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GRACE Phase 2a Medicine > Respiratory > Flashcards

Respiratory Flashcards

1
Q

FEV1:FVC < ? = airway obstruction?

A

0.7

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2
Q

What values of FEV1 or FVC denote airway restriction?

A

normal FEV1, low FVC

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3
Q

Type 1 respiratory failure

A

Low pO2
Low/normal pCO2
Most commonly caused by PE
(Type 1 think 1 change)

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4
Q

Type 2 respiratory failure

A

Low pO2
High pCO2
Hypoventilation causes type 2
(type 2 = 2 changes)

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5
Q

Signs of hypercapnoea (high CO2)

A

bounding pulse, flapping tremor, confusion, drowsiness, reduced consciousness

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6
Q

Obstructive respiratory disease

A

FEV1:FVC < 0.7

Asthma, COPD, bronchiectasis

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7
Q

Restrictive respiratory disease

A

FEV1:FVC >0.7, low FVC, lung volumes are small and most of breath is out in first second
Interstitial lung disease (pulmonary fibrosis, sarcoidosis)

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8
Q

What is bronchiectasis?

A

Chronic inflammation of the bronchi and bronchioles –> permanent dilation and thinning of the airways, also excessive mucus production, recurrent bacterial infections ensue

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9
Q

Main organisms causing bronchiectasis?

A

H.influenzae, Strep.pneumoniae, Staph. aureus

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10
Q

Causes of bronchiectasis?

A

Cystic fibrosis, airway obstruction (tumour/foreign body), defective host defences (primary ciliary dykinesia), immunosuppression

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11
Q

Px of bronchiectasis

A

Persistent cough, wheeze, copious purulent sputum, dyspnoea, wheezing

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12
Q

Ix of bronchiectasis

A

Hx of recurrent respiratory infections, culture sputum, CXR (cystic shadows, thickened bronchial walls), CT scan (Gold standard)

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13
Q

Mx of bronchiectasis

A

Airway clearance techniques and mucolytics, Abx, bronchodilators

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14
Q

What is hypersensitivity pneumonitis? Px?

A

Inflammatory response to innocuous substances, usually associated with jobs/hobbies. Chronic cough, dyspnoea, fatigue

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15
Q

Mx of hypersensitivity pneumonitis?

A

avoid the antigen, corticosteroids

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16
Q

Occupational lung disorders

A

Lung diseases caused by exposure to agents at work, mx - avoid the antigen, corticosteroids

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17
Q

Goodpasture’s syndrome aka

A

anti-glomerular basement membrane disease

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18
Q

What is Goodpasture’s syndrome?

A

Rare autoimmune disease in which antibodies attack the BM in the lungs and kidneys

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19
Q

Px of Goodpasture’s syndrome?

A

Symptoms of upper respiratory tract infection, cough, dyspnoea, haemoptysis, acute glomerulonephritis

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20
Q

Dx of Goodpasture’s syndrome? Mx?

A

Renal and lung biopsy, anti-GBM, corticosteroids for immunosuppression

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21
Q

Wegener’s granulomatosis was renamed?

A

granulomatosis with polyangiitis (due to associations with the Nazi party)

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22
Q

What is Wegener’s granulomatosis?

A

ANCA-associated vasculitis, necrotising granulomatous inflammation with a predilection for the upper respiratory tract, lungs and kidneys

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23
Q

Px of Wegener’s granulomatosis?

A

Saddle-shaped nose, cough, haemoptysis, signs of upper tract respiratory disease

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24
Q

Dx and tx or Wegener’s granulomatosis?

A

cANCA +’ve, raised ESR/CRP

Corticosteroids, plasma exchange

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25
Q

What is pleural effusion?

A

Collection of fluid in the pleural space. Can be exudative (increased protein) or transudative (low protein count)

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26
Q

Exudative pleural effusion (>35g/L) causes

A

Increased pulmonary capillary leakage due to:

infection, inflammation, malignancy (lung cancer, pneumonia, TB, RA)

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27
Q

Transudative pleural effusion (<25g/L) causes

A

Increased venous pressure:

Congestive heart failure, hypoalbuminaemia, hypothyroidism, Meig’s syndrome

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28
Q

What is Meig’s syndrome?

A

Triad of R pleural effusion, ascites and ovarian fibroma

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29
Q

px of pleural effusion?

A

SOB, dyspnoea, pleuritic chest pain, dullness on percussion, decreased chest sounds

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30
Q

Ix of pleural effusion?

