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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
Q

DOC Lung abscess

A

Clindamycin

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26
Q

what is CURB 65 scored used for?

A

Management of Pneumonia

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27
Q

Max score in CURB-65?

A

5 Points

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28
Q

Most important prognostic factor in CURB-65?

A

Respiratory rate

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29
Q

CURB-65 Score indicates what mortality?

A

10-15%

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30
Q

In Community acquired pneumonia 1st line DOC?

A

Beta-lactum

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31
Q

What is seen in COAD?

A

Chronic bronchitis
Damage to ciliated columnar epithelium

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32
Q

Follicular bronchitis is due to?

A

Hyperplasia of bronchial associated lymphoid tissue (BALT)

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33
Q

Desquamative pneumonitis is interstitial lung disease in?

A

Smokers

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34
Q

Chemical pneumonitis is seen after?

A

Aspiration of stomach acid - Mendelson syndrome

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35
Q

Pneumatocele is caused by?

A

Staph aureus

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36
Q

Biot breathing in?

A

Lesion in brain

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37
Q

Cheyne stock breathing in?

A

Neurological disorder

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38
Q

Kussmaul’s breathing in?

A

Diabetic ketoacidosis

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39
Q

Popcorn calcification is seen in?

A

Pulmonary hamartoma

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40
Q

TOC COPD?

A

low flow oxygen

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41
Q

Hyperventilation leads to COW washout which is a feature of?

A

Type 1 respiratory failure

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42
Q

Partial pressure of oxygen in alveoli?

A

103 mm hg

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43
Q

Most common type of emphysema?

A

Centriacinar emphysema

44
Q

Finger in glove is seen in?

A

Bronchocele

45
Q

Features of Emphysema

A

Barrell chest
Type 1 respiratory failure
Associated with smoking
Most reliable radiography sign: flattening of diaphragm
NO CYANOSIS

46
Q

IgE ab agent used in Refractory asthma?

A

Omalizumab

47
Q

IL-5 inhibitor used in Refractory asthma?

A

Mepolizumab/Reslizumab

48
Q

IL-4 inhibitor used in Refractory asthma?

49
Q

TSLP inhibitor used in Refractory asthma?

A

Tezepelumab

50
Q

What is the indication of steroids in COPD?

A

Repeated exacerbation >2/year + has peripheral eosinophilia >300

51
Q

MC Dreaded complication of COPD

A

Cor pulmonale leading to heart failure

52
Q

Common clinical features of Interstitial lung diseases? (and COPD)

A

Chronic cough with exacerbation

53
Q

Spirometry finding in ILD?

A

Restrictive pattern : earliest finding is reduction in FVC

54
Q

Gold std test ILD?

A

Ground glass test opacity on HRCT

55
Q

Worst radiological finding in ILD?

A

Honeycombing (fibrosis, irreversible damage)

56
Q

If CD4:CD8 ratio is less than 1 after Broncho-alveolar lavage?

A

Hypersensitivity pneumonitis syndrome (HP syndrome)

57
Q

Most common HP syndrome in world?

A

Farmer’s lung - Thermophilic actinomyces MC antigen

58
Q

MC HP syndrome presentation?

A

Monday morning chest tightness

59
Q

If silica-laden macrophages in BRL in indicates?

A

Silicosis- stone quarry/miner/construction worker
Can mimic TB

60
Q

MC x-ray finding in Silicosis?

A

Apical fibrosis (can look like TB) or snowstorm appearance due to progressing massive fibrosis

61
Q

If CD4:CD8 ratio is more than 3.5 after Broncho-alveolar lavage?

A

Sarcoidosis - MC auto-immune cause
Also mimics TB

62
Q

Lung biopsy finding in Sarcoidosis?

A

Non-caseating granulomas

63
Q

Presence of PAS positive acellular/proteinaceous material on BRL indicates?

A

PAP (Pul-Alveolar proteinosis)
Surfactant accumulation due to defective macrophage clearance

64
Q

PAP (Pul-Alveolar proteinosis) antigen?

A

Anti-GM CSF positive

65
Q

PAP (Pul-Alveolar proteinosis) HRCT finding?

A

Crazy pavement appearence

66
Q

MC type of ILD associated with auto-immune disease?

67
Q

Only ILD seen in smokers?

