Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Phase 4 > Respiratory > Flashcards

Respiratory Flashcards

1
Q

What are the classifications of lung cancer?

A

Small cell

Non small cell:

  • Squamous cell carcinoma
  • Adenocarcinoma
  • Bronchial derived adenocarcinoma
  • Bronchioloalveolar carcinoma
  • Large cell carcinoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the symptoms of lung cancer?

A 
Persistent cough
Haemoptysis
Shortness of breath
Chest pain
Hoarseness
Weight loss
Bone pain
Headache
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the investigations for lung cancer?

A

X-ray
CT
PET-CT
Biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is stage 1 lung cancer?

A

The cancer is contained wtihin the lung and hasn’t spread to nearby lymph nodes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is stage 2 lung cancer?

A

Cancer is up to 7cm
Involved local lymph nodes
Multiple small tumours
Lung has collapsed and tumour is in airway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is stage 3 lung cancer?

A

Has invaded local structures - mediastinum, pleura, chest wall, oesophagus, trachea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is stage 4 lung cancer?

A

Involves both lungs
Pleural effusion
Distant metastases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What T1 lung cancer?

A

Cancer is in lung.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is T2 lung cancer?

A

Cancer is 3-5cm or involves main bronchus/visceral pleura/lung collapse.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is T3 lung cancer?

A

Cancer is 5-7cm or more than one tumour in same lobe of lung or invading local structures - such as ribs/diaphragm/pericardium/phrenic nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is T4 lung cancer?

A

> 7cm - more than one lobe/mediastinal involvement/spinal bones.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is N0 in lung cancer?

A

No nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is N1 lung cancer?

A

Cancer in nodes in lung or hilum.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is N2 lung cancer?

A

Mediastinal nodes on same side.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is N3 lung cancer?

A

Opposite side of chest or above collar bone.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is M0 in lung cancer?

A

No metastases.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is M1 in lung cancer?

A

Cancer has spread.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is M1a in lung cancer?

A

Cancer has spread to both lungs/pleural effusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is M1b in lung cancer?

A

Single area of cancer outside the lung.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is M1c in lung cancer?

A

More than one area in several organs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the managment of non small cell carcinoma?

A

Aiming for curative treatment:
Surgical resection is first line:
- lobectomy or wedge resection
- mediastinal sampling is done at time of surgery
- pneumonectomy only offered if need to obtain clear margins
- pre-op pFTs to ensure fit
May get post operative chemo
Radiotherapy indicated for some patients.
Chemoradiotherapy for patients who can’t have surgery.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What kind of chemotherapy would be used for non small cell lung cancer?

A

Docetaxel plus cisplatin.

May qualify for immunotherapy e.g. afatinib.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the potential complications of lung cancer?

A 
Superior vena cava obstruction. 
Horners syndrome
Pleural effusion
Endobronchial obstruction
Mets including brain and bleeding
Invasion of main vessels
Shortness of breath
Pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the symptoms of a pleural effusion?

A

Dyspnoea
Pleuritic chest pain
Weight loss/haemoptysis or other symptoms of malignancy
Symptoms of infection - cough/fevers/night sweats

