Respiratory Flashcards
What is pneumonia?
Inflammation of the lung characterised by exudation into the alveoli
Consolidation is a sign of?
Lobar pneumonia
Symptoms of pneumonia?
Cough, fever, rigors, pleuritic chest pain, dyspnoea, tahcycardia, confusion
Pneumonia: chest expansion, vocal fremitus, percussion, breath sounds, additional sounds, vocal resonance?
Reduced chest expansion Increased vocal fremitus Dull percussion Bronchial breath sounds Medium/late or pan-inspiratory crackles as the pneumonia resolves Increased vocal resonance
Top causes of CAP?
S.pneumoniae
M. pneumoniae
Chlamydia pneumoniae
Legionella pneumoniae
Signs of atelectasis?
Tracheal deviation towards collapsed side
Reduced chest expansion
Dull percussion
Absent breath sounds
Intramural, mural and extramural causes of atelectasis?
Intramural- CF, foreign body, aspiration
Mural- bronchial carcinoma
Extramural- aortic aneurysm, peribronchial lymphadenopathy
What criteria used for differentiating transudate vs. exudate?
Light’s criteria:
- comparison of pleural LDH to serum LDH, and pleural protein to serum protein content
Causes of transudative pleural effusion?
Either increased venous pressure (e.g. LVH) or hypoalbuminemia (nephrotic syndrome, CLD)
Causes of exudative pleural effusion?
Infection (pneumonia, TB), inflammation (RA, SLE), malignancy, drugs e.g. cytotoxics, irradiation, trauma, Meig’s syndrome
What are the 5 types of pleural effusion?
Transudate Exudate Haemothorax Chylothorax Empyema
What are classic signs of yellow nail syndrome?
Distorted, yellow nails
Lymphoedema of legs
Pleural effusions and bronchiectasis
Primary vs. secondary pneumothorax?
Primary- spontaneous rupture of subpleural bullae in tall, healthy young males
Secondary- to trauma, iatrogenic causes or emphyesematous bullae rupture
Signs of bronchiectasis?
Fever, cachexia, sinusitis, voluminous sputum, coarse pan-inspiratory (widespread) crackles, clubbing, cyanosis, haemoptysis, signs of respiratory failure
What are some causes of bronchiectasis?
Congenital: PCD, CF
Acquired: childhood infections, TB, ABPA
What is COPD?
Characterised by chronic and progressive obstruction of airway outflow, which affects normal breathing, with little/no reversibility. FEV1<80% predicted and FEV1/FVC < 0.7.
What is the definition of emphysema?
A pathological increase beyond normal in the size of air spaces distal to the terminal bronchioles; diagnosed histologically
What is chronic bronchitis?
Daily production of sputum for 3 months a year for at least 2 consecutive years; diagnosed clinically
Upper lobe predominant fibrosis?
Silicosis Coal worker's pneumoconiasis Ankylosing spondylitis Radiation TB
Lower lobe predominant fibrosis?
Rheumatoid arthritis Asbestosis Scleroderma Idiopathic Other e.g. drugs (busulfan)
Causes of mediastinal compression?
Lung carcinoma
Other tumours e.g. lymphoma, thymoma
Aortic dissection
Large retrosternal goitre
What are signs of mediastinal compression?
SVC obstruction RLN palsy Tracheal compression (stridor) Horner's syndrome Phrenic nerve paralysis
Signs of PE?
Sudden and unexplained dyspnoea
Tachycardia
Tachypnoea
Fever, pleuritic chest pain & haemoptysis (with infarction only)
Pleural friction rub if infarction occurred
Elevated JVP and RV heave if massive PE
