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Respiratory SB > The Rest > Flashcards

The Rest Flashcards

1
Q

what are the risk factors for developing chronic pulmonary infection

A

Abnormal host response
Abnormal innate host defence
Repeated insult

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2
Q

examples of abnormal host response

A

immunodeficiency

immunosuppression

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3
Q

examples of abnormal innate host defence

A

damaged bronchial mucosa e.g. smoking
abnormal cillia e.g. Hartenager’s Syndrome, Youngs Syndrome
abnormal secretion e.g. CF

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4
Q

examples of repeated insult

A

aspiration e.g. NG feeding

indwelling material e.g. NG tube in wrong place

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5
Q

what is a common presentation of intrapulmonary abscess

A

weight loss, lethargy, cough, weakness, usually a preceding illness

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6
Q

what type of pneumonia is likely to cause intrapulmonary abscess and what is the mechanism

A

Staph Pneumonia -> Cavitating Pneumonia -> Abscess

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7
Q

type of poor host immune response that could lead to intrapulmonary abscess

A

Hypogammaglobulinaemia

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8
Q

what is the indicators of a simple parapneumonic effusion

A

Clear fluid
pH more than 7.2
LDH less than 1000
Glucose more than 2.2

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9
Q

what are the indicators of a complicated parapneumonic effusion

A

pH less than 7.2
LDH more than 1000
Glucose less than 2.2
Requires Chest Tube Drainage

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10
Q

what is the definitive signs of a empyema

A

Frank pus

X-ray - “D sign”

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11
Q

what are preferred for ridding an empyema

A

Small bore seldinger type drains

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12
Q

what suggest chronic bronchial sepsis

A

No bronchiectasis on the HRCT

Confirmed positive sputum results

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13
Q

what causes steatorrhoea

A

exocrine complications of CF

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14
Q

what is a headache on wakening suggest

A

CO2 retention headache

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15
Q

what can cause CO2 retention

A

Snoring due to hyperventilating

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16
Q

signs of metabolic acidosis

A

increased CO2 production
increased resp rate
“breathlessness”

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17
Q

what is stridor

A

predominantly inspiratory wheeze due to large airway obstruction

18
Q

causes of stridor in children

A

croup, epiglottis, diphtheria,
Foreign body
Anaphylaxis
angioneurotic oedema

19
Q

causes of stridor in adults

A 
neoplasms - larynx, trachea, major bronchi
anaphylaxis
Retrosternal goitre
bilateral vocal cord palsy
Wegener’s granulomatosis
20
Q

what is tracheomalacia

A

flaccidity of the tracheal support cartilage which leads to tracheal collapse especially when increased airflow is demanded.

21
Q

what investigation should be avoided in acute epiglottis

A

Laryngoscopy

22
Q

signs of anaphylaxis

A 
Flushing, pruritus, urticaria, 
Angioneurotic oedema
Hypotension leading to shock
Stridor
Wheeze
23
Q

what is OSA

A

Intermittent upper airway collapse in sleep

24
Q

what is the best treatment of OSA

A

Remove underlying cause

Continuous positive airway pressure (CPAP)

25
Q

what tool is used to diagnoses OSA

A

Epworth score

26
Q

what organism may colonise in CF patients

A

Staph aureus
Pseudomonas aeruginosa
Burkholderia cepacia
Aspergillus

27
Q

what are causes of pulmonary venous hypertension

A

LVF
Mitral regurgitation
Mitral Stenosis
Cardiomyopathy

28
Q

what are causes of pulmonary arterial hypertension

A

Hypoxic - COPD, OSA

PE

29
Q

clinical signs of pulmonary hypertension and right heart failure

A

central cyanosis if hypoxic
Raised JVP with V waves
RV heave
Tricuspid regurgitation

30
Q

risk factors for DVT and PE

A 
Thrombophilia
Contraceptive pill
Pregnancy
Surgery
Immobility
31
Q

what is the 1st line investigation of DVT

A

Ultrasound Doppler Leg scan

32
Q

what the ABG of a PE

A

Decreased PaO2
Decreased SaO2
(Type 1 resp failure
PaCO2 normal or low)

33
Q

when is a CT pulmonary angiogram used in PE

A

image pulmonary artery filling defect - only pick up larger clots in proximal vessels

34
Q

when is a leg and pelvic ultrasound used in PE

A

to detect silent DVT

35
Q

when is gas transfer factor (DCLO) used in PE

A

to measure perfusion defect

36
Q

what is the first line recommended initial investigation for PE

A

Computed Tomographic Pulmonary Angiography (CTPA)

37
Q

what is the initial treatment of PE

A

Low Molecular Weight Heparin (LMWH)
And
Warfarin

38
Q

when would thrombolyse be used

A

Massive PE + Hypotension

39
Q

when should heparin be stopped in PE

A

3-5 days

when INR >2

40
Q

how long is warfarin continued in PE treatment

A

for 3-6 months

41
Q

how is Warfarin and Heparin reversed

A

Warfarin - Vit K1

Heparin - protamine

42
Q

what is the pathology of diffuse pleural thickening

A

Extensive fibrosis of visceral pleura with adhesion to parietal pleura

Respiratory SB (14 decks)

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