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Respiratory system Flashcards

1
Q

MC symptom in respiratory diseases?

A

Cough (unspecific)

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2
Q

Dreaded symptom in respiratory diseases?

A

Breathlessness

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3
Q

MC source of Hemoptysis?

A

Bronchial artery
Screening - radiology
or CT scan

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4
Q

All patients coming to respiratory OPD must undergo?

A

Pulmonary function test

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5
Q

Two parts of PFT?

A

Spirometry and diffusion capacity

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6
Q

What is Tiffany-Pinelli Index?

A

Most accurate parameter of the spirometry
Its is ratio of FEV1/FVC
(forced expiratory volume in the first one to forced vital capacity)

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7
Q

Tiffany-Pinelli Index range?

A

0.75-85

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8
Q

Low Tiffany-Pinelli Index?

A

Less than 0.70 = specific for obstructive airway disorder

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9
Q

Obstructive airway disorder next step after Tiffany-Pinelli Index?

A

Check for Broncho reversibility.
Give Salbutamol
If 12% or more improvement in FEV1 = Excellent reversibility
If 11% or less improvement in FEV1 = Partial reversibility

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10
Q

Excellent reversibility is gold standard for?

A

Bronchial asthma

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11
Q

Partial reversibility is gold standard for?

A

COPD

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12
Q

Normal Tiffany-Pinelli Index?

A

0.70-0.80

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13
Q

Reduction in FVC is earliest finding in?

A

Restrictive disorders

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14
Q

Restrictive disorders (FVC low) + DLCO normal indicates?

A

Extra-parenchymal disorders
Eg Kyphoscoliosis

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15
Q

Restrictive disorders (FVC low) + DLCO reduced indicates?

A

Parenchymal cause/Interstitial lung disease

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16
Q

FVC normal + DLCO low indicates?

A

Pulm. HTN

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17
Q

FVC normal + DLCO normal

A

Normal Pulmo functiom

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18
Q

What is more sensitive than chest x-ray in Pulmonology?

A

HRCT

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19
Q

Homogenous opacity in chest x-ray means?

A

Pneumonia
But can also be found in tumor/encysted plural effusion

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20
Q

Most specific finding of chest x-ray in Pneumonia?

A

Presence of air bronchogram

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21
Q

MC route of infection in Pneumonia?

A

Aspiration

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22
Q

MC cause of infection in Pneumonia?

A

Strap-pneumoniae

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23
Q

Circumscribed lesion on CXR DD?

