Mixed Lecture questions Flashcards

1
Q

the common cold is usually caused by what virus

A

rhinovirus

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2
Q

what bacteria is epiglottitis commonly caused by

A

H influenzae

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3
Q

what are the clinical features of asthma

A

wheeze
chest tightness
breathlessness
cough

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4
Q

what investigations can help confirm asthma

A

spirometry
challenge test
peak expiratory flow rate monitoring

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5
Q

what is the treatment for acute asthma

A

O2
nebulised SABA
IV aminophylline
Antibiotics if there is infection

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6
Q

what are the main pathological features of COPD

A

mucous hypersecretion
tissue destruction
small airway inflammation and fibrosis

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7
Q

what are the clinical features of COPD

A
tightness 
wheeze SOB
hyperinflated chest
central cyanosis 
productive cough 
accessory muscle use 
prolonged expiration 
cor pulmonale
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8
Q

what are investigations that can be done to diagnose COPD

A
spirometry 
ABG-arterial blood gas
FBC-look for hypoxia 
CXR
Echo-cor pulmonale
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9
Q

what lifestyle factors can a patient change to improve their symptoms of COPD

A

if obese lose weight
stop smoking
pulmonary rehabilitation

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10
Q

what is the management of COPD in general

A
patients offered vaccines for flu etc
pulmonary rehabilitation therapy 
SABA
LABA- if symptoms get worse
high does inhaled steroid if FEV1
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11
Q

how are exacerbation’s of COPD managed

A

O2
nebulised bronchodilator
iv Aminophylline
antibiotics if there is infection

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12
Q

what are the causative agents of pneumonia

A

strept pneumonia
staph aereus
haemophillus influenzae

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13
Q

what are the investigations to diagnose TB

A

3 sputum specimens:

  1. sputum smear with Ziehl Neilsen stain
  2. sputum culture
  3. sputum PCR

CXR
CT scan of thorax
bronchoscopy
pleural aspiration and biopsy

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14
Q

what are the TB drugs used for 4 months

A

Rifampicin
Isoniazid
Ethambutol
Pyrazinamide

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15
Q

what are the TB drugs used for 2 months

A

Rifampicin

Isoniazid

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16
Q

what are the side effects of Rifampicin

A

Orange irn bru tears and urine
induces liver enzymes
OCP ineffective
Hepatitis

17
Q

what are the side effects of Isoniazid

A

hepatitis

peripheral neuropathy

18
Q

what are the side effects of Ethambutol

A

optic neuropathy

19
Q

what re the side effects of pyrazinamide

A

gout

20
Q

what are features a patient may present with that suggest lung cancer

A

heamoptysis
weight loss
poor appetite
breathless and cough

21
Q

what are extrapulmonary signs a patient may have lung cancer

A

finger clubbing
HTPA
cervical lymphadenopathy
superior vena cava obstruction

22
Q

Horners syndrome can be a sign of lung cancer, what is Horners syndrome

A

drooping of the upper eyelid
lack of sweating in the face
constricted pupil

23
Q

what is Horners syndrome caused by

A

damage to the sympathetic nerves in the neck possibly lung cancer metastasis

24
Q

what is Pancoasts syndrome

A

Wasting of the small muscles in the hand in apical lung cancer invading the brachial plexus

25
Q

where is lung cancer most likely to spread to

A

Brain
Bones
adrenal glands
Liver

26
Q

what is the 5 year survival rate for lung cancer

A

fewer than 10% of patients with lung cancer still alive at 5 years

27
Q

how would you treat epiglottitis

A
avoid instrumentation 
monitor for respiratory failure 
O2 if needed 
iv antibiotics according to culture specimens 
may need steroids for  pharyngeal oedema
28
Q

what antibiotics could you give for epiglottitis

A

augumentin and cephlasporin

29
Q

what are the symptoms of glandular fever

A
fever 
sore throat 
fine red rash 
puffy eyes lyphadenopathy 
inflammation of the liver
30
Q

what tests could be done to diagnose glandular fever

A

monospot test
blood film
look for Epstein Barr virus

31
Q

what are the likely pathogens to cause rhinosinsitis

A

haemophillus influenzae
moraxella catarrhalis
streptococcus pneumoniae

32
Q

what virus usually causes the common cold

A

rhinovirus

33
Q

why wouldn’t you give penicillin like ester such as ampicillin in glandular fever

A

it can result in a rash

34
Q

what is one of the key driver mutations that occur in approx 35% of smoking induced lung cancer

A

KRAS

35
Q

apart from KRAS what are 4 other well known key driver mutations in the development of lung cancer

A

EGFR
BRAF and HER2
ALK rearrangements