Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y3 CORE CONDITIONS > RESPIRATORY SYSTEM > Flashcards

RESPIRATORY SYSTEM Flashcards

1
Q

what is the prevalence of acute asthma in children and young adults?

a) 5%
b) 15%
c) 25%
d) 35%

A

b) 15%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

is acute asthma more common in developed or developing countries?

A

developed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is the name for chronic inflammation of the large airways?

A

bronchospasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

name one hypothesis for the development of asthma

A

hygeine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what antibody mediates an asthma allergic reaction?

A

IgE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

name 5 cells which are recruited during an asthma attack

A 
mast cells
dendritic cells
eosinophils
lymphocytes
T helpers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what epithelial and basement re-modelling occurs in asthma?

A

loss of cilia
increase of mucus cells
thickened basement membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what happens to smooth muscle in the airways in chronic asthma?

A

hyperplasia from chronic infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the four main symptoms of worsening asthma?

A

SOB at night
Wheeze at night
Cough
Chest tightness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what would occur upon percussion of a patient with asthma?

A

hyper resonance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

is the airway obstruction of asthma reversible or irreversible?

A

reversible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what 4 things cause bronchial inflammation in asthma?

A

infiltration of immune cells
muscle hypertrophy
mucus plugging
epithelial damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the signs of acute asthma attack?

A 
PEFR <35%-50%
RR= >25
HR=> 110pbm
Can't speak full sentance
Cyanotic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the signs for fatal asthma attack?

A

PEFR <35%
Poor respiratory effort and silent chest sound
Pa02= <8
O2 sats= 92% on air
Unconsciousness and arrhythmia may be present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the atopic triad commonly seen in medical/family history of a patient with asthma?

A

The patient or within the family they are suffering from
Eczema
Asthma
Hay fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

give 4 examples of exacerbating factors for asthma

A 
cold air
exercise
allergens
pets
existing atrophy
acid reflux
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is the difference between intrinsic and extrinsic asthma?

A 
intrinsic = no known cause (chemical/exercise induced)
extrinsic = allergen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what two measurement test might you recommend for a patient with suspected asthma?

A

peak expiratory flow

spirometry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what type of drug is salbutamol and terbutaline and how are they administered and how often?

A

beta agonist
inhaled
short acting up to 4x daily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Give an example of an inhaled steroid for asthma or COPD

A

Corticosteriods such as beclometasone, fluticasone and budesonide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

why are inhaled steroids given for asthma and how often are they administered?

A

prevention

two times daily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

give 3 side effects of inhaled steroids

A

reduced bone mineral density
growth failure
adrenal suppression
oral candida

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the treatment for acute asthma attack?

A

O SHIT ME

Oxygen 15L non rebreathable mask

Salbutamol 5mg Nebulizer ( change oxygen to 6L/8L) = every 15-20 minutes
Hydrocortisone 200mg Iv or prednisolone 40mg oral
Ipratropium bromide Iv 0.5mg 4-6 hours
Theophylline

Magnesium Sulphate 2g Iv
Extra help

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

how many people are affected by COPD in the UK?

a) 50
b) 50,000
c) 500,000
d) 1.5 million

A

d) 1.5 million

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what 2 things is COPD a combination of?

A

emphysema (pink puffer) and chronic bronchitis (blue bloaters)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

how does COPD lead to air collapse?

A

emphysema causes loss of elasticity and loss of alveoli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

how can a patient with COPD get blocked airways?

A

increased goblet cells and mucus secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

why does a COPD patient get lung hyperinflation and shortness of breath?

A

narrowing of small airways and trapping of air

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what is the major cause of COPD?

A

smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

give 2 minor causes of COPD

A 
infections
a1-antitrypsin deficiency
Air pollution (motor vehicles)
Occupational pollution ( dust, chemicals)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

why does a1-antitrypsin deficiency cause COPD?

