Respiratory passmedicine Flashcards

1
Q

Hemithorax whiteout with trachea pulled towards? (3)

A

Pneumonectomy
Lung collapse
Pulmonary hypoplasia

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2
Q

Hemithorax whiteout with trachea central? (2)

A

Consolidation

Mesothelioma

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3
Q

Trachea pushed away from whiteout? (3)

A

Pleural effusion
Diaphragmatic hernia
Large mass in thorax

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4
Q

DDx of cavitating lung lesion on CXR? (5)

A
Abscess
Squamous cell lung cancer
Tuberculosis
Wegener's granulomatosis
Pulmonary embolism
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5
Q

Lung diseases associated with asbestos exposure? (5)

A
Pleural plaques
Diffuse thickening of the pleura
Asbestosis (fibrosis)
Mesothelioma
Lung cancer
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6
Q

What is the most dangerous form of asbestos?

A

Crocidolite

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7
Q

Rheumatoid complications in the lung? (5)

A
Pulmonary fibrosis
Pleural effusion
MTX pneumonitis
Infection 2ndry to immunosuppression
Pleurisy
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8
Q

Multisystem granulomatous disorder which often presents with dyspneoa and dry cough?

A

Sarcoidosis

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9
Q

Symptoms of sarcoidosis (6)

A
Weight loss
Malaise
Dry cough
Dypsnoea
Erythema nodosum
Polyuria
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10
Q

Why does polyuria occur in sarcoidosis?

A

Active sarcoid –> hypercalcaemia –> polyuria

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11
Q

CXR in sarcoid?

A

Bilateral hilar lymphadenopathy

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12
Q

Progressive dypsnoea, dry cough, digital clubbing and fine end-inspiratory crackles?

A

Idiopathic pulmonary fibrosis

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13
Q

Pulmonary function tests in idiopathic pulmonary fibrosis indicate what kind of defect?

A

Restrictive pattern

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14
Q

Diagnostic investigation in suspected idiopathic pulmonary fibrosis?

A

High resolution CT scanning of the thorax

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15
Q

CT thorax findings in idiopathic pulmonary fibrosis?

A

Changes starting in lung periphery; range from “ground-glass opacification” to fibrotic “honeycomb” pattern

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16
Q

The term used to describe the process of adaptation and failure of the right heart as a result of long disease?

A

Cor pulmonale

17
Q

How do diseases such as COPD and idiopathic pulmonary fibrosis lead to right ventricular failure?

A

Chronic hypoxia –> widespread arteriolar constriction –> pulmonary hypertension –> right heart hypertrophy –> failure

18
Q

Autosomal recessive ciliary dyskinesia associated with abnormal mucus clearance and recurrent respiratory infections, and male infertility

A

Kartagener syndrome

19
Q

Radiological feature of Kartagener syndrome?

A

Dextrocardia

20
Q

Methotrexate pulmonary toxicity is related to…

A

Frequency of administration

21
Q

Full blood count clue to MTX pulmonary toxicity?

A

Eosinophilia

22
Q

How is MTX pulmonary toxicity treated?

A

Steroids

23
Q

Causes/types of extrinsic allergic alveolitis?

A

Pigeon-fancier’s lung
Farmers lung (micropolyspora faeni)
Malt worker’s lung
Sugar worker’s lung

24
Q

Investigations in extrinsic allergic alveolitis?

A

Blood- neutrophilia, high ESR and CRP
Positive serum precipitins
Chronic- restrictive spirometry, reduced transfer factor

25
Q

How does TLCO increase in pulmonary haemorrhage?

A

Increased binding of CO to haemoglobin within the alveoli

26
Q

Management of extrinsic allergic alveolitis? (Acute/chronic)`

A

Acute- steroids, oxygen

Chronic- avoid/minimise exposure, sometimes long term steroids

27
Q

Which serum enzyme is often raised in sarcoidosis?

A

ACE

28
Q

Causes of bilateral hilar lymphadenopathy? (6)

A
Sarcoidosis
Infection e.g. TB, mycoplasma
Malignancy e.g. lymphoma, bronchial
Organic dust disease
Extrinsic allergic alveolitis
Histocytosis
29
Q

In idiopathic pulmonary fibrosis, what does ground-glass appearance indicate?

A

Better prognosis- often regresses on treatment

30
Q

The characteristic pathological feature in extrinsic allergic alveolitis?

A

Non-caseating granuloma

31
Q

Causes of erythema nodosum? (5)

A
Sarcoidosis
Tuberculosis
Inflammatory bowel disease
Streptococcal infections
Drugs (oral contraceptives, sulfonamides)
32
Q

ANCA-associated small-medium vessel vasculitis associated with asthma, eosinophilia and sinusitis?

A

Churg-Strauss syndrome