A

CXR - blunt costophrenic angle or meniscus
US
Diagnostic aspiration

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31
Q

MX of pleural effusion?

A

Treat underlying cause, pleuritic aspiration, chest drain

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32
Q

What is a pneumothorax? Typical px in?

A

Air in pleural space, tall thin young males

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33
Q

Causes of pneumothorax?

A
  1. Spontaneous
  2. Chronic lung disease - COPD, asthma
  3. Infection - TB, pneumonia
  4. Trauma
  5. Carcinoma
  6. Connective tissue disorders - Marfans
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34
Q

Px of pneumothorax

A

Dyspnoea, pleuritic pain, hyperresonance on percussion, asymptomatic, reduced expansion

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35
Q

Ix of pneumothorax

A

Erect CXR - area devoid of lung markings

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36
Q

Mx of primary pneumothorax

A

If SOB and/or >2cm –> aspirate, if not discharge and review in 2-4 weeks

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37
Q

Mx of secondary pneumothorax

A

If SOB or >2cm –> chest drain

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38
Q

Tension pneumothorax

A

Medical emergency, trauma to the pleura, one way valve, air drawn in upon inspiration and not released

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39
Q

Px of tension pneumothorax

A

respiratory distress, hypotension, tachycardia, deviated trachea

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40
Q

Mx of tension pneumothorax?

A

Insert a large bore cannula into the 2nd intercostal space, relieve pressure and then insert a chest drain

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41
Q

What is acute respiratory distress syndrome (ARDS)?

A

acute lung injury caused directly or secondary to a systemic illness. Lung damage and release of inflammatory mediators causes increased capillary permeability and non-cardiogenic pulmonary oedema

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42
Q

Pulmonary causes of ARDS

A

pneumonia, inhalation, injury, vasculitis

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43
Q

Px of ARDS

A

cyanosis, tachypnoea, tachycardia, peripheral vasodilation

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44
Q

Risk factors for ARDS

A

sepsis, hypovolaemic shock, trauma, pneumonia, DKA, pregnancy, massive transfusion, acute pancreatitis

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45
Q

What is Cor pulmonale?

A

R sided heart failure caused by underlying respiratory disease, most common = COPD, main presenting symptom = SOB

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46
Q

Physiology of Cor Pulmonale?

A

Lung disorder –> decreased O2 –> hypoxic vasoconstriction –> increased pressure and resistance within lungs –> pulmonary HTN –> difficult for R ventricle to pump –> back flow of pressure in R atrium and venous system

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47
Q

Px of Cor Pulmonale (SCRuFF)

A

SOB, cyanosis, raised JVP and heart rate (tachycardia), fatigue, fainting

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48
Q

Tx of Cor pulmonale

A
  1. Treat underlying cause
  2. Treat respiratory disease (oxygen supplementation)
  3. Treat cardiac failure (diuretics)
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49
Q

What is sarcoidosis?

A

Rare granulomatous inflammatory condition. Granulomas = inflammatory nodules full of macrophages, unknown aetiology, thought to involve immune dysfunction and T cell overactivity, wide-ranging systemic manifestations, most commonly –> LUNGS

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50
Q

Classic patient with sarcoidosis?

A

Black female aged 20-40, presenting with a dry cough and SOB, may have nodules on shins

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51
Q

Pulmonary sarcoidosis?

A

Development of fibrosis (thickening of pulmonary interstitium), bilateral hilar lymphadenopathy and pulmonary nodules

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52
Q

Erythema nodosum sarcoidosis

A

tender red nodules caused by inflammation of the subcutaneous fat

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53
Q

Sarcoidosis that progresses with pulmonary fibrosis and pulmonary HTN may need treatment by?

A

Lung transplant

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54
Q

Common clinical features of interstitial lung diseases?

A

SOB, chronic cough, dyspnoea, abnormal breath sounds, restrictive pulmonary spirometry

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55
Q

How does acute sarcoidosis present? What is this eponymously named as?