25
What are the signs of a pleural effusion?
Reduced expansion Stony dull percusion Diminished breath sounds May be bronchial breathing above it if lung is compressed Tracheal deviation if big Cachexial/clubbing/lymphadenopathy/oedema
26
How is a pleural effusion diagnosed?
Chest x-ray
27
What would be done to investigate a pleural effusion further?
Ultrasound to assess consistency of fluid and where it's located. Sample fluid May need thoracoscopy or biopsy
28
What is the management of a pleural effusion?
May need to be drained if symptomatic (definitely if infected) If malignant likely to get a talc pleuredesis
29
What will be found in the pleural effusion sample if it is an exudate?
Protein >30g/L Pleural fluid to serum ratio of total protein >0.5 Pleural fluid lactic dehydrogenase >200 IU/I Pleural fluid to serum ratio of LDH is >0.6
30
What are the causes of exudate pleural effusions?
``` Infection Malignancy Haemothorax Chylothorax Autoimmune Pancreatitis ```
31
What will be seen in the pleural fluid if it is a transudate?
TPR <0.5 FLDH <200 IU/I LDHR <0.6
32
What are the causes of transudate pleural effusions?
``` Heart failure Hypoalbuminaemia Hypothyroidism Decompensated ALD Nephrotic syndrome ```
33
What is a pneumothorax?
Accumulation of air in the pleural space.
34
How big is a large pneumothorax?
>2cm margin from lung to chest wall.
35
What are the risk factors for a primary pneumothorax?
``` Young Tall Slim Males Smokers Marfans syndrome Homocystinuria Family history of pneumothorax ```
36
What is the main risk factor for secondary pneumothorax?
COPD
37
What is the pathophysiology of a pneumothorax?
Normal alveolar pressure is higher than the intrapleural pressure which is less than atmospheric pressure. Communication between an alveolus and the pleural space, or between the atmosphere and the pleural space and gas causes pressure gradient and flow into the pleural space. Flow continues until the pressure gradient resolved and abnormal communication has been sealed. As thoracic cavity pressure is normally below its resting volume, the thoracic cavity enlarges and the lung becomes smaller when a pneumothorax develops.
38
What are the symptoms of a pneumothorax?
Sudden onset symptoms. Dyspnoea Chest pain May be distressed with rapid breathing.
39
What are the signs of a pneumothorax?
``` Tachycardia Hypoxia and cyanosis Diaphoresis Ipsilateral hyperinflation Decreased breath sounds Hyper resonance on percussion and vocal fremitus ```
40
What is the treatment of a primary pneumothorax?
Observation if small or asymptomatic and may be discharged with early follow up. If short of breath, initial treatment is high flow oxygen therapy. Percutaneous aspiration fo teh air is as effective as wide bore drains. If failed once - chest drain.
41
What is the treatment of a secondary pneumothorax?
Supplemental oxygen Chest drain. 24 hours observation.
42
What is the pathophysiology of a pulmonary embolism?
A dislodged thrombi occludes the pulmonary vessels
43
What are the potential complications of a pulmonary embolism?
Right heart failure | Cardiac arrest
44
What are the risk factors for thrombus formation?
Venous stasis Trauma Hypercoagulability
45
What makes up Virchow's triad?
Vessel endothelial wall damage. Venous stasis Hypercoagulability
46
What can cause hypercoagulability?
``` Cancer High oestrogen sate (oral contraceptives, hormone replacement, obesity, pregnancy) Inflammatory bowel disease Nephrotic syndrome Sepsis Blood transfusion Inherited thrombophilia ```
47
What are the risk factors for venous stasis?
``` Age >40 Immobility General anaesthesia Paralysis Spinal cord injury Myocardial infarction Prior stroke Varicose veins Advanced congestive heart failure Advanced COPD Bed rest >5 days. ```
48
What is the presentation of pulmonary embolism?
``` Acute onset shortness of breath Pleuritic chest pain Fever Cough Unilateral calf swelling ```
49
Which score is used to determine the likelihood of a PE?
Well's score.
50
What does PERC stand for?
Pulmonary embolism rule out criteria.
51
What are the PERC criteria?
``` Age <50 years Initial heart rate <100bpm Initial oxygen >94% on room air No unilateral leg swelling No haemoptysis No surgery or trauma within the last 4 weeks No history of venous thromboembolism No oestrogen use. ```
52
How should PERC criteria be used?
If patients meet all PERC criteria, risk for PE is lower than the risk of testing - no further test is indicated.
53
When is D-dimer indicated?
In haemodynamically stable patients with intermediate clinical probability of PE. Patients whose initial risk stratification is very low risk of PE but who do not meet all PERC criteria. Patients who are low risk but PERC wasn't used.
54
What does a negative V/Q scan show when testing for PE.
Exclude PE.
55
What is the management of pulmonary embolism?
Oxygen to correct hypoxia. Anticoagulation - DOAC Thrombolysis only for massive PEs (hypotensive/significant cardiorespiratory compromise) Echo/troponins to assess right heart strain. .
56
What are the absolute contraindications to thrombolysis?
Haemorrhagic stroke Ischaemic stroke in the preceeding 6 months. Central nervous sytem damage Neoplasms Recent major trauma/surgery/head injury (in the preceding 3 weeks); GI bleeding within the last month Known bleeding risk.
57
What is the pathophysiology of asthma?
Th-2-mediated immunoglobulin E response. Triggers inflammatory reaction in airways and small airways occluded with mucus and swollen membranes. Bronchial hyper-reactivity and bronchospasm Significant airway obstruction through narrowed lumens. Vasoactive prostaglandins, leukotrienes, histamine, and other cellular mediators having a role in pathogenesis.
58
What is the treatment for an acute asthma attack.
Oxygen if needed. Salbutamol and ipratropium nebs. Steroids (PO prednisolone or IV hydrocortisone) Antibiotics if infective. Magnesium - if you're thinking about this get senior help!

Phase 4 (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions