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AMC Flashcards > Respiratory Medicine > Flashcards

Respiratory Medicine Flashcards

1
Q

Normal pH

A

7.35-7.45

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2
Q

Normal PaO2

A

75-100 mmHg

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3
Q

Normal PaCO2

A

35-45 mmHg

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4
Q

Normal HCO3

A

22-26 meq/L

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5
Q

Unprocessed raw cotton + bacterial endotoxin

A

Byssinosis
doesn’t cause COPD

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6
Q

FEV1/FVC ratio

A

0.75-0.85

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7
Q

List of restrictive diseases

A
  • pulmonary fibrosis
  • pneumothorax
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8
Q

List of obstructive diseases

A
  • asthma
  • COPD
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9
Q

FEV1/FVC ratio > 0.85

A

Restrictive airway disease

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10
Q

FEV1/FVC ratio < 0.75

A

Obstructive airway disease

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11
Q

Residual lung volume increased

A

obstructive disease

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12
Q

Residual lung volume decreased

A

restrictive disease

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13
Q

CURB-65 Score

A

– Confusion of new onset.
– Urea greater than 7 mmol/l.
– Respiratory rate of 30 breaths per minute or higher.
– Blood pressure less than 90 mmHg systolic or diastolic blood pressure 60 mmHg
or less.
– Age 65 or older

CURB-65 score equal or >3, an
inpatient treatment for community acquired pneumonia is necessary.

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14
Q

Difference between crackles associated with alveolar fluid vs interstitial lung disease

A

Egophony

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15
Q

(fever, malaise, cough + acute SOB + bilateral crackles + asymptomatic between exacerbations

A

hypersensitivity pneumonitis (alveolitis)

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16
Q

dyspnea + cough + fever + productive sputum +
occasionally pleuritic chest pain

A

pneumonia

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17
Q

Treatment for community acquired pneumonia

A

IV benzyl penicillin and azithromycin

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18
Q

periodontal disease + cough + foul-smelling sputum + immobilised (hiatal, post-op)

A

Aspiration pneumonia

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19
Q

Aspiration pneumonia pathogen

A

oral streptococci

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20
Q

Aspiration pneumonia treatment

A

1st line: ampicillin-sulbactam (1.5 to 3 g IV ampicillin-sulbactam (1.5 to 3 g IV every 6 hours)

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21
Q

abdominal / trans-thoracic procedure post-op + cough and fever + within 48 hours

A

Postoperative atelectasis

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22
Q

Postoperative atelectasis management

A
  1. Removal of impacted secretions by coughing, managed by physiotherapists, and involves active chest percussion and breathing exercises.
    2, oxygen supplementation
  2. Passive postural drainage.
  3. bronchoscopy if px still hypoxic
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23
Q

cough + mucopurulent sputum lasting for months to years + finger clubbing

A

bronchiectasis

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24
Q

Bronchiectasis investigation of choice

A

High-res CT

25
Q

Bronchiectasis treatment

A

IV ticarcillin-clavulanate

26
Q

latent tuberculosis (LTB) treatment

A

Isoniazid (5mg/kg up to a maximum 300mg daily) for 9 months

27
Q

middle/older age + high grade fever + dry cough + severe headache + diarrhoea/vomiting/confusion + hyponatremia + deranged liver function tests

A

Legionnaires disease

28
Q

recurrent asthma exacerbations + patchy opacities + central bronchiectasis + eosinophilia+ elevated immunoglobulin E

A

allergic bronchopulmonary aspergillosis

29
Q

clubbing of nails can be found in

A

– Cystic fibrosis.
– Interstitial pulmonary fibrosis.
– Lung cancer
– Interstitial lung disease

30
Q

IV drug abuse + dyspnoea + bilateral pleuritic chest pain + multiple partners sex hx + hypoxemic

A

Pneumocystis jiroveci pneumonia

31
Q

smoker + pulmonary nodule + hypercalcemia (increased thirst, abdominal pain, constipation, and polyuria)