A

Air-fluid level - Lung abscess

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24
Q

DOC Aspergillus

A

Voriconazole

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25
DOC Lung abscess
Clindamycin
26
what is CURB 65 scored used for?
Management of Pneumonia
27
Max score in CURB-65?
5 Points
28
Most important prognostic factor in CURB-65?
Respiratory rate
29
CURB-65 Score indicates what mortality?
10-15%
30
In Community acquired pneumonia 1st line DOC?
Beta-lactum
31
What is seen in COAD?
Chronic bronchitis Damage to ciliated columnar epithelium
32
Follicular bronchitis is due to?
Hyperplasia of bronchial associated lymphoid tissue (BALT)
33
Desquamative pneumonitis is interstitial lung disease in?
Smokers
34
Chemical pneumonitis is seen after?
Aspiration of stomach acid - Mendelson syndrome
35
Pneumatocele is caused by?
Staph aureus
36
Biot breathing in?
Lesion in brain
37
Cheyne stock breathing in?
Neurological disorder
38
Kussmaul's breathing in?
Diabetic ketoacidosis
39
Popcorn calcification is seen in?
Pulmonary hamartoma
40
TOC COPD?
low flow oxygen
41
Hyperventilation leads to COW washout which is a feature of?
Type 1 respiratory failure
42
Partial pressure of oxygen in alveoli?
103 mm hg
43
Most common type of emphysema?
Centriacinar emphysema
44
Finger in glove is seen in?
Bronchocele
45
Features of Emphysema
Barrell chest Type 1 respiratory failure Associated with smoking Most reliable radiography sign: flattening of diaphragm NO CYANOSIS
46
IgE ab agent used in Refractory asthma?
Omalizumab
47
IL-5 inhibitor used in Refractory asthma?
Mepolizumab/Reslizumab
48
IL-4 inhibitor used in Refractory asthma?
Dupliumab
49
TSLP inhibitor used in Refractory asthma?
Tezepelumab
50
What is the indication of steroids in COPD?
Repeated exacerbation >2/year + has peripheral eosinophilia >300
51
MC Dreaded complication of COPD
Cor pulmonale leading to heart failure
52
Common clinical features of Interstitial lung diseases? (and COPD)
Chronic cough with exacerbation
53
Spirometry finding in ILD?
Restrictive pattern : earliest finding is reduction in FVC
54
Gold std test ILD?
Ground glass test opacity on HRCT
55
Worst radiological finding in ILD?
Honeycombing (fibrosis, irreversible damage)
56
If CD4:CD8 ratio is less than 1 after Broncho-alveolar lavage?
Hypersensitivity pneumonitis syndrome (HP syndrome)
57
Most common HP syndrome in world?
Farmer's lung - Thermophilic actinomyces MC antigen
58
MC HP syndrome presentation?
Monday morning chest tightness
59
If silica-laden macrophages in BRL in indicates?
Silicosis- stone quarry/miner/construction worker Can mimic TB
60
MC x-ray finding in Silicosis?
Apical fibrosis (can look like TB) or snowstorm appearance due to progressing massive fibrosis
61
If CD4:CD8 ratio is more than 3.5 after Broncho-alveolar lavage?
Sarcoidosis - MC auto-immune cause Also mimics TB
62
Lung biopsy finding in Sarcoidosis?
Non-caseating granulomas
63
Presence of PAS positive acellular/proteinaceous material on BRL indicates?
PAP (Pul-Alveolar proteinosis) Surfactant accumulation due to defective macrophage clearance
64
PAP (Pul-Alveolar proteinosis) antigen?
Anti-GM CSF positive
65
PAP (Pul-Alveolar proteinosis) HRCT finding?
Crazy pavement appearence
66
MC type of ILD associated with auto-immune disease?
NSIP
67
Only ILD seen in smokers?
DIP (desquamative)
68
MC source of Pul embolism?
Deep veins of leg
69
MC symptom of Pul embolism?
Breathlessness
70
MC sign of Pul embolism?
Tachypnea
71
Screening test for Pul embolism?
d-DIMER essay (if negative means no embolism)
72
Confirmatory test for Pul embolism?
CT Pulmonary Angiography
73
Risk factors of Pul embolism?
Immobilization-fracture/Malignancy
74
CT Pulmonary Angiography contraindicated in?
Pregnancy & contrast allergy Alternation test: Ventilation perfusion scan (VQ scan)
75
Most important prognostic factor after treatment of Pul embolism?
RV function on ECG - If normal RV function means mild case of Pul embolism (normal BP) - If RV dysfunction/hypotension, Tx Thrombolysis = Alteplase
76
Anticoagulant DOC in Pul embolism?
Fondaparinux (Xs inhibitor)
77
Dreaded complication of Thrombolysis in Pul embolism?
Brain bleed (ICH)
78
Alteplase max dose in Pul embolism?
90 mg (0.90 mg/kg)
79
Window period of Thrombolysis in Pul embolism?
14 days = good prognosis
80
_______________ in indicated in all Pleural effusion cases.
Diagnostic tapping
81
Diagnostic tapping criteria?
Light's criteria - transudative or exudative pleural effusion
82
Exudative Pleural effusion requirements?
PF protein:serum >0.5 PF LDH/serum >0.6 PF LDH >2/3rd of upper normal limit of serum LDH
83
MC cause of Transudative PE?
LVF Nephrotic Cirrhosis Myxedema
84
MC cause of Exudative PE?
TB = MC cancer neoplasm Drug CTDS - RA
85
Indication of chest tube in pneumonia?
Empyema = Pus in Pleural cavity Gross pus pH<7.2 Glucose <60 mg/dl Gram stain + Culture positive
86
Acid-base balance defect parameters?
pH = <7.40 Acid or >7.40 Alkalosis pCO3/PaCO2
87
pH, HCO3(<24) and PaCO2 (<40) all going down means?
Metabolic acidosis
88
pH down but HCO3(>24) and PaCO2 (>40) going up means?
Respiratory acidosis
89
Normal blood pH?
7.35-7.45 <7.35 = Uncompensated 7.35-7.39 = Partly compensated 7.40 = Fully compensated
90
MC ABB defect in pregnancy?
R. Alkalosis
91
MC ABB defect in Vomiting?
M. Alkalosis
92
MC ABB defect in Renal disorders?
M. Acidosis
93
Formula for calculating Plasma anion gap?
Na-(Cl + HOC3)
94
Plasma Ketones increase indicates?
HAGMA due to DKA or starvation
95
Plasma Urates increase indicates?
HAGMA Renal failure
96
Plasma Lactates increase indicates?
HAGMA Shock >> Biguanides
97
Plasma PO4 increase indicates?
HAGMA Rhabdomyolysis
98
Plasma SO4 increase indicates?
HAGMA Salicylate/Methanol/PEG toxicity
99
MC lung Ca in world?
Adenocarcinoma
100
MC lung Ca in Asbestosis?
Adenocarcinoma
101
Strongest association of which Ca is seen with Asbestosis?
Mesothelioma - Pleural cancer
102
Strongest association of which Ca is seen with Smoking?
Small cell lung Ca
103
Lung cancer that looks like TB?
Sq cell ca
104
Lung cancer that has highest risk of hypercalcemia and pancoast syndrome?
Sq cell ca PTHrP high C8-T1 horner's syndrome
105
SVC syndrome MC neuro-endocrine complication Most chemo-radio sensitive
Small cell ca Lambert-eaton/SIDAH>ectopic ACTH Worst prognosis
106

Medicine (6 decks)

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