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FINALS > Respiratory > Flashcards

Respiratory Flashcards

1
Q

How many lobes are there in the right lung?

A

3

Main bronchus wider and more vertical

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2
Q

What is the pattern of lung function tests in normal lungs?

A

FEV1 >80% predicted
FVC >80%
FEV1:FVC 75-80%

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3
Q

What is the pattern of lung function tests in restrictive lung disease?

A

FEV1 <80%
FVC <80%
FEV1:FVC >70%

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4
Q

What is the pattern of lung function tests in obstructive lung disease?

A

FEV1 <80%
FVC normal or low
FEV1:FVC <70%

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5
Q

What are some causes of restrictive lung disease?

A

Fibrosis, sarcoidosis, pneumonia, CTF, effusion, kyphoscoliosis

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6
Q

What are some causes of obstructive lung disease?

A

Asthma, COPD, bronchiectasis, cystic fibrosis

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7
Q

What are the commonest organisms in CAP?

A

Streptococcus pneumoniae

Haemophilius influenzae

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8
Q

What are some causes of aspiration pneumonia?

A

Stroke, myasthenia, bulbar palsies, reduced consciousness, oesophageal disease

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9
Q

What are some examination findings in pneumonia?

A 
Reduced expansion 
Dull percussion 
Increased vocal fremitus 
Bronchial breathing
Pleural rub
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10
Q

What investigations should be done in pneumonia?

A

FBC, U&E, LFT, CRP, ABG
CXR
Sputum culture
Urine - legionella and pneumococcal antigens

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11
Q

What is in the CURB score?

A 
Confusion
Urea >7mmol/L
Resp rate >30 
BP <90 systolic or <60 diastolic
65 years
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12
Q

What are some clinical features of legionella pneumonia and how is it treated?

A

Flu like symptoms then dry cough & dyspnoea
Anorexia, D&V, hepatitis, renal failure, confusion
Fluoroquinolone

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13
Q

What are some clinical features of chlamoydophila pneumonia?

A

Biphasic illness

  1. Pharyngitis, otitis, hoarseness
  2. Pneumonia
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14
Q

What are some complications of pneumonia?

A 
Type 1 respiratory failure
Hypotension
Atrial fibrillation 
Pleural effusion 
Empyema
Lung abscess
Myocarditis and pericarditis
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15
Q

What is the triad of Kartagener syndrome?

A

Primary ciliary dyskinesia
Situs inverts
Frontal sinus abnormalities

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16
Q

What are the symptoms and signs of bronchiectasis?

A

Persistent cough, copious purulent sputum, intermittent haemoptysis
Finger clubbing, coarse inspiratory crepitations

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17
Q

What investigations should be done for bronchiectasis?

A

Sputum culutre
CXR - cystic shadows, thickened bronchial walls, tramline &ring shadows
HRCT
Spirometry

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18
Q

What are some features of small cell lung tumours?

A

Neuroendocrine cells
Central location - smokers
Grow fast
Cause paraneoplastic syndromes

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19
Q

What are some different types of non-small cell lung tumours?

A

Adenocarcinoma - peripheral
SCC - central, smoking, PTH release
Carcinoid
Large cell

20
Q

What does ACTH release from small cell tumours cause?

A

Increased cortisol

Cushing’s and immunosuppression

21
Q

What does autoantibodies release from lung tumours cause?

A

Lambert-Eaton myasthenic syndrome
Type 2 hypersensitivity
Gait difficulty, autonomic involvement, hyporeflexia

22
Q

What does PTH-related protein release from lung tumours cause?

A

Ca released from bones

Weak bones and hypercalcaemia

23
Q

What does ADH release from lung tumours cause?

A

Water retention
Bloating, oedema, hypertension
Increased urinary sodium

24
Q

What different things can aspergillus cause?

A 
Asthma
Allergic bronchopulmonary aspergillosis 
Aspergilloma 
Invasive aspergillosis 
Extrinsic allergic alveolitis
25
Q

What is the pathophysiology of asthma?

