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respiratory Flashcards

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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
ACTH secreting lung tumour indicates what?
Small cell carcinoma of the lung
26
PTH secreting lung tumour indicates what?
Squamous cell carcinoma of lung
27
What does coxiellaburnetti indicate?
Sheep / farm infection
28
Increase serum ACE and Ca2+ indicates what?
Sarcoid
29
Causes of pulmonary fibrosis
- breast cancer - bleomycin / berrylium - radiation extrinsic allergic alveolitis - ankylosing spondylitis - sarcoidosis - TB - cryptogenic fibrosingalveolitis - asbestosis
30
Eggshell calcification at hilar region indicates what?
Silicosis
31
Heart failure cells seen in alveolar spaces indicates what?
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
What is ghon focus?
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
Drugs to treat TB
2 RIPE 4 RI 2 months rifamipicin, isoniazid, pyrazinamide, ethambutol 4 months of rifampicin, isoniazid
34
What is an assmann focus?
Apical lesion of secondary TB infection
35
Coin lesion found on chest radiographs suggest what?
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
Describe horners syndrome
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
Acute management of asthma
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
Thumbprint sign on head x-ray indicates what?
Epiglottitis
39
Snow storm appearance on an x-ray indicates what?
Baritosis, silicosis
40
Management of infective exacerbation of COPD
``` ISOAP Ipratropium Salbutamol Oxygen Amoxicillin Prednisolone ```
41
Non smoker + lung cancer =
Peripheral adenocarcinoma
42
Squamous + small cell lung cancers are what?
Central
43
High D-dimers suspect what?
suspect PE, send for CTPA or V/Q scan
44
Low d-dimers =
Exclude pulmonary embolism
45
What do you do for a large PE?
Thrombolysis
46
What do you do for a small PE?
Low molecular weight heparin
47
Honeycomb lung indicates what?
Fibrosingalveolitis
48
What is an apical lesion called?
Assmann focus
49
What is a key indicator of goodpastures syndrome?
Anti-GBM antibodies
50
Chest infection with a parrot/pigeon as pet indicates what?
Chlamydia psittaci
51
Dry cough and diarrhoea after holiday abroad, some indication of water spread indicates what?
Legionella pneumophila
52
Bronchioles wider than neighbouring arteriole on CT suggests what?
Bronchiectasis
53
D sign on an x-ray indicates what?
Empyema
54
Steeple sign on an x-ray indicates what?
Croup
55
Child with barking cough indicates what?
Croup
56
Pneumocystis pneumonia infection is a red flag for?
HIV
57
How to treat pneumocystis pneumonia?
Co-trimoxazole
58
Asthma + nasal polyps + salicylate sensitivity is what?
Samters triad
59
Alcoholic (danger of aspiration pneumonia) indicates what?
Klebsiella pneumonia
60
Red jelly sputum indicates what?
Klebsiella pneumoniae
61
Mucoid sputum indicates what?
Chlamydia psittaci
62
Rusty sputum indicates what?
Pneumococcal pneumonia
63
Morning headache indicates what?
Hypercapnia or side effects of organic nitrates
64
Increased serum ACE and Ca2+ sarcoidosis indicates what?
Sarcoidosis
65
Eggshell calcification at hilar region indicates what?
Silicosis
66
Hyperexpanded chest indicates what?
COPD
67
Positive sweat test >60mmol/L NaCl indicates what?
CF
68
Fever, night sweats, anorexia, haemoptysis indicates what?
TB
69
Swinging fever, copious foul smelling sputum indicates what?
Lung abscess
70
4 types of autoimmune reactions
ABCD - allergic - blood - clumps - delayed
71
TB drug side effects
``` Rifampicin; orange coloured fluids Isoniazid; peripheral neuropathy / hepatitis Ethambutol; colour blindness Pyrazinamide; gout Streptomycin; hearing problems ```

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