A
  1. Bilateral hilar lymphadenopathy (BHL)
  2. Polyarthralgia
  3. Erythema nodosum

Löfgren’s syndrome

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56
Q

Extra-pulmonary signs of sarcoidosis

A

Hepatomegaly, uveitis, conjunctivitis, arrhythmias, renal stones

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57
Q

Ix of sarcoidosis

A
  1. Spirometry - restrictive
  2. Bloods - raised ESR/CRP, raised serum ACE, raised Ca2+
  3. CXR - BHL, fibrosis
  4. Biopsy - diagnostic
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58
Q

Mx of sarcoidosis

A
  1. Spontaneously resolves
  2. Acute sarcoidosis - NSAIDs and bed rests
  3. Corticosteroids (prednisolone) - parenchymal lung disease, uveitis, hypercalcaemia
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59
Q

What is idiopathic pulmonary fibrosis (IPF)?

A

Interstitial lung disease, inflammatory cell infiltrate of unknown cause

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60
Q

Px of IPF?

A

dry cough, dyspnoea, weight loss, malaise, arthralgia, cyanosis

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61
Q

Complications of IPF?

A

Respiratory failure, increased risk of lung cancer

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62
Q

Ix of IPF?

A
  1. Bloods (ABG - low PaO2), raised CRP, increased Ig
  2. Imaging - honeycomb lung
  3. Spirometry - restrictive
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63
Q

Mx of IPF

A

Supportive care, palliative care, opiates, pulmonary rehabilitation

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64
Q

What is meconium ileus?

A

Neonatal bowel obstruction of the distal ileum due to abnormally thick and impacted meconium. Unlike in the meconium plug syndrome, the meconium is abnormal in consistency, suspect CF in neonates with MI

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65
Q

What is CF?

A

autosomal recessive condition causing a mutation on the CFTR gene leading to a faulty CFTR channel affecting the transport of Cl- ions, predominantly affects the lungs

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66
Q

How does CF affect the CFTR transporters in the GIT, lungs and pancreas?

A

Faulty CFTR –> lack of Cl- secretion, therefore thick mucus, impaired mucociliary clearance, biliary/pancreatic duct blockage –> cysts –> infection

67
Q

When does CF present? When is it screened for?

A

Infants/children, in newborns - positive heel prick test

68
Q

Px of CF (CF PANCREAS)

A

Cough, wheeze
Failure to thrive
Pancreatic insufficiency (steatorrhoea)
Absence/atresia of vas deferens –> male infertility
Neonatal intestinal obstruction
Clubbing
Recurrent infections (–> bronchiectasis)
Elevated electrolytes in sweat
A(malignancies)
Sputum - infected with S.aureus, H.influenzae

69
Q

Ix of CF?

A
  1. Sweat test - Na+ and Cl- >60mmol/L
  2. Genetic screening
  3. Newborn heel prick test
  4. other ix e.g. spirometry, faecal elastase, CXR
70
Q

Mx of CF?

A
  1. Physiotherapy for airway clearance
  2. Mucoactive agents
  3. ABx
  4. Lung transplantation
  5. Vitamin supplements, pancreatic enzyme replacement
  6. Liver reviews
  7. Diabetes - glucose testing
71
Q

Why patients treated with RIPE drugs for TB have regular LFTs?

A

Because 3 of the drugs (RIP) are hepatotoxic

72
Q

Define COPD

A

Progressive disorder characterised by airway obstruction with little/no reversibility, umbrella term for chronic bronchitis and emphysema

73
Q

What is chronic bronchitis?

A

Chronic productive cough for >3 months over 2 years, inflammation of the bronchi

74
Q

Emphysema?

A

Pathological term referring to structural lung changes, abnormal air space enlargement, alveoli destruction –> hypoxia

75
Q

What is the biggest risk factor for COPD?

A

Smoking

76
Q

Genetic disease causing COPD?

A

Alpha-1 antitrypsin deficiency (lack of elastase inhibition, alveoli elastin broken down)

77
Q

Difference between inflammatory cell infiltration in chronic bronchitis and asthma?

A 
CB = neutrophils
Asthma = eosinophils
78
Q

Pathological changes in chronic bronchitis?

A

Mucus hypersecretion, goblet cell hyperplasia, airway narrowing, chronic inflammation and fibrosis

79
Q

How might Cor Pulmonale result from COPD?

A

Chronic hypoxia in alveoli due to decreased ventilation and air trapping –> decreased perfusion/vasoconstriction –> pulmonary HTN –> backs up pressure in R side of heart

80
Q

Signs of COPD?

A

Chronic cough, sputum production, breathlessness, recurrent bronchitis, wheeze, barrel chest

81
Q

Diagnosis of COPD

A

Confirm obstruction on spirometry (FEV1 reduced and FEV1:FVC <0.7) and does NOT reverse following inhalation of bronchodilator

82
Q

5 things to differentiate COPD from asthma?

