

How is alpha 1 antitrypsin deficiency inherited?

A

Autosomal recessive

109
Q

Can alpha 1 antitrypsin be diagnosed prenatally?

A

Yes

110
Q

In which zones does coal workers pneumoconiosis cause fibrosis?

A

Upper

111
Q

What condition is buproprion contraindicated in?

A

Epilepsy

112
Q

What lung defect does Kartgeners cause?

A

Primary ciliary dyskinesia

113
Q

Recurrent chest infections + subfertility + dextrocardia

A

Kartgeners

114
Q

What are the target sats in COPD?

A

88 - 92%

115
Q

What antibody is tested for in Churg-Strauss?

A

pANCA

116
Q

What is the main side effect of rifampicin?

A

Orange stuff - urine, tears, sweat

117
Q

What is the main side effect of iosinazid?

A

Agranulocytosis, neuropathy

118
Q

What are side effects of Pyra…. (the TB one)?

A

Hepatic stuff, photosensitivity, arthralgia

119
Q

What is the main side effect of ethambutol?

A

Eye stuff

120
Q

What is a histological finding in TB granulomas?

A

Epitheloid histocytes

Year 1 MBChB (3 decks)

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