A

DIP (desquamative)

68
Q

MC source of Pul embolism?

A

Deep veins of leg

69
Q

MC symptom of Pul embolism?

A

Breathlessness

70
Q

MC sign of Pul embolism?

71
Q

Screening test for Pul embolism?

A

d-DIMER essay (if negative means no embolism)

72
Q

Confirmatory test for Pul embolism?

A

CT Pulmonary Angiography

73
Q

Risk factors of Pul embolism?

A

Immobilization-fracture/Malignancy

74
Q

CT Pulmonary Angiography contraindicated in?

A

Pregnancy & contrast allergy
Alternation test: Ventilation perfusion scan (VQ scan)

75
Q

Most important prognostic factor after treatment of Pul embolism?

A

RV function on ECG
- If normal RV function means mild case of Pul embolism (normal BP)
- If RV dysfunction/hypotension, Tx Thrombolysis = Alteplase

76
Q

Anticoagulant DOC in Pul embolism?

A

Fondaparinux (Xs inhibitor)

77
Q

Dreaded complication of Thrombolysis in Pul embolism?

A

Brain bleed (ICH)

78
Q

Alteplase max dose in Pul embolism?

A

90 mg (0.90 mg/kg)

79
Q

Window period of Thrombolysis in Pul embolism?

A

14 days = good prognosis

80
Q

_______________ in indicated in all Pleural effusion cases.

A

Diagnostic tapping

81
Q

Diagnostic tapping criteria?

A

Light’s criteria - transudative or exudative pleural effusion

82
Q

Exudative Pleural effusion requirements?

A

PF protein:serum >0.5
PF LDH/serum >0.6
PF LDH >2/3rd of upper normal limit of serum LDH

83
Q

MC cause of Transudative PE?

A

LVF
Nephrotic
Cirrhosis
Myxedema

84
Q

MC cause of Exudative PE?

A

TB = MC
cancer neoplasm
Drug
CTDS - RA

85
Q

Indication of chest tube in pneumonia?

A

Empyema = Pus in Pleural cavity
Gross pus
pH<7.2
Glucose <60 mg/dl
Gram stain +
Culture positive

86
Q

Acid-base balance defect parameters?

A

pH = <7.40 Acid or >7.40 Alkalosis
pCO3/PaCO2

87
Q

pH, HCO3(<24) and PaCO2 (<40) all going down means?

A

Metabolic acidosis

88
Q

pH down but HCO3(>24) and PaCO2 (>40) going up means?

A

Respiratory acidosis

89
Q

Normal blood pH?

A

7.35-7.45
<7.35 = Uncompensated
7.35-7.39 = Partly compensated
7.40 = Fully compensated

90
Q

MC ABB defect in pregnancy?

A

R. Alkalosis

91
Q

MC ABB defect in Vomiting?

A

M. Alkalosis

92
Q

MC ABB defect in Renal disorders?

A

M. Acidosis

93
Q

Formula for calculating Plasma anion gap?

A

Na-(Cl + HOC3)

94
Q

Plasma Ketones increase indicates?

A

HAGMA due to DKA or starvation

95
Q

Plasma Urates increase indicates?

A

HAGMA Renal failure

96
Q

Plasma Lactates increase indicates?

A

HAGMA Shock&raquo_space; Biguanides

97
Q

Plasma PO4 increase indicates?

A

HAGMA Rhabdomyolysis

98
Q

Plasma SO4 increase indicates?

A

HAGMA Salicylate/Methanol/PEG toxicity

99
Q

MC lung Ca in world?

A

Adenocarcinoma

100
Q

MC lung Ca in Asbestosis?

A

Adenocarcinoma

101
Q

Strongest association of which Ca is seen with Asbestosis?

A

Mesothelioma - Pleural cancer

102
Q

Strongest association of which Ca is seen with Smoking?

A

Small cell lung Ca

103
Q

Lung cancer that looks like TB?

A

Sq cell ca

104
Q

Lung cancer that has highest risk of hypercalcemia and pancoast syndrome?

A

Sq cell ca
PTHrP high
C8-T1 horner’s syndrome

105
Q

SVC syndrome
MC neuro-endocrine complication
Most chemo-radio sensitive

A

Small cell ca
Lambert-eaton/SIDAH>ectopic ACTH
Worst prognosis

Medicine (6 decks)

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