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Pulmonology > Pulmonary causes > Flashcards

Pulmonary causes Flashcards

1
Q

Causes of apical lung fibrosis

A
  • Tuberculosis (TB)
  • Extrinsic allergic alveolitis
  • Ankylosing spondylitis
  • Allergic bronchopulmonary aspergillosis
  • Radiation
  • Sarcoidosis
  • Histiocytosis X
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2
Q

Causes of lower lung fibrosis

A
  • Cryptogenic fibrosing alveolitis
  • Asbestosis
  • Aspiration pneumonia
  • Rheumatoid arthritis
  • Drug-related pulmonary fibrosis
  • Systemic sclerosis
  • Sarcoidosis
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3
Q

Tracheal deviation - Pulled toward pathology (inside lung)

A
  • Atelectasis
  • Pneumonectomy
  • Diaphragmatic paralysis
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4
Q

Tracheal deviation - Pulled away from pathology (outside lung)

A
  • Massive pleural effusion
  • Tension Pneumothorax
  • Neck or thyroid mass
  • Large mediastinal mass
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5
Q

Raised TLCO

A
  • Asthma
  • Pulmonary haemorrhage (Wegener’s, Goodpasture’s)
  • Left-to-right cardiac shunts
  • Polycythaemia
  • Hyperkinetic states
  • Male gender, exercise
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6
Q

Lower TLCO

A
  • COPD (much trapped air)
  • Emphysema
  • Pneumonia
  • Pulmonary oedema
  • Pulmonary fibrosis
  • Pulmonary emboli
  • Anaemia
  • Low cardiac output
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7
Q

Bronchiectasis

A
  • Post-infective: tuberculosis, measles, pertussis, pneumonia
  • Allergic bronchopulmonary aspergillosis (ABPA)
  • Immune deficiency: selective IgA, hypogammaglobulinaemia
  • Bronchial obstruction e.g. lung cancer/foreign body
  • Cystic fibrosis
  • Ciliary dyskinetic syndromes: Kartagener’s syndrome, Young’s syndrome
  • Yellow nail syndrome (lymphoedema, pleural effusion & yellow nail)
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8
Q

Most common organisms isolated from patients with bronchiectasis

A
  • Haemophilus influenzae (most common)
  • Pseudomonas aeruginosa
  • Klebsiella spp.
  • Streptococcus pneumoniae
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9
Q

Causes of false positive sweat test

A
  • Malnutrition
  • Glycogen storage diseases
  • G6PD
  • Adrenal insufficiency
  • Nephrogenic diabetes insipidus
  • Hypothyroidism, hypoparathyroidism
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10
Q

Pulmonary eosinophilia

A
  • Churg-Strauss syndrome
  • Allergic bronchopulmonary aspergillosis (ABPA)
  • Loffler’s syndrome
  • Eosinophilic pneumonia
  • Hypereosinophilic syndrome
  • Tropical pulmonary eosinophilia
  • Nitrofurantoin, sulphonamides, daptomycin
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11
Q

Causes of mismatch in V/Q

A
  • PE
  • Old pulmonary embolisms
  • AV malformations
  • Vasculitis
  • Previous radiotherapy

Note: COPD gives matched defects

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12
Q

Oxidant drugs (can cause methemoglobinemia)

A
  • Metoclopramide
  • Dapsone
  • Sulfonamides
  • Local anesthetics (lidocaine)
  • Nitrates

Link

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13
Q

Pleural glucose < 3.3 MMOL

A
  • Tuberculous effusion (typically around 80’s)
  • Malignant effusion (typically around 60’s)
  • Parapneumonic effusion/Empyema
  • Rheumatoid effusion (VERY low, typically < 30’s)
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14
Q

Causes of elevated pleural fluid amylase

A
  • Malignancy
  • Esophageal rupture
  • Pancreatic disease
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15
Q

Causes of low pH < 7.2 in pleural fluid

A

In exudates:
* Complicated parapneumonic effusion/ empyema
* Malignancy
* RA
* TB.