A

Occurs in emphysema and a1 antitrypsin protects lungs from elastase enzyme. when there is a deficiency, the lungs are destroyed by elastase. Lower lobes are more severely affected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

is COPD reversible or irreversible?

A

irreversible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are the general symptoms of COPD?

A 
Recurrent infections
SOB
Fatigue
Productive cough
Fever
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what chest abnormality might you see with a patient with COPD?

A

barrel chest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

give 2 examples of behavioural abnormalities of a patient with COPD in an attempt to ease shortness of breath

A

pursed lip breathing
tripod positioning
use of accessory muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

how long do symptoms have to be present for a diagnosis of COPD to be considered?

A

more than 3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is the FEV1:FVC ratio in a patient with COPD?

A

Less than 0.7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

name 2 things you might see on a chest X-ray of a patient with COPD

A

hyperinflation

enlarged pulmonary vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

name something which you might see on an ECG of a patient with COPD

A

right ventricular hypertrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

in an ABG of a patient with COPD, the PaO2 would be ___ and the PaCO2 would be ____

A

PaO2 low

PaCO2 high

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

what treatment might you recommend for mild COPD?

A

ipratropium inhaler (antimuscarinic)
or
Salbutamol ( Short acting B2 agonist)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

what 3 things might you recommend for moderate COPD?

A

ipratropium
long acting b2 agonist ( salmeterol and formoterol)
steroid (fluticasone and budesonide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

what is seretide a combination of?

A

salmeterol (B2 agonist)

fluticasone (steroid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

what is symbicort a combination of?

A

formoterol (b2 agonist)

budesonide (steroid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

what is combivent a combination of?

A

salmeterol (b2 agonist)

ipratropium (antimuscarinic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

what 3 things would you recommend as combination therapy for severe COPD?

A

long acting beta 2 agonist (salmeterol)+
long acting antimuscarinics (tiotropium) +
Inhaled steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

what drug might you prescribe to reduce inflammation and relax smooth muscle in severe COPD?

A

theophylline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

how would you treat theophylline toxicity?

A

beta blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

give 3 cardiac complications of COPD

A

right sided heart failure
oedema
hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

give an MSK complication of COPD

A

osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

give a metabolic complication of COPD

A

weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

what accounts for 95% of all primary lung tumours?

A

bronchial carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

is bronchial carcinoma more likely in men or women?

A

men

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

what makes up 15-20% of bronchial carcinomas?

A

small cell calcer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

SCC is a cancer of what cells?

A

Kulchitsky cells (endocrine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

what do kulchitsky cells do?

A

secrete polypeptide hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

how do kulchitsky cells stimulate tumour growth?

A

secretion of polypeptide hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

do SCCs metastasise early or late?

A

early

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

is the prognosis of SCCs good or bad?

A

bad - inoperable at presentation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

what makes up 40% of NSCCs?

A

squamous/epidermoid= flat cells near the centre of the lungs presenting which cause bronchial blocking and infeciton

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

what makes up 42% of NSCCs?

A

adenocarcinomas= mucus gland cells in bronchial epithelium which invades lymph nodes and pleura

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

what makes up 10% of NSCCs?

A

large cell cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

large cell carcinomas are _____ differentiated and metastasise _____

A

poorly

early

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What are the common symptoms of bronchial carcinoma?

A 
Chest pain*
Haemoptysis*
Cough*
Dysponea and sob*
Weight loss and fatigue  *
Malaise 
Slow resolving infection/pneumonia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

what is the main risk factor for the development of bronchial cancer?

A

smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

give 2 other risk factors for the development of bronchial cancer

A

urban areas

occupation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

name 2 peripheral signs you might see relating to lung cancer

A

clubbing

weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

what medical imaging technique might you suggest for diagnosis of bronchial cancer?

A

CT (MRI not useful)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

if during a bronchoscopy you noticed that there was a loss of the sharp angle of the carina, what might you suspect?

A

mediastinal lymph node involvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

why might you perform a full blood count in suspected bronchial cancer?

