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respiratory Flashcards

1
Q

Stony dull to percussion indicates what?

A

Pleural effusion

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2
Q

Right sided pleuritic pain suggests what?

A

Most likely pneumonia

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3
Q

Alveolar bat winds, kerley B lines, cardiomegaly, dilated prominent upper lobe vessels, pleural effusion indicates what?

A

Pulmonary oedema

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4
Q

Ground glass appearance on x-ray indicates what?

A

Pulmonary fibrosis or respiratory distress syndrome of the newborn

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5
Q

Zeihl-neelsen stain positive for acid fast bacilli indicates what?

A

TB

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6
Q

Caseous necrosis indicates what?

A

TB

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7
Q

Obstructive respiratory problem has what FEV1, FVC readings?

A
  • reduced FEV1
  • FVC is normal
  • ratio of FEV1 to FVC is reduced
  • PEF reduced
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8
Q

Positive anti-glomerular basement membrane antibodies indicates what?

A

Goodpastures syndrome

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9
Q

Chest infection with a parrot/pigeon as a pet indicates what?

A

Caused by chlamydophilapscittaci

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10
Q

Dry cough and diarrhoea after holiday abroad, some indication of water spread indicates what?

A

Legionella pneumophilia (test urine for antigens), hyponatraemia

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11
Q

tall thin man who indulges in marijuana probably has what?

A

Pneumothorax (marfans)

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12
Q

Bilateral hilar lymphadenopathy, erythema nodosum, granulomas, fatigue, uveitis and weight loss indicates what?

A

Sarcoidosis

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13
Q

Bronchiole wider than neighbouring arterioles (on CT) signet ring sign indicates what?

A

Bronchiectasis

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14
Q

D sign on x-ray indicates what?

A

Empyema

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15
Q

Steeple sign on x-ray indicates what?

A

Laryngotracheobronchitis/croup

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16
Q

Child with barking cough indicates what?

A

Croup

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17
Q

Who gets pneumocystis pneumonia and the treatment?

A

HIV

Treat with co-trimoxazole (+/- prednisolone if severe)

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18
Q

Asthma + nasal polyps + salicylate sensitivity is what?

A

Samters triad

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19
Q

Alcoholic (danger of aspiration pneumonia) indicates which bacteria?

A

Klebsiella pneumoniae

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20
Q

Red jelly sputum indicates what?

A

Klebsiella pneumonia

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21
Q

Mucoid sputum indicates what?

A

Chlamydia psittaci

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22
Q

Rusty sputum indicates what?

A

Pneumococcal pneumonia

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23
Q

Cannonball metastases (also weight loss and haematuria) indicates what?

A

Classically from primary renal cell carcinoma

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24
Q

Morning headache indicates what?

A

Hypercapnia or side effects of organic nitrates

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25
Q

ACTH secreting lung tumour indicates what?

A

Small cell carcinoma of the lung

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26
Q

PTH secreting lung tumour indicates what?

A

Squamous cell carcinoma of lung

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27
Q

What does coxiellaburnetti indicate?

A

Sheep / farm infection

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28
Q

Increase serum ACE and Ca2+ indicates what?

A

Sarcoid

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29
Q

Causes of pulmonary fibrosis

A
  • breast cancer
  • bleomycin / berrylium
  • radiation
    extrinsic allergic alveolitis
  • ankylosing spondylitis
  • sarcoidosis
  • TB
  • cryptogenic fibrosingalveolitis
  • asbestosis
30
Q

Eggshell calcification at hilar region indicates what?

31
Q

Heart failure cells seen in alveolar spaces indicates what?

A

Macrophages that have been absorbed haemosiderin - found in chronic pulmonary oedema, and associated severe left ventricular heart failure, also seen in ling standing pulmonary hypertension

32
Q

What is ghon focus?

A

An areas of infection and caseous necrosis at the periphery of the lung, beneath the pleura - found in TB. Note; ghon focus rupture (rare) through the visceral pleura into the pleura cavity will produce TB pleurisy

33
Q

Drugs to treat TB

A

2 RIPE 4 RI
2 months rifamipicin, isoniazid, pyrazinamide, ethambutol

4 months of rifampicin, isoniazid

34
Q

What is an assmann focus?