A
  1. Smoker/Hx
  2. Older
  3. Productive cough
  4. Breathlessness
  5. COPD - no night time cough
83
Q

CXR findings for COPD?

A

hyperinflation, flat hemidiaphragms

84
Q

Inhaled therapy for stable COPD? (think ice cream parlour)?

A
  1. SABA/SAMA PRN
  2. LABA + LAMA (if steroid unresponsive)
    LABA + ICS (if steroid responsive)
  3. Triple therapy - LABA + LAMA + ICS
85
Q

Oral therapy for COPD

A

Corticosteroids, mucolytics, Abx, theophylline (bronchodilator)

86
Q

Complications of COPD?

A

Respiratory failure, pneumonia, pneumothorax, polycythaemia, anaemia, depression

87
Q

Signs and symptoms of pneumonia?

A

Malaise, confusion, fever, rigor, tachycardia, tachypnoea, dyspnoea, cough (CAN be productive), haemoptysis, dull percussion, reduced breath sounds

88
Q

Risk factors for pneumonia?

A

Elderly, smoker, malnourishment, underlying lung disease, recent respiratory infection, immunocompromised

89
Q

lower respiratory tract is sterile - true or false? How?

A

true - alveolar macrophages and mucociliary clearance (mucus contains IgA antibodies)

90
Q

Common bacteria causing pneumonia?

A

Strep. pneumoniae

Haemophilus influenzae

91
Q

Common viral causes of pneumonia?

A

Influenza, RSV

92
Q

Streptococcus pneumoniae

A

Gram +’ve
Alpha-haemolytic
Most common cause of community acquired pnuemonia, presenting with a cough, pleuritic pain and fever
Classically gives rust coloured sputum

93
Q

What type of body fluid test can detect Strep. pneumoniae infection? Is it affected by Abx?

A

Urinary antigen test, unaffected by antibiotics

94
Q

Mycoplasma pneumoniae

A

Rod shaped bacterium, lacking a cell wall, tends to affect young.
Causes pneumonia with a prolonged, insidious onset with extra-pulmonary features

95
Q

Legionella pneumophilia

A

L. pneumophila is a gram-negative coccobacillus that may cause the atypical CAP (typically lobar) Legionnaire’s disease. It is encountered in those exposed to contaminated cooling systems, humidifiers and showers. Chest symptoms may be preceded by several days of myalgia, headache and fever

96
Q

Causative agents of hospital acquired pneumonia?

A

(gram-negative)

Pseudomonas, anaerobes

97
Q

Pseudomonas aeruginosa

A

Gram -‘ve bacilli that typically cause HAP, causes pneumonia in immunosuppressed patients and those with chronic lung disease, may affect MANY body systems, sputum characteristically green

98
Q

Pulmonary complications of pneumonia

A

pneumothorax, pleural effusion, empyema, lung abscess, respiratory failure

99
Q

Extra-pulmonary complications of pneumonia

A

Sepsis, AF

100
Q

Define pneumonia

A

Acute lower respiratory tract infection associated with fever, chest sign and symptoms and CXR abnormalities (inflammation of lung parenchyma)

101
Q

Pathological changes in pneumonia?

A

Fluid filled alveoli, narrowed airways, increased mucus

102
Q

What is meant by lung consolidation? What part of a lung does it usually occupy?

A

Process that fills the alveoli with fluid, pus, blood –> lobar opacity; occupies a lobe of the lung

103
Q

Classifying pneumonia by location in lung? Difference?

A

Lobar, broncho
Lobar pneumonia starts distally and spreads proximally (starts in the alveoli and fills lobe)
Broncho affects patches throughout the lungs and spreads from the airways – distally

104
Q

Scoring systems to help stratify patients with pneumonia –> risk of mortality

A

CRB-65 and CURB-65, point scored for each category

105
Q

CRB-65

A 
Aid judgement to assess need --> hospital admission, calculated in primary care
C - confusion
R - respiratory rate >30
B - BP (low)
65 - age>65?
0 - outpatient
1-2 - admission
3 - urgent admission
106
Q

CURB-65

A 
Calculated when a patient presents to hospital, includes a urea measurement 
C - confusion
U - urea >7
R - respiratory rate >30
B - BP low
65 - age>65?
0-1 - outpatient
2- secondary care
3 - ICU
107
Q

Mx of pneumonia?

