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Clinical Pathology > Core Respiratory > Flashcards

Core Respiratory Flashcards

1
Q

Type 1 respiratory failure = PC02 > 6.3

T/F?

A

F

PC02 less than 6.3 kPa

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2
Q

Name general respiratory symptoms that you would ask in OSCE.

A 
Cough
Sputum
SOB = dyspnoea
Wheeze
Stridor
Haemoptysis
Chest pain
Pleuritic pain - worse on inspiration
Clubbing
Weight loss
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3
Q

Classification of lung Ds?

A 
Neoplasms
Infections
Obstructive
Restrictive
Vascular
Pleural D
Interstitial D
Occupational
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4
Q

Lung cancers have a HIGH MORTALITY in the UK. Where are they mostly found in the lung?

A

Centrally

  • near main bronchioles
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5
Q

Lung tumours are often 2”, How would you distinguish it from a 1” tumour in tests?

A

immunohistochemistry

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6
Q

Lung tumours can either be Carcinomas, Carcinoid tumours or other malignant tumours. What are the subgroups of the carcinomas?

A

NSCLC - 85%

SCLC

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7
Q

The most common lung carcinoma is…? What hormone does it often secrete?

A

Squamous cell carcinoma (central)

PTH –> hypercalcaemia

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8
Q

Which other NSCLC apart from Squamous carcinoma is seen more peripherally?

A

Adenocarcinoma

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9
Q

Whats the name of the worst NSCLC which has severe atypia and is neuroendocrine?

A

Large cell neuroendocrine carcinoma

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10
Q

What lung tumours are neuroendocrine?

A

Large cell neuroendocrine carcinoma

SCLC

Carcinoid tumours

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11
Q

99% of those with SCLC are smokers. What hormones does this neuroendocrine release?

How aggressive is it?

A

ACTH, ADH

Rapidly progressive &; invasive

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12
Q

Carcinoid tumours consist of typical and atypical groups. Which one has low malignnt potential? Presentation?

A

Typical

Chronic cough
Unresolved pneumonia
Haemoptysis

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13
Q

Other malignant tumours in lungs could be?

A

Lymphomas

Sarcomas

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14
Q

Lymphangitis Carcinomatosa is a rare presentation of what?

A

Lung cancer

= inflammation of lymph nodes from lunG mets

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15
Q

Treatment of lung cancer uses Gefitinib, Tarcera, Crizotinib

A

= inhibit EGFR-TK

  • GF in lung tumours
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16
Q

Paraneoplstic effects of lung cancer happen causing?

A 
Cachexia
Clubbing
Coagulopathies
Skin - darkened/thick
Endocrine effects - PTH in SCC, ACTH/ADH in SCLC

Lambert Eaton myasthenic syndrome
- autoimmune attack of NMJ

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17
Q

Pneumonia, TB, Lung infarct or Lung tumour can cause Pleurisy. Which pleural effusion has high protein content?

A

Exudate - inflammatory

(trasudate - non-inflammatory e.g CHF

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18
Q

Fibroma of pleura is rare. What tumour is common?

A

2” Adenocarcinoma

  • mets from lung/breast
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19
Q

What rare cancer of pleura can be acquired from high asbestos exposure?

A

1” Malignant Mesothelioma

Fatal: 1-3 yrs

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20
Q

Are fibrous plueral plaques pre-malignant or not?

A

NOT

common - low asbestos exposure

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21
Q

In URTI, what are the 3 usual suspects?

A

Haemophilus Influenzae
Streptococcus pneumoniae
Moraxella Catarrhalis

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22
Q

URTI are most common in whom?

A

Children/Teens

Usual viral/bacterial

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23
Q

A patient presents with facial pain, nasal blockage and decreased smell. What do they have? Cause?

A

Rhino-sinusitis.

3 usual suspects

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24
Q

A patient has a sore throat, fever, cervical lymphadenopathy. You find Ig in there blood for EBV. Diagnosis?

A

Glandular fever

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25
Q

Symptoms of dysphagia, fever, headache, red uvula +/- exudate is characteristic of what?

How would you investigate?

A

Pharyngitis (S.pyrogenes)
Tonsilitis

Throat swab

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26
Q

Group A Strep URTI can cause complications such as rheumatic fever, scarlet fever and acute glomerularnephritis. What is the treatment?

A

Penicillins

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27
Q

Which antibiotics are safe for those with penicillin allergies?

A

Monobactams - Aztreonam (AZT)

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28
Q

What MEDICAL EMERGENCY is assoicated with “hot potato speech” and “cherry red” look? Treatment?

A

Epiglottis

Cefotaxime

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29
Q

Acute larngitis presents as…?

A 
Hoarse voice
Fever
Globus pharyngeas
Dysphagia
Myalgia
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30
Q

What is another word for Acute Laryngotracheobronchitis?

Common in whom?

A

Croup

children after URTI

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31
Q

What are the two phases of whooping cough?

Treatment?

A
  1. Catarrhal phase: runny nose, malaise, fever
  2. 1 week later: dry whooping cough

Erythromycin

32
Q

State the name given to infammation of the external acoustic canal?

A

Otitis Externa

33
Q

Otitis externa can be acute/chronic/malignant. However, they all present the same. How?

A 
Pain
Swelling
Redness
Itching
Otorrhoea
34
Q

Who are most suspectible to malignant Otitis externa?

A

Elderly
Diabetics
Immunocompromised

35
Q

Otitis media is common in children and can be viral/3 usual suspects. how would you treat it?

