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Year 3 > Respiratory terminology > Flashcards

Respiratory terminology Flashcards

1
Q

what is interstitial lung disease

A

umbrella term describing lung conditions that affect the lung parenchyma (tissue) causing inflammation and fibrosis

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2
Q

what is fibrosis

A

replacement of normal elastic lung tissue to scarred tissue that is stiff and does not function effectively

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3
Q

Conditions under umbrella of ILD

A

asbestosis
cyrptogenic organising pnuemonia
hypersensitivity pnuemonitis
idiopathic pulmonary fibrosis
drug induced pulmonary fibrosis
secondary pulmonary fibrosis

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4
Q

what is hypersensitivity pneumonitis

A

type III hypersensitivity reaction to an environmental allergen that causes parenchymal inflammation and destruction in people that are sensitive to that allergen

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5
Q

what is acute bronchitis

A

usually an inflammatory response to a virus
rarely a bacterial cause or inflammatory response to an irritant

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6
Q

What is asthma

A

chronic inflammatory condition of the airways that causes episodic exacerbations of bronchoconstriction

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7
Q

Risk factors PE

A

Immobility (long haul flight, recent surgery)
Pregnancy
Hormone therapy with oestrogen
Malignancy
Polycythaemia (high RBCs)
SLE
thrombophilia

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8
Q

What scoring system do you use for a PE and what is it made up of

A

Wells score
clinical signs/symptoms of DVT
PE is number 1 likely diagnosis
tachycardic
Immobilisation at least 3 days or surgery in previous 4 weeks
Previous diagnosed PE or DVT
Haemoptysis
Malignancy w treatment within 6 months

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9
Q

metabolic disturbance in a patient presenting with a PE

A

usually respiratory alkalosis because high RR causes them to blow off CO2

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10
Q

How to diagnose patient presenting with a PE

A

history
examination
CXR
Wells score - likely perform CTPA; unlikely perform D dimer and if positive perform CTPA

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11
Q

Initial management of patient with a PE

A

first line - apixaban or rivaroxaban
- LMWH an alternative or in antiphospholipid syndrome
- Should be started immediately before confirming diagnosis

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12
Q

Long term anticoagulation for patient with a PE

A

options: DOAC, warfarin or LMWH

INR for warfarin is 2-3

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13
Q

When do you thrombolyse PE patients

A

in massive PEs -> when they are haem-dynamically unstable

give streptokinase, alteplase or tenectplase

can be done peripheral IV or central catheter into pulmonary arteries

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14
Q

Causes of a pneumothorax

A

spontaneous
trauma
iatrogenic
lung pathologies -> infection, asthma or COPD

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15
Q

Investigations for a pneumothorax

A

CXR
CT if too small to see on CXR

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16
Q

Management of a patient with a pneumothorax and no SoB and <2cm rim of air on CXR

A

No treatment required as it will resolve spontaneously
follow up in 2-4weeks

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17
Q

Management of a pneumothorax with SoB and/or >2cm rim of air on CXR

A
  • Aspiration followed by reassessment
  • If aspiration fails twice then chest drain is required
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18
Q

Where is a chest drain inserted

A
  • Inserted in the triangle of safety
    • 5th intercostal space (inferior of the nipple line)
    • Midaxillary line ( Lateral edge of latissimus Dorsi)
    • Anterior axillary line (Lateral edge of pectoralis major)
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19
Q

Where is the needle inserted in a chest drain (in relation to the rib)

A

just above the rib to avoid the neurovascular bundle

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20
Q

Two complications of a chest drain

A
  • Air leaks around drain site → indicated by persistent bubbling of fluid, particularly on coughing
  • Surgical emphysema → (also known as subcutaenous emphysema) when air collects in subcut tissue
21
Q

When would a pneumothorax require surgical intervention

A
  • Chest drain fails to correct it
  • Persistent air leak in the drain
  • Pneumothorax recurs
22
Q

Surgical options for a pneumothorax

A
  • Abrasive pleurodesis(using direct physical irritation of the pleura)
  • Chemical pleurodesis(using chemicals, such astalc powder, to irritate the pleura)
  • Pleurectomy(removal of the pleura)
23
Q

What is a tension pneumothorax

A

Caused by trauma to the chest wall that creates a one-way valve that lets air in but not out

24
Q

Signs of a tension pneumothorax

A
  • Tracheal deviation away from the side of the pneumothorax
  • Reduced breath sounds on the side of the pneumothorax
  • Increased resonance to percussion on affected side
  • Tachycardia
  • Hypotension
25
Q

Management of a tension pneumothorax

A
  • Insert a large bore cannula into the second intercostal space in the midclavicular line
  • If suspected do not wait for investigations
  • Once pressure is relieved with cannula inset a chest drain for definitive management
26
Q

TB bacteria and staining

A

described as acid fast bacillus
special staining technique using theZeihl-Neelsen stain. This turns TB bacteriabright redagainst a blue background.

