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1
Q

Obstructive lung disease includes which conditions

A

Asthma
COPD
Bronchiectasis
Bronchiolitis obliterans

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2
Q

what is bronchiectasis

A

result of chronic inflammation compounded by an inability to clear mucoid secretions = enlargement of parts of the airways of the lung. Most commonly seen in cystic fibrosis

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3
Q

restrictive lung diseases include

A 
Pulmonary fibrosis
Asbestosis
Sarcoidosis
Acute respiratory distress syndrome
Infant respiratory distress syndrome
Kyphoscoliosis
Neuromuscular disorders
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4
Q

FEV1 in obstructive

A

FEV1 - significantly reduced

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5
Q

FEV1 in restrictive

A

FEV1 - reduced

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6
Q

FVC in obstructive

A

FVC - reduced or normal

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7
Q

FVC in restrictive

A

FVC - significantly reduced

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8
Q

FEV1% (FEV1/FVC) in restrictive

A

FEV1% (FEV1/FVC) - normal or increased

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9
Q

FEV1% (FEV1/FVC) in obstructive

A

FEV1% (FEV1/FVC) - reduced

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10
Q

B-type natriuretic peptide test is for

A

heart failure

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11
Q

X-ray: Trachea pulled toward the white-out

A

Pneumonectomy or Complete lung collapse

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12
Q

X-ray: Trachea central beside white-out

A

Consolidation
Pulmonary oedema (usually bilateral)
Mesothelioma

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13
Q

X-ray: Trachea pulled away from the white-out

A

Pleural effusion
Diaphragmatic hernia
Large thoracic mass

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14
Q

first line asthma control

A

low-dose inhaled corticosteroid in combination with a short-acting beta agonist.

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15
Q

Asthma: a sign that further add-on therapy is needed.

A

Having to use a SABA more than 3 times per week

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16
Q

2nd line asthma control

A

add in LABA

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17
Q

3rd line asthma control if NO response to LABA

A

stop LABA and increase dose of ICS to medium-dose

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18
Q

3rd line asthma control if there is a response to LABA

A

continue LABA and increase ICS to medium-dose. An alternative to this is to continue on the current treatment but consider a trial of a leukotriene receptor antagonist, SR theophylline or a long-acting muscarinic antagonist (LAMA)

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19
Q

4th line asthma control

A

increasing the ICS to high-dose, OR
the addition of a fourth drug (e.g. a leukotriene receptor antagonist, SR theophylline, a LAMA or an oral beta-agonist tablet)
patient should be referred to specialist care at this point

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20
Q

examples of inhaled corticosteroids

A

Beclometasone dipropionate

Fluticasone propionate

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21
Q

scoring system for suspected PE

A

wells score

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22
Q

what wells score will suggest a PE

A

5 or more

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23
Q

Investigation if wells core 5+

Study These Flashcards
A

CTPA, if delay give LMWH

24
Q

Investigation if wells core 4 or less

Study These Flashcards
A

D-dimer, id comes back positive then CTPA

25
what wells score will suggest NO PE
4 or less
26
Other than recent foreign travel which features strongly suggest Legionella (3)
flu-like symptoms hyponatraemia pleural effusion
27
how do you diagnose legionella
urine antigen
28
legionella treatment
erythromycin
29
what type of AB is erythromycin
macrolide
30
chest infection + low sodium think
legionella
31
what is a low inhaled corticosteroid (beclametisone) doses
200mcg bd
32
CURB65 criteria
Confusion (abbreviated mental test score <= 8/10) U Urea >7 mmol/L R Respiration rate >= 30/min B Blood pressure: systolic <= 90 mmHg and/or diastolic <= 60 mmHg 65 Aged >= 65 years
33
CURB65: urea
Urea >7 mmol/L
34
CURB65: RR
> 30/min
35
CURB65: BP
systolic <= 90 mmHg and/or diastolic <= 60 mmHg
36
CURB65: confusion
abbreviated mental test score <= 8/10
37
CURB65: score of 1
Sa02 assessed which should be >92% to be safely managed in the community and a CXR performed
38
CURB65: score 2+
managed in hospital as this represents a severe community acquired pneumonia.
39
Granulomatosis with polyangiitis; what vessel size
small
40
epistaxis, nasal crusting, x-ray demonstrates multiple cavitary lesions
Granulomatosis with polyangiitis **also get saddle shape nose**
41
Granulomatosis with polyangiitis investigations
cANCA positive in > 90%, pANCA positive in 25% chest x-ray: wide variety of presentations, including cavitating lesions renal biopsy: epithelial crescents in Bowman's capsule
42
Granulomatosis with polyangiitis management
steroids cyclophosphamide (90% response) plasma exchange
43
O2 sats target for COPD
prior to availability of blood gases, use a 28% Venturi mask at 4 l/min and aim for an oxygen saturation of 88-92% for patients with risk factors for hypercapnia but no prior history of respiratory acidosis adjust target range to 94-98% if the pCO2 is normal
44
CT chest showing widespread tram-track and signet ring signs
bronchiectasis
45
what is a normal FEV1
> 80%
46
How many stages of COPD is there
4: mild, moderate, severe, very severe
47
4 COPD stages
FEV1 of predicted 1: mild >80% 2: Moderate 50-79% 3: severe 30-49% 4: very severe < 30%
48
examples of atypical pneumonias (2)
Mycoplasma pneumonia & legionella
49
Most common causes of typical community acquired pneumonia (2)
Streptococcus pneumoniae and Haemophilus influenzae are the commonest
50
Treatment for atypical pneumonias
macrolides: erythromycin/clarithromycin or doxy as alternative
51
diagnostic test for Mycoplasma pneumonia
serology
52
Pneumonia seen in immunocompromised patients
Pneumocystis jiroveci
53
Pneumocystis jiroveci pneumonia, what is a common feature
desaturate on walking
54
which pneumonia is most commonly seen in elderly and IVD users
Staphylococcal pneumonia
55
which pneumonia is most commonly seen in young people
Mycoplasma pneumonia
56
Pneumonia associated with erythema multiforme and cold autoimmune haemolytic anaemia
Mycoplasma pneumonia

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