A

anaemia of malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

why might you perform LFTs in suspected bronchial cancer?

A

liver metastases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

is prognosis better for NSSCs or SCCs?

A

NSSCs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

give 4 examples of where bronchial cancer can directly spread

A 
pleura
ribs
brachial plexus
hilar region
phrenic nerve
oesophagus
pericardium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

give 3 common metastatic sites for bronchial cancer

A

bone
brain
liver
adrenal gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

give 4 examples for benign tumour that can exist in the lung

A 
pulmonary harmatoma
bronchial adenoma
chondroma
lipoma
mesothelioma
tracheal squamous papilloma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

give 2 circulatory complications of bronchial cancer

A

superior vena cava obstruction
pericarditis
AF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

which gender are more likely to get a pneumothorax?

A

males

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Who commonly develops spontaneous pneumothorax?

A

Tall thin white boys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

what could cause a spontaneous pneumothorax?

A

rupture of subdural bulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

what is a major cause of pneumothorax?

A

chest trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

give 3 rare, chronic respiratory causes of pneumothorax

A

asthma
COPD
CF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

give 2 infective causes of pneumothorax

A

TB

pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

give a systemic, connective tissue, inflammatory cause of pneumothorax

A

sarcoidosis= production of granulomas in the body in response to inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

give 2 inherited causes of pneumothorax

A

marfan’s

ehlers-danlos

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

give a rare, more serious cause of pneumothorax

A

cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

CVP line, pleural aspiration and biopsy are all examples of _____ causes of pneumothorax

A

iatrogenic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

why does pneumothorax occur?

A

negative pressure in lungs is lost and the lungs partially deflate - air is sucked into cavity through valve causing lung compression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

pneumothorax can be described as ____ onset ____ pain

A

sudden onset

pleuritic pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

what would you hear on percussion and auscultation of the chest of a patient with a pneumothorax?

A

hyper-resonant and absent breath sounds

90
Q

What is the presentation of tension pneumothorax?

A

Distended neck veins (raised JVP), deviated trachea and cardiac arrest

91
Q

tension pneumothorax is a medical emergency, how would you treat it?

A

Needle thoracostomy ( 14/16g large bore needle into the 2nd intercostal space midclavicular line)

92
Q

how would you treat a normal pneumothorax?

A

If symptoms are severe then do chest drain or needle aspiration

93
Q

what is a unilateral pleural effusion?

A

fluid in pleural space

94
Q

what is the difference between transudate and exudate?

A 
transudate = low in protein
exudate = high in protein
95
Q

give 4 causes of transudate pleural effusion

A

increased venous pressure
hypoproteinaemia
hypothyroidism
meig’s syndrome

96
Q

give 2 examples of what can cause increased venous pressure

A

heart failure
fluid overload
pericarditis

97
Q

give 2 examples of what can cause hypoproteinaemia

A 
malabsorption
liver disease (reduced albumin production)
nephrotic syndrome (albumin loss through leaky glomeruli)
98
Q

what is Meig’s syndrome?

A

unilateral pleural effusion and ovarian fibroma

99
Q

give 6 causes of exudative pleural effusion

A 
increased capillary leakage
infection (pneumonia, TB)
malignancy
rheumatoid arthritis
SLE
pulmonary infarction
100
Q

what would you hear on percussion in a pleural effusion?

A

stony dullness

101
Q

what other sign would be reduced during a respiratory examination on a patient with pleural effusion?

A

decreased vocal resonance/fremitus

102
Q

what is light’s criteria used to distinguish?

A

whether an effusion is exudative or transudative

103
Q

What is the Lights criteria of exudate pleural effusion?

A

Pleural fluid protein:serum protein is >0.5
Pleural fluid LDH: Serum LDH >0.6
Fluid fluid LDH > 2/3 of the upper limit of the serum LDH

104
Q

what might you see on a chest x-ray of someone with a pleural effusion?

A

blunting of costophrenic angles

105
Q

what is pleurodesis?