A
  1. Bronchial muscle contraction
  2. Mucosal swelling/inflammation
  3. Increased mucus production
26
Q

What are some features of severe asthma?

A

Inability to complete sentences
RR >25
PEF 33-50%

27
Q

What are some features of life-threatening asthma?

A

Silent chest, confusion, exhaustion, cyanosis
SpO2 <92%
Increased CO2
PEF <33%

28
Q

What are some complications of COPD?

A 
Acute exacerbations 
Polycythaemia
Respiratory failure 
Cor pulmonale 
Pneumothorax
Lung carcinoma
29
Q

What are the criteria for long term O2 therapy?

A

Stable non-smokers PaO2 <7.3
PaO2 7.3-8 + pulmonary HTN/oedema/polycythaemia
Terminally ill patients

30
Q

What is acute respiratory distress syndrome?

A

Lung damage and inflammatory mediators caused by direct lung injury or secondary to severe systemic illness

31
Q

What are some causes of ARDS?

A

Pneumonia, aspiration, vasculitis

Sepsis, DIC, pancreatitis, ALF

32
Q

What are some diagnostic criteria for ARDS?

A

Acute onset
CXR - bilateral infiltrates
PCWP <19mmHg or no heart failure
Refractory hypoxaemia

33
Q

What are some causes of type 1 respiratory failure?

A

Pneumonia, PE, asthma, emphysema, fibrosis, ARDS

34
Q

What are some causes of type 2 respiratory failure?

A

COPD, obstructive sleep apnoea, CNS tumour/trauma, myasthenia, GBS

35
Q

What are symptoms and signs of a PE?

A

Acute breathlessness, pleuritic pain, haemoptysis

Tachypnoea, tachycardia, hypotension, raised JVP

36
Q

What is the emergency management of PE?

A 
O2 if needed
Morphine and anti-emetic 
IV access and LMWH 
Fluid bolus if needed
Long term anticoagulation
37
Q

What are some causes of a pneumothorax?

A

Spontaneous, asthma, COPD, TB, carcinoma, Marfan’s, Ehler’s Danlos

38
Q

What is a transudate and what causes it?

A

Low protein effusion due to increased venous pressure or hypoproteinaemia
heart failure, cirrhosis, nephrotic syndrome

39
Q

What is an exudate and what causes it?

A

Effusion due to leaky pleural capillaries
Infection
Inflammation - RA, SLE
Malignancy

40
Q

What are the lab values for an exudate?

A

Protein >35g/L
Effusion: serum protein >0.5
Effusion: serum LDH >0.6

41
Q

What is sarcoidosis?

A

A multisystem granulomatous disorder

42
Q

What are the acute signs and symptoms of sarcoidosis?

A

Fever, erythema nodosum, polyarthalgia, bilateral lymphadenopathy

43
Q

What are the pulmonary manifestations of sarcoidosis?

A

Dry cough, dyspnoea, reduced exercise tolerance

BHL +/- fibrosis/infiltrates

44
Q

What are the non-pulmonary manifestations of sarcoidosis?

A

Lymphadenopathy, hepato-splenomegaly
Uveitis, conjunctivitis, glaucoma
Bell’s palsy, neuropathy, SOL
Cardiomyopathy, arrhythmias

45
Q

What is the treatment of sarcoidosis?

A

Acute - bed rest and NSAIDs

May need steroids to induce remission

46
Q

What are some causes of interstitial lung disease?

A

Asbestosis
Amiodarone, sulfasalazine, nitrofurantoin
Sarcoidosis, RA, SLE, CTD, Sjogren’s
Idiopathic

47
Q

What are the symptoms and signs of idiopathic pulmonary fibrosis?

A

Dry cough, exertion dyspnoea, malaise, cyanosis, finger clubbing, end inspiratory crepitations

FINALS (19 decks)

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