Respiratory Buzzwords Flashcards

1
Q

Stony dull to percuss?

A

Pleural effusion

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2
Q

Right-sided pleuritic chest pain?

A

Likely a pneumonia

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3
Q

ABCDE?

A
Alveolar bat's wings
Kerley B lines
Cardiomegaly
Dilated prominent upper lobe vessels
Pleural effusion

Pulmonary oedema

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4
Q

Ground-glass appearance on CXR?

A

Pulmonary fibrosis

Respiratory distress syndrome (newborn and adult)

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5
Q

Ziehl-Nielsen stain positive for acid-fast bacilli?

A

TB

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6
Q

Caseous necrosis?

A

TB

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7
Q

Apical disease?

A

Assman focus due to secondary TB

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8
Q

Miliary TB?

A

Spread of organism into bloodstream:
If the organism spreads via the pulmonary artery, miliary dissemination to the lung occurs
If the organism spreads via the pulmonary vein, miliary dissemination to the liver, spleen and kidneys occurs

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9
Q

Positive anti-glomerular basement membrane antibodies?

A

Goodpasture’s syndrome - autoimmune disease where antibodies attach the basement membrane of the lungs and kidneys, leading to haemoptysis and renal failure

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10
Q

Chest infection with a parrot/pigeon as a pet?

A

Chlamydophilia psittaci

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11
Q

Dry cough and diarrhoea after a holiday abroad (with some indication of water spread)?

A

Legionella pneumophila (urinary antigen testing)

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12
Q

Tall, thin young man who indulges in mariguana (Mr. Snoop Dog/Mr Martin Mitchell)?

A

Probably a pneumothorax (consider Marfan’s syndrome)

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13
Q

Bilateral hilar lymphadenopathy, erythema nodosum, granulomas, fatigue, uveitis, and weight loss (Afro-Caribbean woman)?

A

Sarcoidosis

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14
Q

Bronchiole wider than the arteriole next to it (signet ring sign)?

A

Bronchiectasis

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15
Q

D sign on CXR?

A

Empyema

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16
Q

“Steeple” sign on CXR?

A

Laryngotracheobronchitis (croup)

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17
Q

Child with barking cough?

A

Croup

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18
Q

Pneumocystis pneumonia (PCP)?

A

HIV (treat with co-trimoxazole; if it is severe, add prednisolone)

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19
Q

Asthma + nasal polyps + aspirin sensitivity?

A

Samter’s triad

20
Q

Alcoholic (danger of aspiration pneumonia)?

A

Klebsiella pneumoniae

21
Q

Red jelly sputum?

A

Klebsiella pneumoniae

22
Q

Mucoid sputum?

A

Chlaymdia psittaci

23
Q

Rusty sputum?

A

Pneumococcal pneumonia

24
Q

Cannonball metastases (with weight loss and haematuria)?

A

Classically, from primary renal cell carcinoma

25
Q

Morning headache?

A

Hypercapnia or side effects of organic nitrates

26
Q

ACTH secreting tumour?

A

Small cell carcinoma of the lung; may cause Cushing’s syndrome

SCC of the lung may also secrete ADH, leading to low Na+ levels

27
Q

PTH secreting tumour?

A

Squamous cell carcinoma; results in hypercalcaemia

28
Q

Small cell carcinoma description?

A

Neuroendocrine tumour that is highly malignant and may be assos. with ectopic endocrine syndrome

29
Q

Increased serum ACE + hypercalcaemia?

A

Sarcoidosis

30
Q

Egg-shell calcification at hilar regions?

A

Silicosis

31
Q

Heart failure cells seen in alveolar spaces?

A

Macrophages that have absorbed haemosiderin; this is found in:
Chronic pulmonary oedema, assoc with severe left ventricular heart failure
Long-standing pulmonary hypertension

32
Q

Ghon focus?

A

Foci of granulomatous inflammation and caseous necrosis at the lung peripheries, usually in the mid-zone, due to primary TB

Tuberculous pleurisy can occur due to Ghon focus rupture, through the visceral pleura and into the pleural cavity

33
Q

Assman focus?

A

Apical lesions due to secondary TB

34
Q

“Coin” lesion found on CXR?

A
Rounded solitary lesion; common ones are:
Primary bronchial carcinoma
Metastatic tumour, esp. of the kidney
Bronchial hamartoma 
Carcinoid tumour (neuroendocrine) 
Granulomatous inflammation 
Lung abscess
35
Q

Horner’s syndrome?

A

Can occur when there is local spread of cancer to the intra-thoracic nodes or Pancoast’s tumour

Signs (EVERYTHING DOWN) - ptosis (drooping of the eyelid), enophthalmos (sunken eye), miosis (small pupil) and lack of sweating on the ipsilateral side of the invasion

These occur due to invasion of the cervical sympathetic chain

36
Q

Acute asthma management?

A

Oxygen (15 l/min via a non-rebreather mask)

Salbutamol (nebulised back-to-back)
Hydrocortisone (IV)/Prednisolone (PO)
Ipratropium (IV)
Theophylline/aminophylline (IV)

Magnesium sulphate
Anaesthetist

37
Q

Thumbprint sign on head X-ray?

A

Epiglottitis

38
Q

Inspiratory whoop/barking cough?

A

Pertussis (whooping cough)

39
Q

Snow-storm appearance on CXR?

A

Baritosis/silicosis

40
Q

Management of COPD infective exacerbation?

A
ipratropium
Salbutamol
Oxygen 
Amoxicillin (1st line; doxycycline is 2nd line)
Prednisolone
41
Q

Non-smoker + lung cancer?

A

Peripheral adenocarcinoma

42
Q

Squamous and small cell lung cancers are?

A

Central

43
Q

High D-dimers?

A

Suspect, but do not diagnose, PE

Send for CTPA or V/Q scan)

44
Q

Low D-dimers?

A

Exclude PE

45
Q

Treatment of small and large PEs?

A

Large - thrombolysis

Small - anti-coagulation with LWMH