27
Q

Miliary TB

A

when the immune system is unable to control the disease it causes a disseminated, severe disease

28
Q

what is BCG vaccine for

A

TB

29
Q

Typical signs and symptoms of TB

A
  • Lethargy
  • Fever or night sweats
  • Weight loss
  • Cough with or withouthaemoptysis
  • Lymphadenopathy
  • Erythema nodosum
30
Q

Potts disease of the spine

A

spinal TB

31
Q

Investigations for TB

A
  • Ziehl-Nelson stain
  • Two tests for immune response to TB caused by latent, previous or active TB
    • Mantoux test or interferon-gamma release assay
    • Where active disease is suspected support diagnosis with CXR and cultures
32
Q

What is the Mantoux test

A

Used to look for previous immune response to TB

33
Q

Primary TB on a CXR

A

may show patchy consolidation, pleural effusions and hilar lymphadenopathy

34
Q

Reactivated TB on a CXR

A

may show patchy or nodular consolidation with cavitation (gas filled spaces in the lungs) typically in the upper zones

35
Q

Disseminated miliary TB on a CXR

A

give a picture of “millet seeds” uniformly distributed throughout the lung fields

36
Q

types of cultures for TB

A

Sputum
mycobacterium blood cultures
Lymph node aspiration

37
Q

Management of latent TB

A
  • Isoniazidandrifampicinfor 3 months
  • Isoniazid for 6 months
38
Q

Management of active pulmonary TB

A
  • Rifampicin for 6 months
    -Isoniazid for 6 months
  • Pyrazinamide for 2 months
    -isoniazid causes peripheral neuropathy and pyridoxine (vitamin B6) is usually co-prescribed prophylactically to help prevent this***
  • Ethambutol for 2 months
39
Q

Other management considerations for someone who has TB

A
  • Test for other infectious diseases (HIV,hepatitis B andhepatitis C).
  • Testcontactsfor TB.
  • NotifyPublic Healthof all suspected cases.
40
Q

side effect of Rifampicin

A

can cause red/orange discolouration of secretions like urine and tears

reduces effect of oCP

41
Q

side effect of Isoniazid

A

can cause peripheral neuropathy. Pyridoxine (vitamin B6) is usually co-prescribed prophylactically to reduce the risk of peripheral neuropathy

42
Q

Pyrazinamide

A

can cause hyperuricaemia (high uric acid levels) resulting in gout

43
Q

Ethambutol

A

can cause colour blindness and reduced visual acuity.

44
Q

Patient around 20-40 year old black women presenting with a dry cough and SoB. May have nodules on skins suggesting erythema nodosum think what??

A

Sarcoidosis

45
Q

Lofgren’s Syndrome

A
  • Specific presentation of sarcoidosis
  • Triad of
    • Erythema nodosum
    • Bilateral hilar lymphadenopathy
    • Polyarthralgia (joint pain in multiple joints)
46
Q

Blood tests/results for sarcoidosis

A
  • Raised Serum ACE
  • Hypercalcaemia is a key finding
  • Raised serum soluble interleukin 2 receptor
  • Raised CRP
  • Raised immunoglobulins
47
Q

Gold standard to diagnose sarcoidosis

A

confirm with histology from biopsy

shows non-caseating granulomas with epithelioid cells

47
Q

Gold standard to diagnose sarcoidosis

A

confirm with histology from biopsy

shows non-caseating granulomas with epithelioid cells

48
Q

Management for sarcoidosis

A
  • No treatment → considered first line in patients with mild or no symptoms as the condition can resolve spontaneously
  • Oral steroids → first line when treatment is required and are given for between 6-24 months
    • Patients should be given bisphosphonates to protect against osteoporosis whilst on such long term steroids

Year 3 (14 decks)

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