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Respiratory SB > Childhood and Worker's Diseases > Flashcards

Childhood and Worker's Diseases Flashcards

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1
Q

what is a pleural effusion

A

abnormal collection of fluid in the pleural space

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2
Q

what are the two most useful tests for diagnosing pleural effusion

A

ultrasound and x-ray

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3
Q

what is the appearance of a pleural effusion on an x-ray and what does it suggest

A

flat line suggest pneumothorax or hydro-pneumothorax
round substances in between lobes suggest fluid
meniscus suggest fluid

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4
Q

what is the name for pleural effusions with protein content less than 30mg

A

Transudate

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5
Q

what is the name for pleural effusions with protein content more than 30mg

A

Exudate

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6
Q

what does a straw coloured pleural aspirate suggest

A

cardiac failure, hypoalbuminaema

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7
Q

what does a blood pleural aspirate suggest

A

trauma, malignancy, infection, infarction

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8
Q

what are the causes of transudate effusions

A

heart failure, meigs syndrome, liver cirrhosis

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9
Q

what are the causes of exudate effusions

A

pneumonia, TB, carcinoma,

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10
Q

what is meigs syndrome

A

a triad of benign ovarian tumour, pleural effusion and ascites

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11
Q

what is the normal pleural pH

A

7.6

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12
Q

what does a pleural pH of less than 7.3 suggest

A

pleural inflammation, empyema, malignancy

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13
Q

what is the treatment plan for pleural effusions

A

depends on underlying cause

but can drain the effusion

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14
Q

what is pleurodesis and what is it used as a treatment for

A

artificial procedure to prevent the lung from collapsing again
pleural effusions

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15
Q

what are the related conditions of asbestos

A

benign pleural plaques
diffuse pleural thickening
pleural effusion

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16
Q

what stage of asbestos exposure is asymptomatic

A

benign pleural plaques

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17
Q

what are the symptoms often caused by acute asbestos pleuritis

A

fever, pain, bloody pleural effusions

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18
Q

what do pleural effusions and diffuse pleural thickening cause in patients

A

restrictive impairment

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19
Q

what is malignant mesothelioma

A

incurable pleural cancer

presents with chest pain and pleural effusion

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20
Q

what are the typical features of pulmonary fibrosis related to asbestosis

A

restrictive defect
asbestos bodies in sputum
asbestos fibre in biopsy

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21
Q

what are the two cancers that patients with asbestosis exposure have increased risk to

A

bronchial adenocarcinoma and mesothelioma

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22
Q

what are the clinical features of asbestosis

A

progressive dyspnoea
clubbing
find, end-inspiratory crackles
pleural plaques

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23
Q

what is sarcoidosis

A

a granulomatous (type 4 hypersensitive) disease

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24
Q

symptoms of chronic sarcoidosis

A

lung infiltrates (alveolitis)
skin infiltrates
hypercalcaemia
peripheral lymphadenopathy

