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Respiratory > Zero to Finals > Flashcards

Zero to Finals Flashcards

1
Q

61 year old smoker with haemotysis?

Diagnosis and types?

A

Lung cancer

Adenocarinoma (40%)
Squamous cell carincoma (20%)
Small cell lung cancer (20%)

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2
Q

61 year old smoker with haemotysis.

Cause of a hoarse voice?

A

Recurrent laryngeal nerve palsy

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3
Q

61 year old smoker with haemotysis.

Cause of partial ptosis, anhidrosis and miosis?

A

Horner’s syndrome -> Pancoast’s tumour

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4
Q

61 year old smoker with haemotysis.

Cause of hyponatraemia?

A

SIADH -> SCLC

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5
Q

61 year old smoker with haemotysis.

Investigation for getting histological diagnosis?

A

Bronchoscopy with EBUS and biopsy

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6
Q

61 year old smoker with haemotysis.

Scan for increased metabolic activity in metastasis?

A

Position emission tomography (PET-CT)

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7
Q

61 year old smoker with haemotysis.

Malignancy associated with asbestos

A

Mesothelioma

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8
Q

72 year old presents with a productive cough, fever and breathlessness. A CXR shows a right sided, middle zone consolidation.

Diagnosis?

A

Pneumonia

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9
Q

72 year old presents with a productive cough, fever and breathlessness. A CXR shows a right sided, middle zone consolidation.

Criteria for hospital acquired pneumonia?

A

> 48hrs after admission

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10
Q

72 year old presents with a productive cough, fever and breathlessness. A CXR shows a right sided, middle zone consolidation.

Scoring system?

A

CURB 65

Confusion 
Urea >7 
Resp rate >/ 30 
Blood pressure <90 systolic/< or equal to 60 diastolic 
Over 65 years old
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11
Q

72 year old presents with a productive cough, fever and breathlessness. A CXR shows a right sided, middle zone consolidation.

Most common cause?

A

Streptococcus pneumoniae

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12
Q

72 year old presents with a productive cough, fever and breathlessness. A CXR shows a right sided, middle zone consolidation.

Atypical cause with hyponatraemia?

A

Legionella pneumoniae

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13
Q

72 year old presents with a productive cough, fever and breathlessness. A CXR shows a right sided, middle zone consolidation.

Atypical cause with erythema multiforme?

A

Mycoplasma

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14
Q

72 year old presents with a productive cough, fever and breathlessness. A CXR shows a right sided, middle zone consolidation.

Atypical cause with farmer?

A

Coxiella burnetti (Q-fever)

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15
Q

72 year old presents with a productive cough, fever and breathlessness. A CXR shows a right sided, middle zone consolidation.

Atypical cause with parrot breeder?

A

Chlamydia psittaci

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16
Q

72 year old presents with a productive cough, fever and breathlessness. A CXR shows a right sided, middle zone consolidation.

Atypical cause with chronic wheezy child?

A

Chlamydophilia

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17
Q

19 year old with chronic nocturnal cough and wheezing episode.

Diagnosis?

A

Asthma

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18
Q

19 year old with chronic nocturnal cough and wheezing episode.

First line testing with NICE guidelines?

A

Fractional exhaled nitrous oxide (DeNO)

Spirometry with reversibility testing

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19
Q

19 year old with chronic nocturnal cough and wheezing episode.

Treatment step 1 & 2?

A

Step one: SABA

Step two: Low dose inhaled corticosteroids

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20
Q

19 year old with chronic nocturnal cough and wheezing episode.

Mechanism of action of salneterol?

A

Long acting beta 2 agonist

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21
Q

19 year old with chronic nocturnal cough and wheezing episode.

Mechanism of action of tiotropium?

A

Long acting muscarinic antagonist

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22
Q

19 year old with chronic nocturnal cough and wheezing episode.

Mechanism of action of montelukast?

A

Leukotriene receptor antagonist

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23
Q

19 year old with chronic nocturnal cough and wheezing episode.

Mediations used in moderate attack?

A

Nebulised salbutamol
Nebulised ipratropium bromide
Steroids

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24
Q

Long term smoker with a chronic cough and recurrent chest infections?

Diagnosis?

A

COPD

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25
Q

Long term smoker with a chronic cough and recurrent chest infections?

Dyspnoea scale?

A

MRC Dyspnoea Scale

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26
Q

Long term smoker with a chronic cough and recurrent chest infections?

Diagnostic test?

A

Spirometry

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27
Q

Long term smoker with a chronic cough and recurrent chest infections?

FEV1/FVC ratio?

A

< 0.7

28
Q

Long term smoker with a chronic cough and recurrent chest infections?

Step 1 of treatment?

A

Short-acting bronchodilators

29
Q

Long term smoker with a chronic cough and recurrent chest infections?

Step two of treatment if asthmatic?

A

LABA + inhaled corticosteroids

30
Q

Long term smoker with a chronic cough and recurrent chest infections?

Step 2, no asthmatic features?

A

LABA + LAMA

31
Q

Long term smoker with a chronic cough and recurrent chest infections?

Treatment of an acute exacerbation?

A
  • Bronchodilators (eg Ipratropium)
  • Steroids (eg Prednisolone)
  • Antibiotics if infection)
32
Q

Long term smoker with a chronic cough and recurrent chest infections?

