Respiratory Flashcards
Stony dull to percuss
Pleural Effusion
Right sided pleuritic chest pain
Most likely to be pneumonia
Alveolar bat’s wings, Kerley B lines, Cardiomegaly, Dilated prominent upper lobe vessels, Pleural Effusion
Pulmonary oedema
Ground glass appearance on X ray
Pulmonary fibrosis and ARDS in neonates
Ziehl-Neelson stain positive for acid fast bacilli
Tuberculosis
Caseous necrosis
Tuberculosis
Apical lesion secondary to TB
Assmann focus
Spread of mycobacterium tuberculosis to blood stream
Miliary Tuberculosis
Positive anti glomerular basement membrane antibodies
Goodpasture’s Syndome
Chest infection with a parrot/pigeon as pet
Chlamydophila psittaci
Dry cough and diarrhoea after holiday abroad, some indication of water spread
Legionella pneumophila
“Tall, thin, young man who indulges in marijuana”
Probably a pneumothorax (Marfan’s)
Bilateral hilar lymphadenopathy, erythema nodosum, granulomas, fatigue, uveitis and weight loss
Sarcoidosis
Bronchiole wider than neighbouring arteriole (on CT) (signet ring sign)
Bronchiectasis
“D” sign on X Ray
Empyema
“Steeple” sign on X Ray
Croup (laryngotracheobronchitis)
Child with barking cough
Croup (laryngotracheobronchitis)
Pneumocystis pneumonia treatment
Co-trimoxazole {+/- prednisolone if severe}
Asthma + Nasal polyps + Salicylate sensitivity
Samter’s triad
Cause of Klebsiella pneumoniae
Alcohol abuse (danger of aspiration pneumonia)
Red Jelly Sputum
Klebsiella Pneumoniae
Mucoid Sputum
Chalmydophila psittaci
Cannonball metastases (also weight loss and haematuria)
Classically from primary renal cell carcinoma
Morning headache
Hypercapnia or side effects of organic nitrates
ACTH secreting lung tumour
Small cell carcinoma of the lung
PTH secreting lung tumour
Squamous cell carcinoma of the lung
Increased serum ACE and Ca2+
Sarcoidosis
Eggshell calcification at hilar region
Silicosis
“Hear failure cells” seen in alveolar spaces
Macrophages that have absorsed haemosiderin found in chronic pulmonary oedema and associated (severe) left ventricular heart failure. Also seen in long standing pulmonary hypertension
Area of infection and caseous necrosis at lung periphery, beneath pleura, found in TB infection
Ghon focus
“Coin lesion” found on chest radiographs
Primary bronchial or lung carcinoma/ metastatic tumour (esp kidney)/Bronchial hamartoma/Carcinoid tumour/Granulomatous inflammation/Lung abscess
This can occur if there is local spread of cancer to intrathoracic nodes or a Pancoast tumour
Horner’s Syndrome
Acute management of Asthma “O SHIT MAN”
Oxygen 100% Salbutamol Nebulised back to back Hydrocortisone IV or Prednisolone PO Ipratropium Bromide Nebulised hourly Theophylline IV or aminophylline IV Magnesium and call an Anaesthatist
Thumbprint sign on head X Ray
Epiglottitis
Inspiratory Whoop/Barking cough
Pertussis
Snow storm appearance on X Ray
Baritosis OR Silicosis
Management of infective COPD exacerbation
iSOAP "Ipratropium Salbutamol Oxygen Amoxicillin Prednisolone
Non-smoker + lung cancer
(Peripheral) Adenocarcinoma
CENTRAL lung cancer
Squamous or small cell lung cancer
High D-dimers
Suspect Pulmonary Embolism (send for CTPA or V/Q scan)
Low D-dimers
Exclude Pulmonary Embolism
Large PE treatment
Thrombolysis
Small PE treatment
Low molecular weight heparin