A

treatment of pleural effusion and recurrent pneumothorax

Adhesion of 2 pleural layers to remove pleural space

106
Q

give 4 complications of pleural effusions

A

scarring
sepsis
empyema
pneumothorax

107
Q

how common is pneumonia?a) 2/1000 a year

b) 10/1000 a year
c) 50/1000 a year
d) 100/1000 a year

A

a) 2/1000 a year

108
Q

what is the mortality of pneumonia?

a) 1%
b) 5%
c) 10%
d) 20%

A

c) 10%

109
Q

in what age group is pneumonia most dangerous?

A

elderly

110
Q

what is pneumonia?

A

inflammation of lungs, consolidation fluid in alveoli

111
Q 
how can pneumonia be classified by area?
Describe
a) age of onset
b) gender
c) common causes
d) spread
e)
A

bronchial:, extreme of ages, common in both genders. Caused by strep/staph and h.influenz, spread around the brocnhial and not limited to one lobe. Bilateral in spread = secondary in sick

lobular= male 20-50, pneumococcus, entire lobe, uniltaeral = primary in healthy

112
Q

how can pneumonia be classified by cause?

A

bacterial
fungal
viral
parasitic

113
Q

how can pneumonia be classified by location of onset?

A

community acquired

hospital acquired

114
Q

name a type of pneumonia that can have iatrogenic causes

A

aspiration

115
Q

what is the 3 most common causative organism for community acquired bacterial pneumonia?

A

1) pneumococcal pneumonia. (+VE)
2) h. infleunza (-VE)
3) atypical bacteria e.g mycoplasma pneumoniae
4) Staphylococcal aureus,
5) mycobacterium tuberculosis,
6) viruses.

116
Q

what are 3 most common causative bacteria for hospital acquired pneumonia? 48 hours after admission

A

Pseudomonas aeruginosa (-ve)
Staphylococcal aureus
Enterobacteriaceae (especially Klebsiella, E. coli and Enterobacter spp.

HAP related to ventilation assoiciated pneumonia

117
Q

what type of pain is present in pneumonia?

A

pleuritic chest pain

118
Q

what sign may be present in the sputum of someone with pneumonia?

A

It can be dry or productive of green grey phlegm

Severe cases cause haemoptysis

119
Q

What are the common symptoms of pneumonia?

A 
Chest pain worse by coughing
Tachycardia
Tachypnea
Hypotension 
Dyspnea 
Lost of appetite 
Fever
Rigors
120
Q

what are the 4 stages of pneumonia progression?

A

congestion
consolidation
grey hepatisation
resolution

121
Q

what 3 things occur in the congestion phase of pneumonia?

A

fluid accumulation
pulmonary oedema
neutrophil accumulation

122
Q

what occurs in the consolidation phase of pneumonia and where?

A

exudate forms of neutrophils, fibrin and RBCs in the alveoli

123
Q

what occurs in the grey hepatisation stage of pneumonia?

A

only neutrophils and fibrin persist in exudate - paler colour

124
Q

give 2 examples of how the exudate is removed in the resolution stage of pneumonia

A

digested by macrophages

coughed up

125
Q

what does CURB 65 stand for? (is a 5 point score)

A

confusion
urea >7
respiratory rate >30
blood pressure 65

126
Q

On examination of the lungs what do you find in pneumonia?

A

Dull percussion
Basal Crackles on auscultation of the lung bases due to consolidation
Bronchial breathing
Increased tactile vocal fremitus

127
Q

what would tactile vocal fremetus be like in a patient with pneumonia?

A

increased

128
Q

what would happen to the blood markers WCC, CRP and ESR in a patient with pneumonia?

A

all increase

129
Q

is there a vaccine available for pneumonia?

A

yes

130
Q

a CURB score of 0 would recommend what antibiotic treatment for pneumonia?

A

oral amoxycillin OR clarithromycin

131
Q

a CURB score of 1-2 would recommend what antibiotic treatment for pneumonia?

