Week 8 Flashcards

1
Q

4 endotypes of COPD

A
  1. eosinophilic
  2. alpha 1 anti trypsin
  3. persistent bacterial colonisation
  4. persistent systematic inflammation
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2
Q

3 COPD phenotypes

A
  1. frequent exacerbations
  2. persistent breathlessness
  3. chronic bronchitis
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3
Q

3 T1RF signs

A

pursed lips
accessory muscles
wheeze

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4
Q

3 T2RF signs

A

flapping tremor
increased JVP
warm peripheries
cyanosis

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5
Q

3 treatments for pneumothorax

A
  1. aspiration
  2. intercostal drain
  3. VAT
    talc pleurodises
    pleural abrasion
    staple blebs
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6
Q

3 pleural effusion examination signs

A

clubbing
ascites
lymphadenopathy

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7
Q

3 features of parapneumoic effusion

A
  1. LDH over 1000
  2. Glucose less than 2.2
  3. ph less than 7.2
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8
Q

4 management of pleural infection

A

antibiotics
fibrinolytic
drain
surgery

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9
Q

5 clinical signs of pleural effusion

A
  1. decreased chest expansion
  2. decreased tactile fremitis
  3. quiet breath
  4. rub
  5. stony dull percussion
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10
Q

OSA defintion

A

recurrent partial or complete airflow obstruction during sleep, intermittent hypoxia and sleep fragmentation

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11
Q

measure for OSA

A

apnoea hypoxia index
ap+hypop / total time asleep

normal 0-4
moderate 15-29

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12
Q

OSA symtoms

A
excessive daytime sleepiness with 2 +:
choking
decreased concentration 
recurrent awaking 
fatigue 
unrefreshing sleep
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13
Q

apnoea

A

decreased airflow of over 90% for at least 10 seconds

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14
Q

hypopnea

A

dressed airflow of over 30% for at least 10 seconds

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15
Q

pathophysiology of OSA

A

pharyngeal narrowing
negative thoracic pressure
increases BP
decreases sleep

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16
Q

epworth sleepiness score

A

0 to 10 = normal range of sleepiness in healthy adults.
11 to 14 = mild sleepiness.
15 to 17 = moderate sleepiness.
18 to 24 = severe sleepiness

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17
Q

2 quizzes in OSA

A

stop bang

berlin

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18
Q

oxygen desaturation index

A

no of times per hour that spo2 goes less than 4% from baseline

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19
Q

compliance in CPAP

A

over 4 hours for over 70 days

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20
Q

what is wheeze

A

narrowing

allergy

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21
Q

what is stridor

A

whistling inspiration

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22
Q

4 histological changes in asthma

A
  1. subepithalial fibrosis
  2. smooth muscle hypertrophy
  3. thick BM
  4. mast cell
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23
Q

bronchial hyper responsiveness

A

drop of over 20% FEV1 by less than 8mg/ml of histamine or mannitol

24
Q

reversible airflow obstruction

A

over 15% improvement in FEV1 after 5mg nebulised salbutamol

25
Q

4 triggers of extrinsic allergic alveolitis

A

moulds
humidifiers lung
organic dust
pigeon fanciers lung

26
Q

in EEA which type of hypersensitivity acute

A

3

27
Q

in EEA which type of hypersensitivity subacute

A

4

28
Q

4 clinical consequences of EEA

A

septa thickening
loss of O2 with normal CO2
airspace shadowing
T1RF

29
Q

management of EEA

A
  1. avoid trigger
  2. corticosteroids
  3. oxygen
30
Q

4 lung cancer risks

A
  1. smoking
  2. HPV
  3. radiation
  4. polymorphisms in p450
31
Q

2 lung cancers in smoking

A

small cell and squamous cell

32
Q

2 consequences of a central tumour

A

hemoptisis

bronchial obstruction

33
Q

1 consequences of a peripheral tumour

A

pain

34
Q

3 consequences of a tumour in mediastinum

A

SVC obstruction and increased JVP
recurrent laryngeal
phrenic nerve paralysis

35
Q

3 non metatsic effects of lung cancer

A

ACTH - cuhsings
ADH - SIADH
PTH related peptide - hypercalcemia

36
Q

4 appearance of small cell

A
  • oval to spindle shaped
  • inconspicuous nuclei
  • scant cytoplasm
  • nuclear moulding
37
Q

who gets adenocarcinoma and where is it

A

in periphery

non smoking females

38
Q

4 appearance of adenocarcinoma

A

glandular
muslin production
solid
papillary

39
Q

squamous cell carcinoma where

A

major bronchi

40
Q

3 appearance of squamous cell carcinoma

A

cavitation
intracellular bridges
keratinisation

41
Q

diagnose of large cell carcinoma

A

diagnosis of exclusion

sheets of malignant undifferentiated cells

42
Q

6 other lung tumours

A
carcinoid 
mesenchymal 
salivary gland 
germ cell
lymphatic
43
Q

non small cell lunger cancer med

A

EML 4 ALK

44
Q

what are 5 sarcoidosis symptoms

A
fever 
night swetas
weight loss
hemoptysis
iritis
cough
chest apin
45
Q

3 physical findings of sarcoid

A

nodules on skin
cardiac rub
non specific neurological

46
Q

4 stages of sarcoid

A
  1. bilateral hilar lympahdenopathy no infiltration
  2. bel with infilled
  3. infiltration alone
  4. fibrotic bands, bull, hilarious retraction
47
Q

non nectrosing granulomatous

A

sarcoidosis

48
Q

2 treatment of sarcoid

A

NSAIDs

steroids

49
Q

4 histological of sarcoid

A

mastoid body
cytokeritin
calcification
nuclei with giant cell

50
Q

idiopathic pulmonary fibrosis 6 features

A
breathlessness
clubbing
periperal linterstital pattern
sub pleural honeycombing
clubbing
bibasalr crackles
51
Q

5 clinical presentation of IPF

A
bretahless
hacking dry cough
featigue
weight loss
clubbing
52
Q

4 causes of non IPF

A

CTD
cocaine
sarcoid
genetic

53
Q

2 diagnose of IPF

A

HRCT

VATS

54
Q

treatment of IPF

A

pirfenidone

55
Q

fibroblastic foci
spatial heterogeneity
chicken wire

A

UIP