In transudates:
* Urinothorax

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16
Q

Most common causes of malignant effusion

A
  • Lung cancer 30 %
  • Breast cancer 25 %
  • Lymphoma 20 %
17
Q

Eosinophilic pleural effusion

A
  • Air or blood in the pleural space (e.g., pneumothorax, hemothorax)
  • Infectious processes (particularly parasitic)
  • Malignancy (especially Hodgkin lymphoma)
  • Pulmonary embolism
  • Benign asbestos

Link

Pearl: Presence of eos and > 5% mesothelial cells makes TB unlikely

18
Q

> 50% lymphocytes in pleural effusion

A
  • TB
  • Fungal
  • Malignancy
19
Q

PMN predominance in pleural effusion

A
  • Parapneumonic
  • Pancreatitis
  • PE
  • Peritonitis
20
Q

Differential of turbid, pale or whitish pleural fluid

A
  • Chylothorax
  • Pseudochylothorax
  • Complicated parapneumonic effusions (empyema)
21
Q

Chemicals associated with occupation-related asthma

A
  • Diisocyanates
  • Persulfates
  • Aldehydes
  • Amines
22
Q

Differential diagnosis of bilateral hilar adenopathy

A
  • Sarcoidosis
  • Lymphoma
  • Tuberculosis
  • Pneumoconiosis
  • Berylliosis
  • Fungal diseases like histoplasmosis.

Note: no amyloidosis

23
Q

Bacterial causes of postinfluenza pneumonia

A
  • Streptococcus pneumoniae
  • Staphylococcus aureus
24
Q

Disorders associated with increase D-dimer

A
  • Arterial thromboembolic disease
  • Venous thromboembolic disease
  • DIC / severe sepsis
  • Preeclampsia and eclampsia
  • Vaso-occlusive episode of sickle cell disease
  • Systemic inflammatory response syndrome
  • Severe liver disease /Renal disease
  • Malignancy
  • Normal pregnancy
25
Q

Causes of central sleep apnea

A
  • Heart failure
  • Left heart disease
  • CNS
  • Medications (opioids)
  • Hypercapnia
  • High altitude
26
Q

Causes of increased vocal resonance

A
  • Consolidation
  • Bronchiectasis
  • Cavitation
  • Mass
27
Q

Causes of decreased vocal resonance

A
  • Pleural effusion
  • Pneumothorax
  • Lung fibrosis
  • Lobectomy
  • Pneumonectomy
28
Q

Drugs that can cause pneumonitis and/or pulmonary fibrosis

A
  • Amiodarone
  • Nitrofurantoin
  • Methotrexate
  • Cyclophosphamide
  • Bleomycin
29
Q

Cavitating lung lesion in x-ray

A
  • Staphylococcus aureus
  • Klebsiella pneumoniae
  • Squamous Cell Lung Cancer
  • Tuberculosis (TB)
  • Granulomatosis with Polyangiitis (formerly known as Wegener’s Granulomatosis)
  • Aspergillosis
  • Histoplasmosis
  • Coccidioidomycosis
30
Q

Bilateral interstitial infiltrates

A
  • Pneumocystis jirovecii (formerly known as Pneumocystis pneumonia or PCP)
  • Mycoplasma pneumoniae
  • Chlamydophila pneumoniae (formerly known as Chlamydia pneumoniae)
  • Various Viral infections
31
Q

Lobar pneumonia

A
  • Streptococcus pneumoniae (Pneumococcus)
  • Haemophilus influenzae
  • Klebsiella pneumoniae
32
Q

Interventions in COPD with survival benefit

A
  • Smoking cessation: The most effective intervention. Reduces the rate of decline in lung function and improves survival rates significantly.
  • Long-term oxygen therapy (LTOT): Improves survival in severe COPD with chronic hypoxemia.
  • Pulmonary rehabilitation: Improves quality of life and exercise tolerance, and can decrease hospitalizations, but direct impact on survival is less clear in the literature.
  • Lung Volume Reduction Surgery (LVRS): Has shown survival benefit in selected groups of patients, particularly those with upper lobe predominant emphysema and low exercise capacity.
  • Lung transplantation: Provides survival benefit in selected patients, usually those with advanced disease not responding to other treatments.

Pulmonology (9 decks)

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