A
  1. Oxygen
  2. IV fluids
  3. Antibiotics
  4. Analgesics
108
Q

Ix for pneumonia?

A
  1. CXR - lobar/ patchy consolidation
  2. Sputum for microscopy
  3. Urine - check for urinary antigens
  4. Blood tests - raised ESR/CRP, LFTs, FBC, U&Es
109
Q

Empirical Abx used in pneumonia to target gram positive and negative bacteria?

A

Amoxicillin (penicillins) +’ve

Clarithromycin (-mycins) -‘ve

110
Q

Beta lactams Abx

A

Target cell wall of bacteria (e.g. amoxicillin, target staph species)

111
Q

What is community acquired pneumonia (CAP)?

A

pneumonia acquired outside a hospital in a patient who is not immunocompromised

112
Q

What is hospital acquired pneumonia? (HAP)

A

Pneumonia contracted >48hrs after hospital admission that was not incubating at the time of admission

113
Q

Typical CAP

A

Strep. pneumoniae most common cause, common symptoms - fever, cough, pleuritic chest pain

114
Q

Likely organisms causing HAP?

A

Gram -‘ve bacilli (pseudomonas aeruginosa), staph. aureus, legionella pneumophila

115
Q

What are aspiration pneumonias?

A

Caused by inhalation of oropharyngeal or gastric contents which brings bacteria into the lungs

116
Q

What sort of px is aspiration pneumonia seen in?

A
  • Reduced conscious level (stroke, post-ictal, drunk)
  • NM disorders (MG)
  • Oesophageal conditions (reflux)
  • Mechanical interventions e.g. endotracheal tubes
117
Q

Hospitalised patients on which medication are seen to suffer with HAP pneumonia more (aspiration)?

A

PPIs

118
Q

Organisms causative of pneumonia in immunocompromised patients?

A
  1. More bacterial pathogens
  2. Fungal pathogens
  3. Viral pathogens - varicella zoster
  4. Parasitic - almost exclusive to aspiration pneumonias
119
Q

Bacteria classically causing pneumonia in alcoholics?

A

Klebsiella pneumophilia

Symptoms - cough, fever, flu, red-currant jelly sputum

120
Q

3 cardinal symptoms of pneumonia

A

cough, SOB, signs of consolidation

121
Q

What is TB?

A

infectious disease caused by the mycobacterium complex, commonly presents in lungs

122
Q

Latent TB

A

Suppression of initial TB infection, but later re-activated

123
Q

Active TB

A

Symptomatic, contagious, progressive - often presents with malaise, fever, weight loss

124
Q

Staining TB?

A

Bright red with Zelhl-Neelsen stain

125
Q

What is a Ghon focus? What is a Ghon complex?

A

Granuloma of phagocytosed TB, caseous necrosis occurs inside = Ghon focus

Ghon complex = Ghon focus + nearby involved lymph node

126
Q

3 cardinal symptoms of TB

A

weight loss
fever
malaise

127
Q

Mantoux test for TB

A

Intradermal injection of tuberculin (TB proteins) - type IV hypersensitivity reaction if exposed to TB, diagnosis based on degree of epidermal reaction

128
Q

Interferon gamma release assay test for TB

A

Patients blood mixed with TB antigens. If previously exposed to TB, WBCs with release interferon gamma

129
Q

Ix of active TB?

A
  1. CXR - millet seeds, patches, pleural effusions
  2. Cultures (sputum, blood)
  3. Nucleic acid amplification
130
Q

BCG vaccine?

A

Live attenuated (weakened) vaccine, required a -‘ve mantoux test if >6 to rule out exposure to TB

131
Q

Mx of active pulmonary TB (RIPE)

A
  1. Rifampicin
  2. Isoniazid
  3. Pyrazinamide
  4. Ethambutol
132
Q

SE of each of the abx used in TB? (RIPE)

A

Rifampicin - red-orange body fluids
Isoniazid - neuropathy (give pyridozine = vitB6)
Pyrazinamide - gout
Ethambutol - optic neuropathy

133
Q

Tx for extra-pulmonary disease of TB?

A

corticosteroids

134
Q

Mx of latent TB

A
  1. 6 months of isoniazid (+pyridoxine)

2. 3 months of isoniazid (+ pyridoxine) + rifampicin

135
Q

Abx used in HAP?