A

If well: symptomatically

if unwell: Amoxiciillin

36
Q

What condition presents the same as Otitis media + pain/swelling over mastoid?

Treatment?

A

Mastoiditis

Co-amoxiclav

37
Q

Name common investigations done in URTI.

A

Throat/pus swabs
blood culture
Serology: Ig
Sensitivity testing

38
Q

Common antibiotics used in URTI?

A

Erythromycin - Whooping Cough, Diphtheria

Amoxicillin - Otitis media

Penicillin - Step A, Diphtheria

39
Q

LRTI include?

A 
Tracheitis
Bronchitis - A/C
Bronchiolitis
Pneumonia ( diff types)
Pulmonary TB
40
Q

1” LRTI occur n healthy people, whereas 2” infections occur in…?

A

Those with weakened defence:

  • immunocompromised
  • Mucociliary dysfunction
  • pulmonary oedema
41
Q

Acute bronchitis often occurs in kids and during winter. Its self-limting

What are tthe symptoms?

A

Croup
Dry Cough
SOB
Tachypnoea

42
Q

What condition is defined as productive cough + sputum > 3 months > 2 consecutive years?

A

Chronic Bronchitis

43
Q

Cause of chronic bronchitis?

A

Irritation from foreign particles

  • smoking
  • pollution
  • allergens
44
Q

What virus commonly causes Bronchiolitis in kids?

A

RSV

45
Q

How would you diagnose bronchiolitis?

A

Chest x-ray
FBC
Snot sample

46
Q

What condition is defined as infection of distal airways and alveoli forming inflammatory exudate –> CONSOLIDATION?

A

Pneumonia

47
Q

Which type of pneumonia is the most commonly acquired?

How is it assessed?

A

Commuity acquired Pneumonia (CAP)

CURB-65 score

48
Q

What organisms tend to cause CAP?

A

3 usual suspects
S. Aureas
Atypical bacteria (4)

49
Q

Name the 2 pneumonias based on anatomical site.

Which is more common?

A

Bronchopneumonia*

Lobar pneumonia
- S. pneumonia

50
Q

State the type of pneumonia caused often by those who have impaired cough/swallow reflex/elderly.

A

Apsiration Pneumonia

51
Q

Signs of CAP?

A

High RR
High pulse
Low BP
Low SATS

52
Q

Symptoms of CAP?

A

rapid onset + fever + productive cough + mucopurulent sputum + pleuritic chest pain + malaise

53
Q

Which atypical mycobacteria is associated with water outbreaks and abnormal LFT/na+ in CAP?

A

Legionella pneumophillia

54
Q

1” viral pneumonia is often seen in patients with pre-exisitng heart/lung D. What are the symptoms?

A

Cough
SOB
Cyanosis

55
Q

Mycobacteria are gram -VE intraceullar organisms. T/F?

A

T

56
Q

State 2 conditions that are caused by mycobacteria?

A

TB

Leprosy

57
Q

What are the 2 clinical forms of leprosy?

A

Tuberculoid

Lepromatous

58
Q

Whats the most common site of TB?

A

Lung

59
Q

TB has 3 phases/manifestations. What are they?

A

Flu-like

Dissesminated D

Latent phase

60
Q

State the treatment for TB.

A

6 months DOTS:
2 months - 1 tablet
4 months

61
Q

What investigations are neccessary in moderate/severe CAP?

A

(OBS, Blood, Chest x-ray)

Microbiological:
Sputum gram stain/culture
Blood culture
Pneumococcal urinary antigen
Legionella
PCR serology
62
Q

State the standard treatment for CAP

A

If low severity: PENICILLIN

If high: PENICILLIN + CLARITHROMYCIN

63
Q

What fraction of world are INFECTED with TB?

A

1/3

64
Q

Sarcoidosis, Pneumonconiosis, Silicosis, Asbestosis and Hypersensitivity Pneumonitis are examples of what?

A

CHRONIC INTERSTITIAL LUNG D

65
Q

Pneumoconiosis is also called what and a common occupational D?

A

Dust D

66
Q

Define Sarcoidosis

A

= non-caseating granulmoas

  • hypercalcaemia
  • Inceased serum ACE
  • Reanl dysfunction
  • Neurological
67
Q

Silicosis causes lung fribrosis by inhalation of what?

A

Silica in sand/dust

68
Q

Asbestosis causes lung oedema. T/F?

A

False

Causes lung fibrosis

69
Q

CF presents as..?

A

Recceurrent infections
Failure to thrive (child)
Pancreatic insufficiency
Abnormal viscous secretions

70
Q

Whats the management of CF?

A

Mucolytics

Physio

Digestive enzymes

Heart/Lung Transplant

71
Q

Define interstitial lung D.

A

= inflammation/fibrosis of alveolar-capillary wall

A/C

72
Q

Which chronic interstitial lung D is more common in women and presents with hypercalcaemia?

A

Sarcoidosis

73
Q

A P02 of less than what signifies respiratory failure?

A

P02 less than 8 kPa

74
Q

Cynanosis = ?

A

Decreased oxygenation of Hb

75
Q

Ziehl-neelsen is a specific stain used to detect what organism?

A

Mycobacteria

76
Q

Gene mutation giving sensitivity to new lung cancer drugs codes for..?

A

Epidermal GF receptor

77
Q

Name the rare autoimmune disease that attacks the lung and kidneys causing pulmonary bleeding & glomerulonephritis (Anti-GBM D)

A

Good pastures syndrome

Clinical Pathology (13 decks)

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