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Phase 2a Questions > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Bronchiectasis - CXR

A
  1. Dilated bronchi
  2. Thickened walls (tramline and ring shadows)
  3. Multiple cysts containing fluid - cystic shadows
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2
Q

Hospital acquired pneumonia - causative organisms

A
  1. Aerobic Gram -ve bacilli
    - Pseudomonas Aeruginosa
    - Escherichia coli
    - Klebsiella Pneumoniae
  2. Staphylococcus aureus (gram +ve cocci)
    Staff = Staph
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3
Q

Pulmonary embolism - Treatment

A
  1. High flow Oxygen (60-100%)
  2. LMWH (Enoxaparin/Dalteparin)
  3. Thrombolysis if severe (altepase)
  4. Vit K antagonist for prevention (Warfarin) - slower
  5. Surgical embolectomy
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4
Q

Pulmonary TB - laryngeal involvement

A

Hoarse voice

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5
Q

Goodpasture’s Syndrome - Definition

A

Co-existence of acute glomerulonephritis and pulmonary alveolar haemorrhage.
Circulating antibodies directed against intrinsic antigen kidney/lung bm.
Type II hypersensitivity reaction.

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6
Q

TB - Histology

A
  1. Caseating granuloma - central area of necrosis, surrounded by epitheliod histocytes and Langhans giant cells (multiple nuclei).
    Both cells from macrophage
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7
Q

TB - Treatment

A

RIPE

  1. Rifampicin - 6mths
    - Orange discolouration of urine
  2. Isoniazid - 6mths
    - Neuropathy
  3. Pyrazinamide - 2mths
    - Arthralgia
  4. Ethambutol - 2mths
    - Optic neuritis
  5. Fluroquinolones if resistance
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8
Q

Sarcoidosis- Definition

A

Interstitial lung D
Cellular infiltrates and extracellular matrix deposition in lung distal to terminal bronchiole.
Dry cough and increased ACE (due to granuloma)

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9
Q

Pulmonary hypertension - definition

A

mPAP (mean pulmonary arterial P) above 25mmHg as measured at R heart catheterisation and 2ndary RV failure

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10
Q

Pulmonary hypertension - X ray

A
  1. Enlarged proximal pulmonary A - taper distally
  2. Cardiomegaly (RA)
  3. Reveal cause (emphysema / calcified mitral valve)
  4. Lucent lung fields
  5. Elevated cardiac apex (RV hypertrophy)
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11
Q

Chemotherapy - SE

A
  1. Alopecia
  2. Fatigue
  3. N+V
  4. C/D
  5. Rash
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12
Q

Pleural effusion w exudate - causes

A
  1. Malignancy
  2. Infection
  3. Inflammatory
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13
Q

Non-small cell carcinoma - types

A
  1. Squamous carcinoma
  2. Adenocarcinoma (C)
  3. Large cell and differentiated carcinoma
  4. Carcinoid tumours
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14
Q

COPD - conditions

A
  1. Chronic bronchitis
  2. Emphysema

Alpha-1 antitrypsin deficiency predisposes to COPD

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15
Q

Pulmonary embolism - Plasma D dimer

A
  1. See Haem

2. -ve = rules out PE –> no imaging needed

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16
Q

TB - microbiology

A
  1. Mycobacterium tuberculosis (C)

2. Ziehl Neelson Stain +ve

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17
Q

Community acquired pneumonia - CURB 65

A 
C - Confusion
U - Urea >7mmol/L
R - RR >30/min
B - BP <90 (S) +/or 60 (D)
65 - Age > 65
1 point each
0-1 = mild, 2 = mod (admit to 
 hospital), 3-5 = severe, 4-5 = critical care unit
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18
Q

Community acquired pneumonia - Treatment

A
  1. Amoxicillin (mild)
  2. Clarithromycin / co-amoxiclav (severe)
  3. Maintain O2 sats
  4. Analgesia - pleuritic pain
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19
Q

Bronchiectasis - clinical presentation

A
  1. Chronic cough
  2. Foul smelling purulent sputum
  3. Dyspnoea
  4. Clubbing
  5. Haemoptysis
20
Q

Extrinsic allergic alveolitis - Treatment

A
  1. Remove allergen
  2. Give O2
  3. Oral prednisolone
21
Q

Asthma - Airway narrowing

A
  1. Inflammation of mucosa
  2. SM contraction - bronchoconstriction
  3. Increased mucus production
22
Q

Asthma - Short acting Beta agonists (SABA)

A
  1. Salbutamol
  2. Binds to B2 adrenoreceptors
  3. SM relaxation
  4. Bronchodilation
23
Q