A

co-amoxiclav

136
Q

Define asthma

A

Chronic inflammation disorder of the airway, characterised by recurrent episodes of dyspnoea, cough, wheeze caused by reversible airway obstruction (airway hyperresponsiveness)

137
Q

3 factors contributing to airway narrowing in asthma?

A
  1. Bronchial muscle contraction
  2. Mucosal swelling/inflammation
  3. Increased mucus production
138
Q

What causes mucosal swelling/inflammation in asthma?

A

Mast cell and basophil degranulation –> inflammatory mediators

139
Q

Atopic asthma?

A

Genetic predisposition to IgE mediated allergen sensitivity

140
Q

Why are the airways hyperresponsive in asthma?

A

Increased eosinophils in mucus, increased mast cells and neutrophils in lamina propria

141
Q

Classic symptoms of an asthmatic?

A

Intermittent dyspnoea, wheeze, cough (often nocturnal), chest tightness

142
Q

Precipitants of asthma?

A

Cold air, exercise, emotion, allergens, smoking, pollution, NSAIDs, beta-blockers

143
Q

Diurnal variation asthma?

A

Symptoms/ peak expiratory flow vary throughout the day - markedly worse at night

144
Q

Hygiene hypothesis asthma

A

Reduced exposure to infectious pathogens at a young age predisposes individuals to asthma

145
Q

Pathophysiology of the early phase of asthma

A

Inhalation of allergens –> type 1 hypersensitivity reaction (allergic). Allergen exposure causes the release of IgE antibodies (due to increased sensitivity) from plasma cells. IgE bind to high affinity receptors on mast cells –> degranulate –> histamine –> bronchoconstriction

146
Q

Acute asthma attack?

A

Worsening of symptoms, can’t complete sentences, tachycardia, exhaustion, tachypnoea, reduced PEF (<33%)

147
Q

Asthma and spirometry

A

Performed at time of diagnosis, reduced FEV1, FEV1:FVC <0.7, reversibility after bronchodilator inhalation

148
Q

Asthma and PEFR (peak expiratory flow rate)

A

Classically varies throughout the day

149
Q

Fractional exhaled nitric oxide (FeNO)

A
  • Offered at the same time as spirometry
  • Tests for eosinophilic airway inflammation (NO produced by eosinophils = messenger)
  • > 25ppb at 50ml/sec = 70-80% of patients
150
Q

What value for FeNO is supportive of a diagnosis for asthma?

A

> 40ppb

151
Q

tests for asthma variability?

A
  1. Reversibility testing with spirometry

2. PEFR

152
Q

Tests for eosinophilic inflammation to help diagnose asthma?

A
  1. FeNO
  2. Blood eosinophilia
  3. Skin prick test (IgE)
153
Q

mx of asthma (think nutella sandwich)

A

SABA - PRN

  1. ICS
    • LABA
  3. ^ICS or LTRA
  4. specialist referral
154
Q

SABA

A

short-acting beta-2 agonist, acts in airways to stimulate bronchodilation
E.g. =salbutamol
SE - tachycardia, tremor, palpitations

155
Q

ICS

A

inhaled corticosteroids, beclomethasone, reduced inflammation
SE - osteoporosis, HTN

156
Q

LABA

A

long acting beta-2 agonist

157
Q

LTRA

A

leukotriene receptor antagonist

E.g.=montelukast

158
Q

Initial mx of an acute asthma attack?

A
  1. Nebulised salbutamol
  2. Oxygen
  3. Steroids (prednisolone)
  4. Ipratropium bromide nebuliser (anticholinergic)
159
Q

Salbutamol is associated with hypo-?

A

Hypokalaemia

160
Q

Tx for interstitial lung disease?

A

Remove underlying cause, stop smoking, physiotherapy and respiratory rehabilitation, pneumococcal and flu vaccine

161
Q

What condition gives a honeycomb appearance on CXR?

A

idiopathic pulmonary fibrosis

162
Q

Drugs that can cause pulmonary fibrosis?

A

Amiodarone, cyclophosphamide, methotrexate, nitrofurantoin

163
Q

Conditions that can cause secondary pulmonary fibrosis? (ARSE)

A

Alpha-1 anti-trypsin deficiency
RA
Systemic sclerosis
(SL)E

164
Q

Hypersensitivity pneumonitis (extrinsic allergic alveolitis) = type ??? hypersensitivity reaction?

A

3

GRACE Phase 2a Medicine (20 decks)

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