A

oral amoxycillin AND clarithromycin

132
Q

a CURB score of >3 would recommend what antibiotic treatment for pneumonia?

A

co-amoxiclav &; clarithromycin IV

133
Q

give 4 respiratory complications of pneumonia

A

respiratory failure
pulmonary effusion
empyema
lung abscess

134
Q

give 4 cardiac complications of pneumonia

A

hypotension
AF
pericarditis
myocarditis

135
Q

give a systemic complication of pneumonia

A

septicaemia

136
Q

what percentage of pulmonary emboli are present undiagnosed in patients?

a) 10%
b) 30%
c) 60%
d) 80%

A

c) 60%

137
Q

what percentage of PEs are fatal?

a) 1%
b) 10%
c) 50%
d) 100%

A

b) 10%

138
Q

what is PE classically a complication of?

A

DVT

139
Q

what is virchow’s triad?

A

blood constituents
blood flow
vessel properties

140
Q

a change in virchow’s triad can cause what?

A

DVT or PE

141
Q

how can bacterial endocarditis cause a pulmonary embolism?

A

septic emboli dislodges from RHS of heart and travels to lung

142
Q

how can an MI lead to a pulmonary embolism?

A

right sided thrombus after MI

143
Q

What are the symptoms of PE?

A

Sudden SOB and dysponea
Hypoxia
Sudden Pleuritic chest pain and also back pain
Coughing ( dry but can have mucus and blood)
Feeling light headness and dizzines
Fainting
Symptoms of DVT

144
Q

when in a PE might you get haemoptysis?

A

if lung tissue is damaged

145
Q

give 3 physiological risk factors for PE

A

age >60
obesity
pregnancy

146
Q

give 3 pathological risk factors for PE

A

trauma
varicose veins
previous DVT/PE

147
Q

give a blood-related risk factor for PE

A

hyper coagulability e.g. thrombophilia, factor V leiden, protein C/S deficiency, antithrombin def

148
Q

give a lifestyle risk factor for PE

A

long air travel/immobility, diet and smoking

149
Q

give 2 iatrogenic risk factors for PE

A

COCP

HRT

150
Q

if a patient with a PE has an ABG showing low PaO2 and normal PaCO2 what does this show?

A

type 1 respiratory failure

151
Q

what might an echo show of a heart of a patient with a PE?

A

dilated right ventricle and increased contraction of LV

152
Q

what part of the lung is affected in a small or medium pulmonary embolism? what affect does this have?

A

terminal vessels

Causes coarse crackles, pleural rub and tachyponea.

153
Q

what occurs to the lung in a massive PE?

A

sudden lung collapse due to pulmonary obstruction

154
Q

what occurs systemically and peripherally in a massive PE?

A

shock

peripheral shutdown

155
Q

What are the circulatory signs of massive PE?

A

Tachycardia
Tachypnea
Hypotension
Raised JVP

156
Q

where might you feel a heave in a patient with a massive or multiple recurrent PE?

A

right ventricle

157
Q

what might occur to the second heart sound in a patient with a massive or multiple recurrent PE?

A

split

158
Q

What are the symptoms of multiple recurrent PE?

A

Increased shortness of breath over a few weeks
Syncope, weakness and angina
Pulmonary hypertension and RV overload signs
RV heaves and loud 2nd heart sound

159
Q

what 3 immediate suppurative treatments would you give to a patient with a PE?

A

high flow oxygen
IV fluids
analgesia

160
Q

give an example of a thrombolytic that you could give in a pulmonary embolism

A

streptokinase IV for 30 mins

161
Q

give 2 methods you would use to prevent a further pulmonary embolism occurring in the future?

A

LMWH ( tinzaparin) initially and then warfarin following on or rivaroxaban

162
Q

What are the symptoms of pulmonary fibrosis?

A 
SOB on exertion
Lose of apeptite
Rapid Weight loss 
Fatigue and tired
Clubbing 
Chest discomfort 
Chronic dry hacking cough
163
Q

What therapy treatment can you have at home for pulmonary fibrosis?

