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Respiratory > sessions 8+ > Flashcards

sessions 8+ Flashcards

1
Q

AP or PA

A

AP = scapula further medial

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2
Q

AP or PA

A

PA = scapular further lateral

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3
Q

Most common lung cancer in non smokers

A

Bronchogenic adenocarcinoma

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4
Q

Common lung cancers in smokers

A

small cell carcinoma, squamous cell carcinoma

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5
Q

abnormality on CXR of active TB

A

Ghon’s complex

Ghon foci + enlarged hilar lymph nodes

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6
Q

Risk factors for TB

A

HIV, immunosuppressive drugs, non Uk born, poorly controlled T2DM, homeless, drug user

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7
Q

Symptoms of adrenal insufficiency

A

Fatigue, weakness, poor appetite, salt craving, weight loss, dizziness, hypotension, hyper pigmentation

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8
Q

SIADH is most commonly caused by

A

Small cell carcinoma of the lung- causes electrolyte disturbance on Us and Es

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9
Q

muscle weakness causes what type of respiratory failure

A

Type 2 respiratory failure

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10
Q

some causes of respiratory failure T2

A

opioid OD, brainstem injury, muscular dystrophy, severe kyphoscoliosis

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11
Q

Increased 2,3 DPG results in

A

decreased Hb Oxygen affinity, curve shifted to right

Right = easier RRRRelease off oxygen

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12
Q

cough reflex muscles

A

internal intercostal muscles and abdominal muscles

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13
Q

30 cigarettes a day for 42 years pack years

A

42 x 1.5 packs = 63 pack years

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14
Q

CXR features of pneumothorax

A

more radiolucent area beyond collapsed lung

Edge of collapsed lung is seen

Decreased lung markings

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15
Q

Hyperventilating plus PE will cause

A

Type 1 respiratory failure with low oxygen and co2

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16
Q

Why is a patient with tension pneumothorax cyanosed

A

hypoxaemia

17
Q

Why does trachea deviate away from pathology in pneumothorax

A

higher pressure in pleural cavity due to tension pneumothorax pushes trachea and mediastinum away to other side

18
Q

Why is the chest hyper resonant on tension pneumothorax

A

air in pleural space, lung deflated

19
Q

Why are breath sounds absent in pneumothorax

A

collapsed lung = presence of air between chest wall and lung further reduces the intensity of breath sounds

20
Q

why is blood pressure low in tension pneumothorax

A
  • One way valve system at site of breach in pleural membrane
  • Air can enter pleural cavity but not leave during expiration
  • Increased in intrapleural pressure
  • Venous return impaired
  • Drop in CO
  • Hypoxaemia from impaired ventilation may directly impair cardiac function
21
Q

Emergency treatment for pneumothorax

A

needle decompression, insert needle into pleural cavity, 2nd ICS in MCL

Cannula introduced over the needle

22
Q

Conditions which will cause mediastinal displacement away from affected side

A

pleural effusion- volume displacement
Pneumothorax

23
Q

conditions which cause mediastinal displacement towards the affected side

A

Pulmonary fibrosis (healed TB), as fibrous tissue shrinks, it pulls the mediastinum towards the affected side

Lung collapse secondary to obstructive atelectasis

24
Q

visceral pain

A

generalised, vague

25
Q

shoulder tip pain

A

suggests diaphragmatic pleura not cardiac referred pain

26
Q

Typical features of cardiac pain

A

central, tight, radiates to arms and neck, angina brought on by exertion, pericardial = sharp

27
Q

Pleuritic pain

A

sharp, over affected area

28
Q

Important features of DVT history

A

long haul flights, medications, COCP, history of blood clots, calf pain/swellling

29
Q

PE presentation

A

acute onset, sharp, pleuritic, risk factor of long haul flight

haemoptysis/cough

30
Q

What is important to state in ABG interpretation

A

alkalosis/acidosis
respiratory/metabolic
Type of failure if respiratory

31
Q

Which mechanism explains hypoxaemia in PE

A

V/Q mismatch

32
Q

questions to explore cough complaint

A

mucous, PMH, smoker, trigger factors, URTI, atopy ,FH

33
Q

Bronchitis (acute viral) vs asthma

A

Bronchitis; symptoms don’t vary with time of day, no significant PMH, infective symptoms such as fever, coloured sputum

Asthma: symptoms worse at night and early morning, atopy

34
Q

How to tell between asthma and COPD with spirometry

A

pre and post bronchodilator treatment would differentiate- 12% or greater improvement if asthma

35
Q

when is there a one way valve in pneumothorax

A

only in tension (mediastinal shift and cardiovascular collapse)

NOT IN SIMPLE

Respiratory (7 decks)

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