Respiratory medicine Flashcards
Typical clinical presentation: community acquired pneumonia
20-50y M presents with 3 days high fever, dyspnoea, pleuritic chest pain and rusty sputum
Typical clinical presentation: hospital acquired pneumonia
Elderly immunocompromised pt in hospital
Typical clinical presentation: atypical pneumonia
Child/young adult presents with 1-3 slow onset of headache, malaise and fever with severe dry cough and wheeze, minimal clinical signs (i.e. no consolidation)
Pathogenesis of Bronchiolitis obliterans organising pneumonia
reactive pneumonia – to irritants. Type II cell hyperplasia (surfactant-producing) –> fill airspaces.
Three pathological consequences of aspiration pneumonia
lower lobe involvement, inflammation, and abscess formation
Three pathological consequences of lipoid pneumonia including pathogenesis in this
airway obstruction –> atelectasis and necrosis, with fat deposits
Differential diagnoses for hoarseness including two most common
Most common = use of inhaled steroids due to asthma
Most common = laryngitis
Vocal cord tumour
Bronchial carcinoma –> recurrent laryngeal nerve palsy
Hypothyroidism/goitre
TCP for interstitial pulmonary fibrosis, include relevant examination finding on lungs
50yo man (M>F, above 50) presents with dry cough, weight loss, fatigue. On examination he has an elevated JVP + dry FINE inspiratory crackles over bases - like “velcro”
Most common genetic abnormality in smoker lung cancer? what is the term for this?
3p deletion in bronchial epithelium of smokers –> dysplasia
This mutation = field cancerisation - concept of laying the “fertile soil” for other mutations to develop and produce cancer, when one continues to smoke
Carcinogens in smoke and their role
Benzo-pyrene = initiator
Phenyl derivates = promoter
Polonium = radioactive substance
Most common mutation in non-smoker lung cancer?
EGFR
What are the three neuroendocrine lung tumours?
Carcinoid
Small cell lung cancer
Large cell NE cancer
