Week 3 Flashcards
A 50 year old lifelong smoker presents with a persistent cough for 3 weeks with haemoptysis, and has noticed some weight loss. Diagnosis?
Lung cancer
Female 40 smoker presents with hoarse voice and stridor, and tiredness. Diagnosis?
Tumour in trachea compressing laryngeal nerve
What are some of the clinical findings of someone with lung cancer?
Finger clubbing Enlarged lymph glands Dull percussion Stridor Dysponea Thrombophlebitis (rare and red vein)
What is a pancoast tumour? Where does it effect?
Tumour of the pulmonary apex usually non-small cell cancers.
Can cause weakness and lack of control of the arm due to compression of brachial plexus
What are the common metastatic sites of lung cancer?
Liver, brain, bone, adrenal, skin
What are the four classifications of lung tumours?
Adenocarcinoma (glandular cancer)
Squamous carcinoma (keratin deposition)
Small cell carcinoma (worse type)
Large cell carcinoma (large cells no differntiation)
At what stage in development are the lungs made? What are they made from?
Week 5
Budded from oesophagus
When are the lung lobes and alveoli made during embryological development?
Week 6 for lobes
Week 8 for alveoli
What is the function of the conchae?
To cause turbulence of air allowing heating and moistening
What are the function of club cells in the bronchioles?
That detoxify and modulate immune and surfactant production
What is the function of type 2 alveolar cells? What is their cell description
To produce surfactant, they are polygonal shape with lamellar bodies that secrete surfactant
Women who is a non-smoker who presents with lung cancer. What is the most likely type she has?
Adenocarcinoma
During lung formation, what structure are they budded from? At what week?
Oesophagus week 5
At what week does the lung bud to make lobes and branches?
Week 6
What occurs in week 8 of embryological of lung development?
Alveoli
What is the treatment for small cell cancer?
Chemotherapy
What is the cell type in the oesophagus?
Squamous cell
What is the cell type in the stomach
Cuboidal
What is the difference between epidemic and pandemic?
Epidemic is due to antigenic drift (where the surface proteins slightly change) occuring in a set area
Pandemic is prevalent in a whole country or the world, occurring due to the complete changing of surface antigens
What is the treatment for small cell lung cancer?
Chemotherapy
What are the treatment options for non-small cell lung cancer?
Surgery, radiotherapy, chemo
What are some of the side effects to cytotoxic chemotherapy?
Opportunistic infection, hair loss
Women is suffering from stridor due to incurable lung cancer. What palliative care could you provide for this?
Stent to stop stridor
What is a transudate?
If proteins within a pleural effusion are less than 30
Transudate Tiny
What is an exudate?
When there are more than 30 proteins in a pleural effusion
Man presents with breathlessness, fever, weight loss, and a cough. He used to work on a shipyard. Diagnosis?
Exposure to asbestos
So mesothelioma
What are the treatment options for mesothelioma?
Radiotherapy
Chemotherapy
Surgery
What score is used to determine survival rates in those with malignant pleural effusions?
LENT score
Young man presents having fallen in the park, he has quiet breath sounds on auscultation, reduced chest expansion unilaterally, and has pain in the right side of his chest. Diagnosis?
Pneumothorax
How would treat an emergency pneumothorax?
Insert a large bore cannulae in 2nd intercostal space of mid-clavicular line
Where would you insert a chest drain for complete management of a pneumothorax?
4th intercostal space mid-axillary line
What is the orientation of the intercostal muscles?
External; hands in pockets
Internal; hands on chest
Innermost; horizontal
What is the function of the pectoralis major muscle for deep inspiration?
When arms in a fixed position it allows the elevation of the clavicle and expansion of the chest
What nerve stimulates contraction forming guarding on the abdominal muscles?
Thoracoabdominal
What are some of the causative organisms for community acquired pneumonia?
Pneumococcus
Haemophilus influenzae
Coliforms ( klebsiella, ecoli, enterobacter)
Women presents with mild community acquired pneumonia. Traetment?
Amoxicillin for 5 days
Women presents with severe community acquired pneumonia. Treatment?
Co-amoxiclav IV
Doxycycline
What are some of the causative organisms for hospital acquired pneumonia?
Pneumococccus, haemophilus influenzae
More likely coliforms (ecoli, klebsiella, proteus, enterobacter)
What do you use to treat non-severe hospital acquired pneumonia
Amoxicillin
Metronidazole
What do youuse to treat severe hospital acquired pneumonia
Amoxicillin
Metronidazole
Gentamicin
All IV
The stage of lung maturation that takes place between 6-16 weeks’ gestation. It involves the development of multiple branches of the bronchial tree down to the level of the terminal bronchioles.
Pseudoglandular
The stage of lung maturation that takes place between 26 days’ and 6 weeks’ gestation. It involves the first stages of lung development, and sees the formation of the lungs’ lobes and segments.
Embryonic
The germ layer that forms the cartilage and smooth muscle in the thorax.
Visceral mesoderm
What does the vagus nerve innervate?
The soft palate and intrinsic laryngeal muscles
What does stimulation of the glossopharyngeal and vagus nerve cause?
A cough reflex response
- The stage of lung maturation that takes place between 16-28 weeks’ gestation. It sees the branching of terminal bronchioles into respiratory bronchioles and finally alveolar ducts.
Canalicular
What germ layer forms the lining of the trachea and bronchial tree?
The endoderm
What is the first respiratory structure to develop
Respiratory diverticulum
What occurs during the pseudoglandular phase of lung developemnt
Bronchial branches are formed, occuring 6-16 weeks gestation
What stage of lung development is surfactant beginning to be produced
Saccular stage 28-36 weeks
What tumour produces keratin pearls and may produce thyroid transcription factor?
Squamous carcinoma