A

squamous cell carcinoma

32
Q

pigmentation of skin + lung mass + hypokalaemia + hirsutism

A

Small cell lung carcinoma
-Ectopic production of adrenal corticotropin (ACTH)

33
Q

X-ray pleural thickening + significant weight loss + plural effusion

A

mesothlioma

34
Q

Small cell lung carcinoma complication

A

Ectopic production of ACTH can lead to Cushing’s syndrome
- hypokalaemia

35
Q

Small cell lung carcinoma treatment

A

chemotherapy and radiation

36
Q

cough + weight loss + lung nodule in X-ray

A

adenocarcinoma

37
Q

adenocarcinoma investigation

A

FNAC gold standard

38
Q

superior vena cava syndrome investigation

A

chest CT angiogram

39
Q

Most common causes pulmonary hypertension and cor-pulmonale

A

Chronic obstructive pulmonary disease Emphysema

40
Q

Types of asthma

A

mild:
moderate:
severe:

41
Q

Asthma causes

A

emotional changes
gord
allergies
pregnancy
occupational hazards
dust mites

42
Q

Exercised induced asthma management

A

Cromolyn

43
Q

physical symptoms that are not indicated in assessing severe asthma

A
  • wheezing
  • respiratory rate
44
Q

4 hallmark indicators of severe asthma

A

altered mental state +effort on breathing + struggling to talk + <94% oxygen saturation

45
Q

role of oral steroids in asthma

A

can only be used in exacerbation, not for long term
prolonged use of oral steroids (prednisolone):
- Cushing syndrome,
- osteoporosis,
- immunosuppression

46
Q

Asthma dx

A

triad: dyspnoea + wheeze + cough
fev1/fevc ratio < 75
PEF: improvement in fev1 more > 12% after medication (salbutamol)
- prolonged expiration
- resonant
- expiratory wheeze
respiratory acidosis

47
Q

best bed-side measure to assess the severity of asthma

A

Use of accessory muscles upon inspiration

48
Q

pleural fluid analysis

A
  • pH always below 7.30
  • Pleural/serum protein ratio greater than 0.5
  • Pleural/Serum lactic dehydrogenase ratio of greater than 0.6
  • Glucose concentration (30-50 mg/dL)
  • Bloody pleural fluid is strongly suggestive of malignancy
49
Q

High altitude pulmonary oedema caese

A

Hypoxic pulmonary vasoconstriction

50
Q

family hx of emphysema/liver disease + + weight loss, + jaundice + dyspnoea

A

Alpha-1 antitrypsin (AAT) deficiency

51
Q

idiopathic pulmonary fibrosis (IPF) treatment

A

Antifibrotic therapy

52
Q

black + 20-30 years + erythema nodosum + arthritis + hilar lymphadenopathy

A

Sarcoidosis Lofgren syndrome

53
Q

black + 20-30 years + fever + parotid gland enlargement + uveitis + facial palsy

A

Sarcoidosis

54
Q

pneumothorax in the absence of trauma and no history of lung disease

A

Primary spontaneous pneumothorax (PSP)

55
Q

Pneumothorax as well as other lung disease

A

Secondary spontaneous pneumothorax (SSP)

56
Q

Pneumothorax management

A

PSP < 15%: observation
PSP > 15%: needle aspiration
SSP: mechanical ventilation (can’t put needle into an already damaged lung)
Symptomatic SSP: Catheter drainage/water sealed thorcostomy

57
Q

Most common finding in plural effusion

A

Dyspnoea

58
Q

Most effective preventative therapy for asthma

A

ICS
- fluticasone
- beclomethasone
- budesonide
Montelukast if ICS contraindicated

NOTE: Montelukast is associated with nightmares in children

59
Q

when to add preventer

A

using preventer if they use salbutamol more than 3x week

AMC Flashcards (39 decks)

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