A

Oxygen therapy

Pulmonary rehabilitation

164
Q

What are the life style advice for a patient with pulmonary fibrosis?

A

Stop smoking
Exercise
Healthy diet

165
Q

what is pulmonary fibrosis?

A

scarring of the lungs

166
Q

pulmonary fibrosis is excess accumulation of what?

A

fibrous connective tissue

167
Q

pulmonary fibrosis results in ____ of alveolar walls and ____ gaseous exchange

A

thickening

reduced

168
Q

give an example of a cause of idiopathic pulmonary fibrosis

A

genetic mutation of a surfactant protein
FHx
GORD
Smocking

169
Q

give 3 examples of diseases for which pulmonary fibrosis can be a secondary effect

A

TB
bacterial lung infection
viral lung infection
autoimmune diseases (e.g. sarcoidosis, granulomatosis)

170
Q

give a lifestyle cause of pulmonary fibrosis

A

smoking

171
Q

give a immune mediated cause of pulmonary fibrosis

A

hypersensitivity

172
Q

give examples of 4 drugs which can cause pulmonary fibrosis

A

amoidarone
methotrexate
nitrofurantoin
apomorphine

173
Q

which of these would NOT be reduced in a spirometry reading for pulmonary fibrosis

a) FEV1
b) FEV2
c) FVC

A

b) FEV2

174
Q

is the scarring of pulmonary fibrosis permanent or temporary?

A

permenant

175
Q

give 2 types of drugs that pulmonary fibrosis may respond to

A

steroids

immunosuppressents

176
Q

give an example of an anti-fibrinic drug that can be used in treatment of pulmonary fibrosis

A

pirfenidone

nintedanib

177
Q

what is end stage treatment of pulmonary fibrosis?

A

lung transplant

178
Q

give 3 complications of pulmonary fibrosis

A

Hypoxia leading to pulmonary hypertension then heart failure
Pulmonary embolism
Chest infection

179
Q

What is chronic bronchitis?

A

It is inflammation of the bronchioles causing production of mucus. Causing the patient to be cyanosed but not breathless

180
Q

What is emphysema?

A

It is destruction, dilation and distention of the alveolar sacs. Which leads to being breathless but not cyanosed

181
Q

What is the affect of
a) chronic bronchitis
b) emphysema
on alveolar ventilation?

A

a) decreased

b) increased

182
Q

What can COPD be exacerbated by?

A

Infection
Exercise
Bad weather
Pollution

183
Q

What heart condition can chronic bronchitis cause?

A

Cor pulmonale

184
Q

What is cor pulmonale?

A

It’s right heart failure secondary to lung disease

Caused by pulmonary hypertension consequence of hypoxia

185
Q

What is the treatment for exacerbation of COPD?

A

Abx and Steroids (prednisolone) for 7 days

186
Q

What are pre medical treatment for COPD?

A

Stop smoking, nutrition and exercise

187
Q

For acute asthma attack what is the 2 drugs plus oxygen you give immediately?

A

Salbutamol 5g Nebulizer

Hydrocortisone/Prednisolone

188
Q

Why do you do a ECG when administrating continuous doses of salbutamol for acute asthma attack?

A

To identify any arrhythmias

189
Q

What additional treatment do you give if acute asthma become severe?

A

Increase frequency of salbutamol
Ipratropium 0.5mg nebulizer
Magnesium sulphate over 15-20 minutes

190
Q

Differential diagnosis of asthma for adults?

A 
	Chronic obstructive pulmonary disease
	Bronchiectasis
	Inhaled foreign body
	Lung cancer
	Sarcoidosis
191
Q

Differential diagnosis of asthma for children?

A 
	Inhaled foreign body.
	Viral-associated wheeze of infancy, bronchiolitis, pneumonia, croup, bronchitis, pertussis.
	Sinusitis.
	Post-nasal drip.
	Bronchiectasis.
192
Q

What are the usual clinical presentation of primary spontaneous pneumothorax?