Target sats when retaining CO2?

A

88-92%

33
Q

Long term smoker with a chronic cough and recurrent chest infections?

Criteria for non-invasive ventilation (NIV)?

A

pH < 7.35

PaCO2 > 6 despite treatment

34
Q

74 year old non-smoker with bibasal fine inspiratory crackles?

Fingernail changes?

A

Clubbing

35
Q

74 year old non-smoker with bibasal fine inspiratory crackles?

Diagnosis?

A

Idiopathic pulmonary fibrosis

36
Q

74 year old non-smoker with bibasal fine inspiratory crackles?

Diagnostic test?

A

High resolution CT

37
Q

74 year old non-smoker with bibasal fine inspiratory crackles?

Characteristic test finding?

A

“Ground glass” appearance to lungs

38
Q

74 year old non-smoker with bibasal fine inspiratory crackles?

Life expectancy post diagnosis?

A

2-5 years

39
Q

74 year old non-smoker with bibasal fine inspiratory crackles?

Medication to slow disease progression?

A
  • Pirfendione

- Nintedanib

40
Q

74 year old non-smoker with bibasal fine inspiratory crackles?

Medication that cause similar lung pathology?

A
  • Amiodarone
  • Cyclopathosphamide
  • Methotrexate
  • Nitrofurantoin
41
Q

21 year old tall slim male with sharp chest pain on inspiration and shortness of breath.

Diagnosis?

A

Pneumothorax

42
Q

21 year old tall slim male with sharp chest pain on inspiration and shortness of breath.

Investigations?

A

Chest X-ray

43
Q

21 year old tall slim male with sharp chest pain on inspiration and shortness of breath.

Cutoff for treatment if not short of breath?

A

More than 2cm rim of air on CXR

44
Q

21 year old tall slim male with sharp chest pain on inspiration and shortness of breath.

Treatment options?

A
  • Aspiration

- Chest Drain

45
Q

56 year old with progressive shortness of breath?

Diagnosis?

A

Pulmonary hypertension

46
Q

56 year old with progressive shortness of breath?

5 groups of causes?

A
  1. Primary pulmonary hypertension
  2. Left sided heart failure
  3. Chronic lung disease (eg COPD)
  4. Pulmonary vascular disease (eg PE)
  5. Miscellaneous (eg sarcoidosis)
47
Q

56 year old with progressive shortness of breath?

Clinical skills?

A
  • Tachycardia
  • Hepatomegaly
  • Raised JVP
  • Peripheral oedema
48
Q

56 year old with progressive shortness of breath?

ECG changes?

A
  • Right ventricular hypertrophy
  • Right axis deviation
  • Right bundle branch block
49
Q

56 year old with progressive shortness of breath?

Chest Xray?

A
  • Dilated pulmonary veins

- Right ventricular hypertrophy

50
Q

56 year old with progressive shortness of breath?

Raised blood test?

A

NR-PRO BNP

51
Q

30 year old black woman with a dry cough and shortness of breath?

Diagnosis?

A

Sarcoidosis

52
Q

30 year old black woman with a dry cough and shortness of breath?

What are granulomas?

A

Nodules of inflammation full of macrophages

53
Q

30 year old black woman with a dry cough and shortness of breath?

Tender lumps on shins?

A

Erythema nodosum

54
Q

30 year old black woman with a dry cough and shortness of breath?

Screening blood test?

A

Serum ACE

55
Q

30 year old black woman with a dry cough and shortness of breath?

Electrolyte abnormality?

A

Hypercalcaemia

56
Q

30 year old black woman with a dry cough and shortness of breath.

CXR finding?

A

Hilar lymphadenopathy

57
Q

30 year old black woman with a dry cough and shortness of breath?

Gold standard investigation?

A

Histology (biopsy)

58
Q

30 year old black woman with a dry cough and shortness of breath?

First line treatment?

A

Steroids

59
Q

57 year old obese man presents with snoring and daytime sleepiness. His wife reports episodes where he stops breathing during sleep.

Diagnosis?

A

Obstructive Sleep Apnoea

60
Q

57 year old obese man presents with snoring and daytime sleepiness. His wife reports episodes where he stops breathing during sleep.

Risk factors not mentioned?

A
  • Smoking

- Alcohol

61
Q

57 year old obese man presents with snoring and daytime sleepiness. His wife reports episodes where he stops breathing during sleep.

Key morning symptom?

A

Headache

62
Q

57 year old obese man presents with snoring and daytime sleepiness. His wife reports episodes where he stops breathing during sleep.

Scale?

A

Epworth sleepiness scale

63
Q

57 year old obese man presents with snoring and daytime sleepiness. His wife reports episodes where he stops breathing during sleep.

Refer to?

A

ENT/Sleep clinic

64
Q

57 year old obese man presents with snoring and daytime sleepiness. His wife reports episodes where he stops breathing during sleep.

Step after correcting risk factors?

A

Continuous positive airway pressure (CPAP) machine used during sleep

65
Q

57 year old obese man presents with snoring and daytime sleepiness. His wife reports episodes where he stops breathing during sleep.

Surgical prodecure?

A

Uvulopalatopharyngoplasty

UPPP

Respiratory (32 decks)

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