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Phase 2a Yellow Conditions > Respiratory COPY > Flashcards

Respiratory COPY Flashcards

1
Q

What is bronchiectasis

A

permanent dilation of airways

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2
Q

Causes of bronchiectasis

A
  • post-infection
  • CF
  • lung cancer
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3
Q

Signs and symptoms of bronchiectasis

A
  • dyspnoea
  • cough
  • haemoptysis
  • recurrent chest infections
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4
Q

Investigations for bronchiectasis

A
  • chest xray → kerly B lines
  • sputum → H.influenzae most common
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5
Q

Management of bronchiectasis

A
  • physical training
  • postural drainage
  • prophylactic Abs
  • surgery if disease localised
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6
Q

What is pleural effusion?

A

collection of fluid in the pleural cavity → space between parietal ad visceral pleura

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7
Q

Types of pleural effusion

A

exudative → high protein count
- transudative → lower protein count

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8
Q

Causes of exudative pleural effusion

A

related to inflammation
- proteins leak out of tissue into pleural space

  • lung cancer
  • pneumonia
  • RA
  • TB
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9
Q

Causes of transudative pleural effusion

A

related to fluid moving across pleural space

  • congestive cardiac failure
  • hypoalbuminaemia
  • hypothyroidism
  • Meig’s syndrome
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10
Q

What is Meig’s syndrome?

A

right sided pleural effusion with ovarian malignancy

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11
Q

Presentation of pleural effusion

A
  • SOB
  • cough
  • stony dull percussion over effusion
  • reduced breath sounds
  • tracheal deviation away from effusion if large
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12
Q

Investigations for pleural effusion

A
  1. chest xray
    - pleural US
    - thoracocentesis → diagnoses underlying cause
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13
Q

What would you seen on a chest xray with pleural effusion

A
  • blunting of costophrenic angle
  • fluid in lung fissures
  • meniscus
  • tracheal and medial deviation
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14
Q

Treatment of pleural effusion

A

dependent on cause

  • congestive HF → loop diuretics
  • infective → Abs
  • malignant → therapeutic thoracocentesis
  • large effusions often need aspiration or drainage
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15
Q

What is interstitial lung disease?

A
  • umbrella term for conditions that affect lung parenchyma
  • cause inflammation and fibrosis
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16
Q

Diagnosis of interstitial lung disease

A
  • clinical features
  • high resolution CT thorax → ground glass appearance
  • lung biopsy if unsure
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17
Q

Treatment of interstitial lung disease

A

supportive, prevent progression

  • remove/treat underlying cause
  • home O2 if hypoxic at rest
  • stop smoking
  • physiotherapy
  • pneumococcal/flu vaccine
  • lung transplant
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18
Q

What are the three types of interstitial lung disease?

A
  • idiopathic pulmonary fibrosis
  • occupational lung disorders
  • systemic disease → Wegner’s, Goodpasture’s
19
Q

What is idiopathic pulmonary fibrosis?

A

formation of scar tissue in lungs with no known cause

20
Q

Presentation of IPF

A
  • dyspnoea
  • dry cough
  • bibasal crackles
21
Q

Treatment of IPF

A
  • prifenidone
  • nintedanib
  • treatments for ILD
22
Q

What is sarcoidosis?

A
  • granulomatous inflammatory condition
  • varied severity
23
Q

Presentation of sarcoidosis

A

affects any organ in body

most common = lung

  • mediastinal lymphadenopathy
  • pulmonary fibrosis
  • pulmonary nodules
24
Q

Investigations for sarcoidosis

A

GOLD STANDARD = histology from biopsy
- non-caseating granulomas with epithelioid cells

25
Q

Treatment for sarcoidosis

A
  • if mild, resolves spontaneously
  1. oral steroids, bisphophonates
  2. methotrexate/azathrioprine
  • lung transplant if severe
26
Q

What is pulmonary HTN?

A
  • disease of small pulmonary arteries
  • vascular proliferation and remodelling
  • progressive increased in PVR
27
Q

What are the main vascular changes in pulmonary HTN?

A
  • vasoconstriction
  • smooth muscle cell and endothelial cell proliferation
  • thrombosis
28
Q

Symptoms of pulmonary HTN

A
  • exertional dyspnoea
  • lethargy, fatigue
  • ankle swelling
29
Q

Signs of pulmonary HTN

A
  • accentuated component to 2nd heart sound
  • tricsupid regurgitation murmur
  • fatigue, peripheral oedema, cyanosis
30
Q

Diagnosis of pulmonary HTN

A

initial tests

  • chest xray → enlarged main pulmonary artery/hilar vessels
  • ECG
  • trans-thoracic echo

GOLD STANDARD = right heart catheterisation

31
Q

Treatment of pulmonary HTN

A

supportive

  • treat underlying cause
  • oral anticoagulants
  • if fluid retention, diuretics
  • supplemental O2
  • supervised exercise training
  • avoid pregnancy

treatment-resistant patients

  • balloon atrial septostomy
  • lung transplantation
32
Q

What are the two types of bronchial carcinoma?

A
  • small cell lung carcinoma → worse prognosis
  • non-small cell carcinoma → more common
33
Q

Why is it useful to identify different types of lung cancer?

A
  • different types differ in histology and behaviour
  • helpful for providing prognosis and determining treatment
  • presentations are similar
34
Q

Risk factors of lung cancer

A
  • smoking
  • asbestos
  • coal and products of coal combustion
  • radon exposure
  • pulmonary fibrosis
  • HIV
  • genetic factors
35
Q

Symptoms of local disease in lung cancer

A
  • persistent cough
  • SOB
  • haemoptysis
  • weight loss
  • chest pain
  • wheeze
  • infections
36
Q

Symptoms of metastatic disease in lung cancer

A
  • bone pain
  • headache
  • seizures
  • neurological deficit
37
Q

Paraneoplastic changes in lung cancer

A

increased

  • PTH → hyperparathyroidism
  • ADH → SIADH
  • ACTH → Cushings

finger clubbing

38
Q

Investigations for lung cancer

A
  1. chest xray → central mass, hilar lymphadenopathy, pleural effusion
  • CT chest/liver/adrenal glands → staging
  • sputum cytology → malignant cells in sputum

GOLD STANDARD = percutaneous/bronchoscopic biopsy and histology

39
Q

Treatment of lung cancer

A
  • depends on cell type
  • surgery → lobectony, segmentectomy, wedge resection
  • radiotherapy
  • chemo
  • palliative care
40
Q

Small cell lung cancer

A
  • strong association with smoking
  • arises from endocrine cells in central bronchus
  • secretes polypeptide hormones
  • treatment = chemo
41
Q

Squamous cell carcinoma

A
  • most strongly associated with smoking
  • arises from epithelial cell in central bronchus
  • associated with production of keratin
42
Q

Adeoncarcinoma

A
  • most common primary lung cancer
  • most common type in non-smokers
  • originate from mucus-secreting glandular cells
  • metastasises to pleura, lymph nodes, brain, bone, adrenals
43
Q

Secondary lung cancer

A
  • more common than primary

can spread from

  • breast
  • bowel
  • bladder
  • prostate
  • kidney
44
Q

Common sites of metastasis of lung cancer

A
  • liver
  • bone
  • adrenal glands
  • brain

Phase 2a Yellow Conditions (12 decks)

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