A

Pleuritic chest pain with mild or moderate dyspnea

193
Q

What are the usual clinical presentation of secondary spontaneous pneumothorax?

A

Pleuritic chest pain often absent but laboured dyspnea

194
Q

What is the pathology of tension pneumothorax?

A

A tear in the lung causing a one way valve that leads air into the pleural space.
Causing collapse of the lungs and positive mass effect (shifting )of the mediastinum and heart.

195
Q

How does tension pneumothorax cause cardiac arrest and potentially death?

A

Impaired venous return leads to reduced preload that leads to tachycardia
Over time this leads to reduced diastole period that means lead blood to the heart
Over time causes death of the heart

196
Q

What is the treatment if you get recurrent pneumothorax?

A

Pleurodesis

197
Q

Differential diagnosis of pneumothorax?

A

Pleural effusion

Pulmonary embolism

198
Q

What is a life style risk factor for pneumothorax?

A

smocking

199
Q

What lung conditions can occur in a patient with bronchial carcinoma?

A

Collapse
Pleural effusion
Slow resolving pneumonia

200
Q

What are the 5 common causes of bone mets?

A 
Lungs
Prostate
Kidney
Thyroid
Breast
201
Q

What system is used to assess the staging of bronchial carcinoma?

A

TNM system

202
Q

In what age group do you get confusion with pneumonia?

A

Elderly

203
Q

What type of pneumonia is CURB 65 used for?

A

CAP

204
Q

What is the treatment for HAP?

A

Gentamicin and ticarcillin

205
Q

What types of surgery increase the likelihood of PE?

A

Surgery of the abdomen and pelvic area

Knee and hip replacement

206
Q

What scan would you do if their was a positive D dimer test for PE?

A

CTPA

207
Q

Is D Dimer test definitive for DVT and PE?

A

If -ve then yes

However if +ve then need to do other test to confirm

208
Q

What would a ECG show of a PE?

A

Tachycardia and RV strain

209
Q

What is the triad of symptom for PE?

A

Sudden onset of
Hypoxia
SOB
Pleuritic chest pain

210
Q

What criteria is used for the development of potential PE?

A

WELLs score

211
Q

What is the wells score for PE?

A 
No other possible diagnosis
HR= >100
Previous DVT or PE
Active malignancy
Haemoptysis
DVT symptoms and signs 
Immobilisation for 3 days or surgery in past 4 weeks

Score of 4 or more =likely it is PE

212
Q

What scan do you do if it is not possible to do a CTPA for a patient with potential PE?

A

VQ scan

213
Q

What are differential diagnosis of PE?

A 
Pneumonia
Pneumothorax
ACS
GORD
MSK pain
214
Q

What are the signs and symptoms of pleural effusion?

A 
Usually asymptomatic
However 
Dyspnea and pleuritic chest pain can be present
Reduced chest expansion and chest sound
Stony Dull percussion
Reduce vocal resonance and fremitus
Bronchial breathing over the effusion
215
Q

What is empyema?

A

It is collection of pus in the pleural space and a complication of pneumonia and pleural effusion

216
Q

What does dull percussion indicate?

A

Consolidation, tumour or lung collapse

217
Q

What would a increase in vocal resonance and dull percussion indicate ?

A

Consolidation, tumour or lung collapse

218
Q

When is the criteria for a patient to be prescribed prophylaxis steroid inhaler for asthma?

A

If they are using their reliever inhaler more than 3 times a week or
Asthma is disturbing their sleep at least once a week or
They have had a asthma attack in the last 2 years that needed systemic steroids

219
Q

What are the 7 most common primary tumours to cause mets in the lung?

A

kidney, prostate, breast, bone, gastrointestinal tract, cervix and ovary.

220
Q

Which bronchial carcinoma is most commonly linked to asbestos and occurs in non smokers?

A

Adenocarcinoma

Y3 CORE CONDITIONS (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions