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Review Flashcards

1
Q

Atelectasis Causes

A

Post-Surgery
TB
Blockage of a bronchus (tumour - most common is non-small cell lung Ca)

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2
Q

Hilar-Mediastinal Lymphadenopathy differentials

A

Tumour - Lung Ca, Lymphoma, Mets

Sarcoidosis

Active TB

Scleroderma

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3
Q

Subcutaneous Emphysema Causes

A

Trauma
Infectious
Spontaneous

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4
Q

Subcutaneous Emphysema - Trauma causes

A 
Broken rib from blunt trauma
Chest drain 
Dental extraction 
Endotracheal tube
Postive pressure ventilation (BiPAP)

Valsava
Boeerhave Syndrome (spontaneous oesophageal perforation)
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5
Q

Subcutaneous Emphysema -

Infectious causes

A

Anaerobic bacteria e.g. Clostridium

Associated with cellulitis, fasciitis

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6
Q

Subcutaneous Emphysema -

Spontaneous presentation

A

Young men

Benign, resolves on its own

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7
Q

Booerhaave Syndrome

A

Rupture of oesophagus due to vomiting.

  1. Vomiting
  2. Chest pain
  3. Subcutaneous emphysema
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8
Q

Ground Glass Shadowing

A

Hazy GREY diffuse opacification (do not obscure airways/blood vessels)

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9
Q

Ground Glass Shadowing Differential Dx

A

COVID 19

Atypical pneumonias 
Pulmonary aspiration 
Lung cancer 
Inflammatory lung disease
Wegener's
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10
Q

Consolidation

A

White out

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11
Q

COVID 19 CXR

A

CT is needed to confirm dx.

Bilateral peripheral ground glass shadowing which progresses to consolidation.

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12
Q

COVID 19 CT

A

Ground Glass Shadowing
Consolidation
Crazy Paving Pattern

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13
Q

Non-Cardiogenic Pulmonary Oedema - Most common cause

A

ARDs

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14
Q

ARDs

A

Non-cardiogenic pulmonary oedema caused by:

Underlying sepsis
Pneumonia (COVID)
Gastric aspiration
Blood transfusion
Pancreatitis
Trauma 
Drug overdose
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15
Q

Non-Cardiogenic Pulmonary Oedema - other causes

A

High Altitude Pulmonary Oedema

Opioid Overdose

Salicylate Toxicity

Neurogenic Pulmonary Oedema

PE

Reexpansion Pulmonary Oedema

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16
Q

Lobar Pneumonia CXR Findings

A

Lobar consolidation with bronchograms

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17
Q

Lobar Pneumonia - Causative Organism

A

Community Acquired infection by Streptococcus Pneumonia (Gram +ve)

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18
Q

Lobar Pneumonia - Other Causative Organism

A

Legionalla Pneumonia

Dx supported by non-respiratory signs:

  • Diarrhoea
  • Raised LFTs
  • Neurological dysfunction
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19
Q

Bronchopneumonia

A

Infection which originates in the airways and spreads to air spaces

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20
Q

Bronchopneumonia CXR Findings

A

Patchy consolidation

No bronchograms

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21
Q

Bronchopneumonia - Causative Organisms (HAP)

A 
E. Coli 
Pseudomonas Aeruginosa (Gram -ve)
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22
Q

Bronchopneumonia - Causative Organism (CAP)

A

Staphylococcus Aureus (Gram +ve)

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23
Q

Nodular Opacification

A

Seen in

Varicella Zoster
Mycoplasma Pneumoniae
TB (in upper zones)

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24
Q

Interstitial Consolidation

A

Seen in immunocompromised patients

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25
Q

Pneumonia Complications

A 
Pleural Effusion (Parapneumonic)
Empyema 
Abscess Formation
Pneumatocele
Pneumothorax
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26
Q

Abscess Formation Organisms

A

TB
S. Aureus
Klebsiella Penumoniae

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27
Q

Limited clinical improvement in pneumonia patient

A

?Cancer
?Alternative Organisms
?Non-infectious causes

28
Q

Pneumatocele

A

Air filled cyst, associated with Staph A

29
Q

Pneumatocele v Abscess

A

Abscess has air:fluid level, pneumatocele doesn’t

30
Q

Pleural Effusion = Exudative

A

Fluid leaks OUT of the lungs due to inflammation/cancer

31
Q

Exudative Pleural Effusion causes

A

Lung Cancer
Rheumatoid Arthritis
Pneumonia
TB

32
Q

Pleural Effusion = Transudative

A

Fluid moves ACROSS the membrane

33
Q

Transudative Pleural Effusion causes

A 
Hypoalbuminaemia 
Hypothyroidism 
Renal failure
Heart Failure 
Meig's Syndrome
34
Q

Meig’s Syndrome

A

Right Pleural Effusion
Ovarian Ca
Ascites

35
Q

Parapneumonic Effusion

A

Pleural Effusion due to pneumonia (most common cause of exudative effusion)

pH is normal

36
Q

Empyema

A

Parapneumonic effusion progresses and enough neutrophils gather to form frank pus,

Low pH, low glucose, low neutrophils
High LDH

37
Q

Asthma Chronic Management

A
  1. SABA
  2. SABA + Low ICS
  3. SABA + Low ICS + LTRA
  4. SABA + Low ICS + LABA
  5. SABA + Low MART (Low ICS + Fast LABA)
    6a) SABA + Mod MART (Mod ICS + Fast LABA)
    6b) SABA + Mod ICS + LABA