A

Apical lesion of secondary TB infection

35
Q

Coin lesion found on chest radiographs suggest what?

A

A rounded solitary lesion. The common lesions are; primary bronchial carcinoma or kung carcinoma, metastatic tumour (esp. of kidney), bronchial hamartoma, carcinoid tumours, granulomatous inflammation, lung abscess

36
Q

Describe horners syndrome

A

Can occur when there is a local spread of cancer to intrathoracic nodes or a pancoasts tumour. Signs include; ptosis (drooping of eyelid), enophthalmos (sunken eye), misosis (small pupil) and lack of sweating on the ipsilateral side of the face. This us due to invasion, of the cervical sympathetic chain

37
Q

Acute management of asthma

A

OHSHIT MAN

Oxygen 100% through a non-rebreather mask 
Salbutamol nebulised back to back 
Hydrocortisone IV or prednisolone PO 
Ipratropium bromide nebulised hourly 
Theophylline IV or aminophylline IV
Magnesium 
Anaesthetist
38
Q

Thumbprint sign on head x-ray indicates what?

A

Epiglottitis

39
Q

Snow storm appearance on an x-ray indicates what?

A

Baritosis, silicosis

40
Q

Management of infective exacerbation of COPD

A 
ISOAP 
Ipratropium 
Salbutamol 
Oxygen 
Amoxicillin 
Prednisolone
41
Q

Non smoker + lung cancer =

A

Peripheral adenocarcinoma

42
Q

Squamous + small cell lung cancers are what?

43
Q

High D-dimers suspect what?

A

suspect PE, send for CTPA or V/Q scan

44
Q

Low d-dimers =

A

Exclude pulmonary embolism

45
Q

What do you do for a large PE?

A

Thrombolysis

46
Q

What do you do for a small PE?

A

Low molecular weight heparin

47
Q

Honeycomb lung indicates what?

A

Fibrosingalveolitis

48
Q

What is an apical lesion called?

A

Assmann focus

49
Q

What is a key indicator of goodpastures syndrome?

A

Anti-GBM antibodies

50
Q

Chest infection with a parrot/pigeon as pet indicates what?

A

Chlamydia psittaci

51
Q

Dry cough and diarrhoea after holiday abroad, some indication of water spread indicates what?

A

Legionella pneumophila

52
Q

Bronchioles wider than neighbouring arteriole on CT suggests what?

A

Bronchiectasis

53
Q

D sign on an x-ray indicates what?

54
Q

Steeple sign on an x-ray indicates what?

55
Q

Child with barking cough indicates what?

56
Q

Pneumocystis pneumonia infection is a red flag for?

57
Q

How to treat pneumocystis pneumonia?

A

Co-trimoxazole

58
Q

Asthma + nasal polyps + salicylate sensitivity is what?

A

Samters triad

59
Q

Alcoholic (danger of aspiration pneumonia) indicates what?

A

Klebsiella pneumonia

60
Q

Red jelly sputum indicates what?

A

Klebsiella pneumoniae

61
Q

Mucoid sputum indicates what?

A

Chlamydia psittaci

62
Q

Rusty sputum indicates what?

A

Pneumococcal pneumonia

63
Q

Morning headache indicates what?

A

Hypercapnia or side effects of organic nitrates

64
Q

Increased serum ACE and Ca2+ sarcoidosis indicates what?

A

Sarcoidosis

65
Q

Eggshell calcification at hilar region indicates what?

66
Q

Hyperexpanded chest indicates what?

67
Q

Positive sweat test >60mmol/L NaCl indicates what?

68
Q

Fever, night sweats, anorexia, haemoptysis indicates what?

69
Q

Swinging fever, copious foul smelling sputum indicates what?

A

Lung abscess

70
Q

4 types of autoimmune reactions

A

ABCD

  • allergic
  • blood
  • clumps
  • delayed
71
Q

TB drug side effects

A 
Rifampicin; orange coloured fluids 
Isoniazid; peripheral neuropathy / hepatitis 
Ethambutol; colour blindness
Pyrazinamide; gout 
Streptomycin; hearing problems

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