Cystic fibrosis - Diagnostic tests

A
  1. Sweat test (Na and Cl conc >60mmol/L)
  2. Genetics screening
  3. Faecal elastase test - exclude pancreas D (elastase produced by pancreas and found in faeces) CF - no elastase as mucus blocks release
24
Q

Pulmonary embolism

A
  1. Sudden unexplained dysponea
  2. When infarction - pleuritic chest pain (on inspiration) and haemoptysis
  3. Dizziness
  4. Pyrexia
  5. Cyanoisis
25
Q

Community Acquired Pneumonia - causative organism

A
  1. Strep pneumoniae (C)
  2. Legionella spp
  3. Haemophilius influenzae (vaccine)
  4. Mycoplasma pneumoniae
26
Q

Hypersensitivity reactions

A

ACID
I = Allergic (anaphylaxis
II = Cytotoxic (antibody against collagen - GPS)
III = Immune complex deposition (IgG/IgM - SLE)
IV = Delayed (Graft rejection)

27
Q

Lung cancer - Metastasis

A
  1. Adrenal glands
  2. Bone
  3. Brain
  4. Liver
28
Q

TB - X ray

A
  1. Patchy/nodular shadows in upper zone
  2. Loss of volume
  3. Fibrosis
  4. W or w/out cavitation
  5. Consolidation
29
Q

Pneumonia - X ray

A
  1. Air bronchogram in consolidated A (black branch)

2. Abnormalities can lag behind clinical signs - repeat 2-3 days

30
Q

Values

A 
FEV1 = forced expiratory V in 1s
- >80% than predicted values = normal
FVC = forced vital capacity - amount of air forcibly expired
- >80% predicted valuee = normal
- Low = airway restriction
FEV1/FVC ration
- Below 0.7 = obstruction
- Normal w low FVC = respiratory
31
Q

Type 1 respiratory failure

A
  1. pO2 low
  2. pCO2 norma
    1 change
  3. PE
32
Q

Type 2 respiratory failure

A
  1. pO2 low
  2. PCO2 high
    2 changes
  3. Hypoventilation
33
Q

Obstructive

A
  1. Asthma
    - Variable airflow obstruction
    - Reversible
  2. COPD
    - Fixed airflow obstruction
    - Mix of R + O
34
Q

Restrictive

A
  1. Lung V small -> most of breath out in 1st sec
  2. Interstitial lung D
    - Sarcoid
    - Fibrosing alveolitis
35
Q

COPD - Presentation

A 
1. Productive cough w white/clear sputum
(smokers cough)
2. Wheeze 
3. Breathlessness at rest
4. Prolonged expiration
5. Poor chest expansion
6. Hyperinflated (barrel chest)
36
Q

COPD - Stages

A
  1. FEV1 <80%
  2. FEV1 50-79%
  3. FEV1 30-49%
  4. FEV! <30%
37
Q

Asthma - types

A
  1. Allergic/eosinophilic 70%
    - Allergens + atopy
  2. Non-allergic/ non-eosinophilic 30%
    - Exercise, cold air and stress
    - Smoking and non smoking associated
    - Obesity
38
Q

Asthma - immediate management

A
  1. O2 therapy
  2. Nebulised 5mg salbutamol
  3. Prednisolone
  4. ABG
  5. PEFR
39
Q

Asthma - inhaled corticosteroids examples

A

Prednisolone
Beclomatasone
Budesonide

40
Q

Good pasture’s Syndrome - Diagnosis

A
  1. Anti-basement membrane antibodies
  2. CXR
    - Transient patchy shadows
    - Pulmonary inflitrates - due to pulmonary haemorrhage in lower zones
  3. Crescentic glomerulonephritis in biopsy
41
Q

Asthma - symptoms

A
  1. Intermittent dysponea
  2. Wheeze
  3. Nocturnal cough
  4. Sputum
  5. Worse at night
42
Q

Asthma - Signs in attack

A
  1. Tachypnoea
  2. Reduced chest expansion
  3. Cyanosis
  4. Silent chest
  5. Bradycardia
43
Q

Asthma - Treatment

A
  1. Short acting Beta 2 agonist (salbutamol)
  2. Inhaled corticosteroids
  3. Long acting Beta 2 agonist (salmeterol)
  4. Anti-IgE monoclonal antibody (omalizumab)
44
Q

TB - Systemic features

A
  1. Weight loss
  2. Low grade fever
  3. Anorexia
  4. Night sweats
  5. Malaise
45
Q

TB - Prevention

A
  1. Active case finding
    - Mantoux test
  2. Neonatal BCG

Phase 2a Questions (14 decks)

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