Reductions 25-50% every 3 months
Uncontrolled = 3 episodes/week or nightwaking

38
Q

Acute Asthma Management

A

OSHITME

O2 15L via Non-Rebreather
Salbutamol 2.5-5mg NEB every 10 minutes (O2 driven)
Hydrocortisone IV 100mg every 6 hours OR 40-50mg Prednisolone OD 5 days
Ipatropium Bromide 500mcg every 6 hours NEB

Theophylline (Aminophylline)
Magnesium Sulphate
Escalate

39
Q

Chronic COPD Management

A
  1. SABA or SAMA
  2. Asthmatic Features - LABA + ICS
    No Asthmatic Features - LABA + LAMA
  3. LABA + LAMA + ICS
40
Q

COPD Grading

A

80, 50, 30

FEV1

41
Q

COPD Organisms

A

HSM

Haemophilus Influenza
Streptococcus Pneumoniae
Moraxella Catarrhlis

42
Q

Acute COPD Management

A

OSIP

O2 24-48% Venturi
Nebulised Salbutamol
Nebulised Ipatropium Bromide
30-40mg Prednisolone

43
Q

Asthma Drugs

A

SABA = Salbutamol, Terbutaline

LABA = Salmeterol

Fast Acting LABA = Formetorol

ICS = Budenosine, Beclomethasone (<400mcg, 400-800mcg, >800mcg)

LTRA = Montelukast

Anti-muscarinic Antagonist = Ipatropium Bromide

44
Q

PEFR Procedure

A

Sit/stand
Best of three tries
Baseline PEFR needed

45
Q

Spirometry Procedure

A

Sit
Do three times, take the best two (within 100ml of eachother)

Reversibility:
Salbutamol with spacer 4 x 100mcg
OR
Salbutamol 2.5-5mg with nebuliser

46
Q

CLUBBING Causes

A 
Cyanotic Heart Disease
Lung Disease (ABCDEF)
UC + Chron's
Biliary Cirrhosis - PBC
Birth defect
Infective Endocarditis
Neoplasm
GI malabsorption - Coeliac
47
Q

CLUBBING - Lung Disease (ABCDEF)

A 
Abscess
Bronchiecstasis 
Cystic Fibrosis
Don't say COPD
Empyema
Fibrosis
48
Q

Lung Disease - Obstructive

A

Asthma
COPD
Bronchiectasis

49
Q

Lung Disease - Restrictive

A

ILD (CHARTS, DIAL)
Scoliosis
NMD
Obesity

50
Q

Interstitial Lung Disease - CHARTs, DIAL

A

CHARTS - Upper Zone

Coal Miners Pneumoconiosis 
Hypersensitivity (EAA) 
Ankylosing Spondylitis
Radiation 
TB
Sarcoidosis/Silicosis 
DIAL - Lower Zone 
Drugs (Pulmonary Fibrosis)
Idiopathic Pulmonary Fibrosis
Asbestosis 
Lupus
51
Q

Bronchiectasis

A

Chronic inflammation causes irreversible airway dilation with mucus plugs

52
Q

Bronchiectasis Causes

A

Can be due to:

Chronic infection
Chronic Inflammation/destruction
Impaired mucociliary clearance

53
Q

Bronchiectasis Causes - Infection

A

Immunodeficient state (HIV) allowing recurrent infection
Pertussis, measles
TB
Pneumonia

Allergic Bronchopulmonary Aspergillosis (ABPA)
Granulomatous disease

54
Q

Bronchiectasis Causes - Impaired Mucociliary Clearance

A

Cystic Fibrosis
Primary Ciliary Dyskinesia (Kartagener’s Syndrome)
Muscular Dystrophy
Lung Cancer

55
Q

Kartagener’s Syndrome

A

Situs Invernus
Chronic Sinusitis
Bronchiectasis
Sub fertility

56
Q

Bronchiectasis Causes - Chronic inflammation/destruction

A

Chron’s
UC
SLE
Marfans

57
Q

Bronchiectasis Clinical Presentation

A

Chronic daily cough with sputum with episodic exacerbations

Haemoptysis

Fatigue due to low FEV1 (later in disease)
Cyanosis (in children)

58
Q

Bronchiectasis Episodic Exacerbations

A

Increased cough
Increased sputum
SOB

Fever, chest pain

59
Q

Bronchiectasis Physical Examination

A

Crackles
Wheeze
Clubbing (<2%)

60
Q

Bronchiectasis CXR

A

Tram track sign due to thickened airway walls

Cystic dilations

61
Q

Bronchiectasis CT

A

Signet Ring sign

Tram Track sign

62
Q

Bronchiectasis Bloods

A

FBC - to see if current infection
Sputum culture

IG Screen - immunodeficiency is a cause
CFTR Mutation

63
Q

Bronchiectasis Treatment

A 
Physical training 
Postural drainage 
Abx for exacerbations/maintenance 
Bronchodilators 
Immunisation (pneumococcal)
Surgery
64
Q

Bronchiectasis - Organisms isolated from Patients

A

Haemophilus influenzae (most common)

Pseudomonas aeruginosa

Klebsiella spp.

Streptococcus pneumoniae

65
Q

Allergic bronchopulmonary aspergillosis

A

History of bronchiectasis and eosinophilia

Manage with steroids

Respiratory (9 decks)

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