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Respiratory Conditions Flashcards

1
Q

What conditions cause fibrosis of the upper lobe?

A

C - coal worker pnuemoconiosis
H - hypersensitivity pneumonitis
A - Ank Spond
R- Radiation
T - tuberculosis
S - sarcoidosis

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2
Q

Common causes of Respiratory Alkalosis

A
  • hyperventiliation
  • PE
  • Salicylate overdose
  • Stroke, subarachnoid, encephalitis
    -altitude
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3
Q

Moderate Asthma attack criteria

A

PEFR 50-75% best or predicted
Speech normal
RR < 25 / min
Pulse < 110 bpm

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4
Q

Severe Asthma attack criteria

A

PEFR 33 - 50% best or predicted
Can’t complete sentences
RR > 25/min
Pulse > 110 bpm

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5
Q

Life- threatening asthma attack criteria

A

PEFR < 33% best or predicted
Oxygen sats < 92%
‘Normal’ pC02 (4.6-6.0 kPa)
Silent chest, cyanosis or feeble respiratory effort
Bradycardia, dysrhythmia or hypotension
Exhaustion, confusion or coma

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6
Q

What is the criteria for high risk pneumothorax?

A
  • bilateral pneumothorax
  • hemodynamically unstable (tension)
  • severe hypoxia
  • haemothorax
  • > = 50 yo and smoker
  • underlying lung disease
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7
Q

What two things do you need to assess when a patient presents with pneumothroax?

A
  • symptomatic or not
  • high risk or not
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8
Q

What is conservative management of pneumothorax?

A

primary - outpatient follow up every 2-3 days
secondary - monitor inpatient

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9
Q

What are the paraneoplastic features of small cell lung cancer?

A

SIADH
Ectopic Cushing syndrome
Lambert- eaton syndrome

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10
Q

What is lambert eaton syndrome?

A

antibodies against the calcium channels in the presynaptic membrane

causes less acetylcholine

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11
Q

How does Lambert - Eaton syndrome present?

A

weakness that getters better with movement

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12
Q

What are the paraneoplastic features of squamous cell lung cancer?

A

PTHrP ( hypercalcaemia)
Clubbing
ectopic TSH
Hypertrophic pulmonary osteoarthropathy

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13
Q

What are the paraneoplastic features of adenocarcinoma?

A

gynaecomastia
Hypertrophic pulmonary osteoarthropathy

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14
Q

Causes of upper zone lung fibrosis

A

Coal workers pneumoconiosis
Hypersensitive pneumonitis
Ank spond
Radiation
TB
Silicosis/ sarcoidosis

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15
Q

Causes of lower zone lung fibrosis

A

Idiopathic
Connective tissue disorders
drugs
asbestosis

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16
Q

Whats the investigation of choice for a PE + renal impairment?

A

V/Q scan as the contrast on CTPA is nephrotoxic

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17
Q

What is first line treatment for Allergic bronchopulmonary aspergillosis in CF?

A

oral glucocorticosteroids

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18
Q

What is second line treatment for Allergic bronchopulmonary aspergillosis in CF?

A

itraconazole

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19
Q

What are the clinical features of Allergic Bronchopulmonary aspergillosis?

A

Bronchoconstriction
bronchiectasis

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20
Q

What are the investigations for Allergic Bronchopulmonary Aspergillosis?

A

eosinophilia
flitting CXR changes
positive radioallergosorbent (RAST) test to Aspergillus
positive IgG precipitins (not as positive as in aspergilloma)
raised IgE

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21
Q

What type of bacteria causes cavitating lesions in the upper zones?

A

Klebsiella
mainlys in diabetics and alcoholics

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22
Q

What is the gram staining of klebsiella?

A

gram negative rod

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23
Q

What does the sputum classically look like with a klebsiella infection?

A

red current jelly

24
Q

What is first line in management of COPD?

A

SABA or SAMA

need to determine if patient has asthmatic features because if they do then can prescribe steroids

25
What criteria suggest a COPD patient has a cross over with asthma?
- previous history of asthma or atopy - high eosinophil count - variation in FEV1 over time - diurnal variation in peak flow
26
What is normal FEV1/FVC?
70-80%
27
What does Total gas transfer (TLCO) measure?
measures gas transfer from alveoli into lungs (essentially looking at how much oxygen enters RBC)
28
What causes raised TLCO?
asthma pulmonary haemorrhage (e.g. granulomatosis with polyangiitis, Goodpasture's) left-to-right cardiac shunts polycythaemia hyperkinetic states male gender, exercis
29
What causes lowered TLCO?
pulmonary fibrosis pneumonia pulmonary emboli pulmonary oedema emphysema anaemia low cardiac output
29
When do you place a chest tube in patients with effusion?
1) fluid is purulent 2) fluid is clear but pH<7.2
29
What is a contraindication for the use of Bupropion?
past medical history of Epilepsy reduces seizure threshold
29
Management of Acute COPD exaceration
- 5 day course of oral prednisolone if clinical signs of infection ( change in colour of sputum, etc) 1st line - amoxicillin or clarithromycin or doxcycline
30
Manifestations of sarcoidosis
uveitis hypercalcaemia erythema nodosum bilateral hilar lymphadenopathy lupus pernio dyspnoea cough malaise weight loss
31
What type of lung cancer is most associated with cavitating lesions?
squamous
32
What is another name for Kartagener's?
Primary ciliary dyskinesia
33
What are features of Kartageners?
sinusitis dextrocardia bronchiectasis subfertility
34
What does a lymphocyte pleural effusion mean?
chronic pleural process malignancy TB
35
What does a neutrophil pleural effusion mean?
acute
36
What is commonly the FEV1/FVC ratio in restrictive disease?
FEV1/FVC>0.7
37
What type of pH abnormality does opiate overdose cause?
Respiratory acidosis
38
What may be seen in a blood test for lung cancer?
Raised platelets
38
What does a Wells score of 4+ mean?
PE is likely
39
What is the management process if WELLS score is 4+?
- organise CTPA - if CTPA delayed, give a DOAC in interim (apixaban or rivaroxaban) - if CTPA negative, do US to check for DVT
40
What to do if WELLS score is <4?
- perform D-Dimer test - positive D-Dimer --> do CTPA - negative D-Dimer --> stop anticoagulation and consider other diagnosis
41
What can fast aspiration of pneumothorax cause?
re-expansion pulmonary oedema
42
What do you prescribe alongside isoniazid to prevent peripheral neuropathy?
Vitamin B6 Pyridoxine
43
What is a parapneumonic effusion?
effusion associated with pneumonia
44
What to do if D-Dimer is positive but US is negative in suspected DVT?
stop anticoagulation repeat scan 1 week later
45
What is diagnostic for mycoplasma?
mycoplasma serology
46
Complications of mycoplasma
erythema multiforme GBS HA cold pericarditis bullous meringitis
47
What pH range should NIV be considered in a COPD patient?
7.25-7.35
48
If patient is steroid responsive in COPD what do you add?
ICS + LABA
49
Management for CAP
Amoxicillin
50
What is used to treat legionella?
Mcarolides
51
What pneumonia is known to reactive herpes simplex virus?
strep pneumonia
52
What is the cause of rapid deterioration of a patient on NIV?
tension pneumothorax
53

Year 6 (19 decks)

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