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Respiratory SBAs Flashcards

1
Q

what is a normal FEV1:FVC ratio

A

80%

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2
Q

what does a reduced and increased FEV1:FVC ratio indicate

A

reduced - obstructive

increased - restrictive

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3
Q

is fibrosis a obstructive or restrictive defect

A

restrictive

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4
Q

def of chronic bronchitis

A

productive cough for >3 months a year for at least 2 consecutive years

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5
Q

haemophilus influenzae + streptococcus pneumoniae are responsible for what types of pneumonia

A

community acquired pneumoniae

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6
Q

staphylococcus aureus + pseudomonas are responsible for what types of pneumoniae

A

hospital acquired pneumonia

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7
Q

what is an atypical CAP

A

legionella pneumophilia

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8
Q

what is the def of T1RF

A

PO2 <8kPa (hypoxia) with normal or low PCO2

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9
Q

what is the cause of T1RF

A

ventilation/perfusion mismatch

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10
Q

what are common causes of ventilation/perfusion mismatch

A

pneumonia
pulmonary oedema
PE
asthma

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11
Q

what is the def of T2RF

A

PO2 <8kPa (hypoxia) and PCO2 >6.5kPa (hypercapnia)

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12
Q

what are the causes of T2RF

A 
1 pulmonary disease
-pneumonia
-COPD
-asthma
2 reduced respiratory drive
-sedative drugs
3 neuromuscular disease
-myasthenia gravis
-guillain barre syndrome
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13
Q

what are features of pleural effusion

A

reduced air entry
dullness to percussion (‘stony dullness’)
reduced chest expansion

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14
Q

def of transudate

A

extravascular fluid with low protein content

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15
Q

def of exudate

A

extravascular fluid with high protein content

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16
Q

aetiology of transudate

A

increased hydrostatic pressure (this pushes fluid out of the circulatory system)
decreased oncotic pressure (exerted by proteins, notably albumin, which pulls fluid into the circulatory system, therefore reduced fluid drawn into the circulatory system)

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17
Q

what are the common causes of transudate

A 
1 increased hydrostatic pressure
-HF
-restrictive pericarditis
2 decreased oncotic pressure (hypoproteinaemia)
-cirrhosis
-nephrotic syndrome
-malasbsorption
3 hypothyroidism
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18
Q

aetiology of exudate

A

increased capillary permeability secondary to inflammation

any fluid which filters from the circulatory system into areas of inflammation

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19
Q

what does a clear and cloudy pleural aspirate commonly indicate

A

clear - transudate (low protein)

cloudy - exudate (high protein)

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20
Q

what are the common causes of exudate

A 
1 infection
-pneumonia
-TB
2 inflammation
-pulmonary infarction
3 malignancy
-bronchogenic carcinoma
-mesothelioma
21
Q

what is commonly seen on an ECG with PE

A

sinus tachycardia

22
Q

what is occasionally seen on an ECG with PE

A

RAD
RBBB
new onset AF

23
Q

what is rarely seen on an ECG with PE

A

S1Q3T3

deep s waves in lead 1
pathological Q waves in lead 3
inverted t waves in lead 3

24
Q

a 46y/o female has been diagnosed with bronchiectasis. which of the following is not a cause of bronchiectasis

kartageners syndrome
CF
pneumonia
LVF
bronchogenic carcinoma
25
respiratory causes of clubbing
``` bronchogenic carcinoma empyema mesothelioma CF lung abscess fibrosing alveolitis bronchiectasis ```
26
is clubbing found in COPD
no
27
what can lung cancers be divided into
non-small cell carcinomas | small cell carcinomas
28
what can non-small cell carcinomas be divided into
squamous cell carcinoma adenocarcinoma large cell carcinoma carcinoid tumour
29
what is the most common form of lung cancer is someone who has never smoked
adenocarcinomas
30
what is cor pulmonale
RHF caused by chronic pulmonary HTN
31
what are the causes of cor pulmonale
``` 1 lung disease -asthma -COPD -bronchiectasis -pulmonary fibrosis -lung resection 2 peripheral vascular disease -primary pulmonary HTN -PE -sickle cell disease 3 thoracic cage abnormalities -kyphosis -scoliosis 4 neuromuscular disease -myasthenia gravis ```
32
what is a common cause of bilateral reticulo-nodular shadowing on CXR
pulmonary fibrosis | starts at bases and moves superiorly
33
why does the volume of the peripheral pulse fall as a patient inspires in an exacerbation of asthma
as the patient inspires, air flow compromise (due to narrowing of airways in asthma exacerbations) causes an increase in negative intrathoracic pressure the increased negative thoracic pressure causes pulmonary vasculature dilatation decreased LA filling occurs as the pooling of blood in the lungs causes reduced venous return to LA
34
what is a transudate
protein <30g/l
35
what is a exudate
protein >30g/l
36
what criteria is used to differentiate between exudate and transudate pleural effusion
lights criteria
37
what are the lights criteria
defined as exudate if one of the following is present 1 effusion protein/serum protein ratio >0.5 2 effusion LDH/serum LDH <0.6 3 effusion LDH greater than 2/3s of the upper limit of normal serum LDH
38
what is a positive NaCl sweat test and what does it indicate
>60mmol/l | CF
39
what chronic pneumonia is associated with CF
pseudomonas aeruginosa
40
what are drug causes of pulmonary fibrosis
amiodarone | methotrexate
41
features of legionella pneumophilia
colonise water tanks + AC units history includes initial nonspecific flu-like symptoms followed by dry cough + SOB deranged LFTs hyponatraemia
42
what are the medication for aspergillosis infection
antifungal | amphotericin B
43
what is secreted from small cell carcinomas
ADH ACTH cause high urine osmolality and high urine Na conc hyponatraemia
44
what does salbutamol do to potassium levels
reduces potassium levels
45
what is the medical management for TB
4 months of isoniazid, rifampicin, ethambutol, pyrazinamide | followed by 2 months of isoniazid + rifimapicin
46
what is a risk with isoniazid
hepatotoxic which can derange LFTs | depletion of Vit B6 can cause peripheral neuropathy
47
what are criteria for ARDS
``` if ALL four are present 1 acute onset 2 bilateral infiltation on CXR 3 pulmonary capillary wedge pressure <19 or lack of CCF 4 refractory hypoxaemia PaO2:FiO2 >200 ```
48
what is PaO2:FiO2
ratio of arterial oxygen partial pressure to fractional inspired oxygen

Respiratory (18 decks)

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