Respiratory Flashcards
Stony dull to percuss
pleural effusion
Right sided pleuritic chest pain
most likely pneumonia
ABCDE of pulmonary oedema on a CXR
Alveolar bat’s wings, kerley B lines, Cardiomegaly, Dialled prominent upper lobe vessels, pleural Effusions
ground glass appearance on X-ray
pulmonary fibrosis
Ziehl-neelsen stain positive for acid fast bacilli
TB
Caseous necrosis
TB
apical disease
most likely (secondary)TB; apical lesion is known as assmann focus
military TB
spread of organism into bloodstream.
Pulmonary artery = military dissemination into the lungs
pulmonary vein - systemic dissemination into the liver, spleen and kidneys
Positive anti-glomerular basement membrane antibodies
goodpastures syndrome
Chest infection with parrot or pigeon as pet
chlamoydophila psittaci
dry cough and diarrhoea after holiday abroad
legionella pneumophila (test urine for antigens)
Tall, thing young man that indulges in weed - or a mr snoop dog
someone who is likely to get a pneumothorax (Marfan’s)
Bilateral hilar lymphadenopahty, erythema nodosum, granulomas, fatigue and weight loss
Sarcoidosis
bronchiole wider than neighbouring arteriole on CT - signet ring sign
Bronchiectasis
D sign on CXR
empyema (looks like it is stuck to the edge of the chest)
Steeple sign on CXR
laryngotracheobrinchitis or croup
child with barking cough
croup
Pneumocystis pneumonia
HIV (co-tramoxazole)
Asthma + nasal polyps + salicylate sensitivity
samter’s triad
alcoholic (danger of aspiration pneumonia)
klebsiella pneumonia (red jelly haemoptysis)
rusty sputum
pneumococcal pneumonia
cannonball metastases (weight loss and haematuria- blood in the urine)
primary renal cell carcinoma
morning headache
hypercapnia or side effects of organic nitrates
ACTH secreting lung cancer
Small cell lung cancer
PTH secreting secreting lung cancer
Squamous cell carcinoma
neuroendocrine, highly malignant and may be associated with exotic endocrine syndromes
small cell lung cancer
increased serum ACE and Ca2+
sarcoidosis
eggshell calcification
silicosis
heart failure cells seen in alveolar spaces
macrophages that absorbed haemosiderin - chronic pulmonary oedema, left ventricular failure and long standing pulmonary hypertension
Ghon focus
area of infection and caseous necrosis at the periphery of the lung, beneath the pleura - found in TB
tuberculous pleurisy
Ghon focus rupture through the visceral pleura into the pleural cavity
Assmann focus
apical lesion of secondary TB infection
coin lesion found on CXR - rounded solitary legion
common lesions are - primary bronchial or lung carcinomas, metastatic tumour (kidney), bronchial hamertoma, carcinoid tumour, granulomatous inflammation, lung abscess
Horner’s syndrome
occur when there is a local spread of cancer to the intrathoracic nodes
signs include: drooping eyelids(ptosis), enophthalmos(sunken eye), mitosis(small pupil) and lack of sweating on the ipsilateral(same side of invasion) side of face - invasion of cervical sympathetic chain
acute management of asthma
OSHITMAN
oxygen, salbutamol, hydrocortisone, ipratropium, Theophylline, magnesium, anaesthetist
Thumprint sign on Xray
epiglottitis
inspiratory whoop or barking cough
pertussis
snow storm appearance on x ray
baritosis or silicosis
mucoid sputum
chalmydia pneumonia
Management of acute COPD exacerbation
ISOAP - ipratropium, salbuatamol, oxygen, amoxycillin and prednisolone
peripheral adenocarcinoma?
non-smoker and lung cancer
squamous + small cell lung cancers
CENTRAL
high d dimers
suspect PE - send for CTPA or VQ scan
low d dimer
exclude PE
Large PE
thrombolysis
Small PE
Low molecular weight heparin
Forced vital capacity
Volume of air that can be forcibly blown out after full inspiration