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25
signs of sarcoidosis seen on an x-ray
bilateral hilar lymphadenopathy
26
symptoms of acute sarcoidosis
``` erthyema nodosum (red nodules on the legs) painful joints and eyes inflammation of the glands bilateral hilar lymphadenopathy fever dry cough progressive dyspnoea chest pain decreased exercise tolerance ```
27
differential for bilateral hilar lymphadenopathy on an x-ray
sarcoidosis | TB
28
signs of sarcoidosis seen on a CT-scan
peripheral nodular infiltrate
29
signs of sarcoidosis seen on a tissue biopsy
non-caseating granuloma
30
signs of sarcoidosis in blood tests
raised ACE serum levels raised calcium levels raised inflammatory markers
31
Treatment of acute and chronic sarcoidosis
Acute - self limiting, NSAIDs, steroids (if vital organ damage) Chronic - oral steroids, immunosuppresion
32
buzzwords for sarcoidosis
- African-Carribean woman - Raised Ca2+ and ACE levels - Bilateral hilar lymphadenopathy, erythema nodosum, granulomas, fatigue, uveitis and weight loss
33
buzzwords for pleural effusion
stony dull to percuss
34
what is EAA
hypersensitive pneumonitis | type III hypersensitive (immune complex deposition)
35
what are some causes of EAA
Bird-fanciers and Pigeon-fanciers lung Farmer's and mushroom workers lung Malt worker's lung
36
acute presentation of EAA
dry cough, breathlessness, fever, myalgia, no wheeze, crackles, hypoxia
37
chronic presentation of EAA
increasing dyspnoea, weight loss, clubbing, crackles, dry cough
38
what is common of EAA on x-rays
upper zone mottling/consolidation
39
what is the results of pulmonary function test in EAA (what type of defect)
restrictive defect low FEV1 and FEV high or normal ratio low gas transfer
40
how to diagnosis EAA
history of exposure | presence of IgG antibodies to guilty antigen
41
treatment for EAA
remove antigen | steroids if needed
42
4 C's of idiopathic pulmonary fibrosis (IPF)
(dry) cough, clubbing, crepitations, cyanosis
43
secondary causes of IPF
RA, systemic sclerosis, asbestos, drugs
44
presentation of IPF
progressive breathlessness, dry cough, malaise, weight loss, joint pain (arthralgia)
45
PFT of patient with IPF
``` restrictive defect decreased FEV1 and FVC normal or raised ratio reduced lung volumes low gas transfer ```
46
X-ray of patient with IPF
- honeycomb lung | - bilateral lower zone reticulonodular shadowing
47
CT scan of IPF
- ground glass appearance
48
treatment of IPF
oxygen, opiates, pallative care | recommended high dose steroids not used
49
buzzwords for IPF
Ground-glass appearance on X-ray | Honeycomb lung
50
what are the two types of coal worker pneumoconiosis
Simple | Complicated
51
what is simple pneumoconiosis
chest x-ray abnormality only no impaired lung function associated with COPD
52
treatment of simple and complicated pneumoconiosis
avoid coal dust treat co-exisiting chronic bronchitis claim compensation
53
what is complicated pneumoconiosis
progressive massive fibrosis leading to restrictive pattern with breathlessness associated with emphysema
54
what does complicated pneumoconiosis eventually go on to cause
Cor pulmonale
55
what is Caplan's syndrome
association between rheumatoid arthritis, pneumoconiosis and pulmonary rheumatoid nodules
56
what is silicosis
simple pneumoconiosis - chest XR abnormality only
57
what is seen in a chest x-ray of silicosis
egg-shell calcification of hilar nodes | diffuse miliary or nodular pattern in the upper zone
58
clinical features of silicosis
progressive dyspnoea, increased incidence of TB, restrictive tendency
59
buzzwords for silicosis
- Snow storm appearance on x ray | - egg-shell calcification of hilar nodes on x ray
60
what is the pathology of neonatal respiratory distress syndrome
not enough surfactant in the lungs to keep them inflated
61
what is in surfactant and what is its production stimulated by
phospholipids, apoproteins | steroids
62
what is the complications of neonatal distress syndrome
no breath sounds on 1 side | sudden deterioration
63
what is the x-ray appearance of neonatal distress syndrome
distinctive cloudy appearance
64
what is the treatment of neonatal distress syndrome
ventilation, artificial surfactant
65
buzzwords for neonatal distress syndrome
ground glass appearance on x-ray
66
what is a pneumothorax
air in the pleural space
67
what can causes a pneumothorax in infants
intermittent postive - pressure ventilation
68
what is the classification of chronic lung disease in infants
O2 requirements beyond 36 weeks corrected gestation plus evidence of ILD
69
what is indicative of cystic fibrosis
infant with raised immune-reactive trypsin levels on neonatal screening
70
what is CF
autosomal recessive | mutations in the CF transmembrane conductance regulator (CFTR) gene on chromosome 7
71
what does the defect in CF cause
error in Cl- channel leads to defective Cl secretion and increase sodium absorption across airway epithelium
72
what does CF predispose the lungs to
chronic pulmonary infections | bronchiectasis
73
clinical features of CF in neonatal
failure to thrive rectal prolapse loose stool due to meconium ileus (bowel is sticky causes it to block)
74
clinical features of CF in young adult
``` cough, wheeze, recurrent infections cor pulmonale male infertility nasal polyps gallstones ```
75
how is CF diagnoses
sweat test - sodium and chloride levels > 60mmol/L | genetics - screen for mutatiosn
76
tests for CF
bacteriology - cough swab, sputum culture | spirometry - obstructive defect
77
management of CF
physiotherapy, bronchodilators
78
what is Kartagener's syndrome
autosomal recessive disease | defect in the structure and function of sensory and motile cilia
79
presentation of Kartagener's syndrome
- possible neonatal RDS - chronic rhinorrhoea, rhinitis, otitis - COPD, recurrent pneumonia, bronchiectasis - male infertility, decreased female fertility
80
features of Kartagener's syndrome
dextrocardia
81
what is croup
viral laryngotracheobronchitis | i.e. infection of the larynx and trachea
82
signs of croup
stridor | barking cough
83
treatment for croup
oral steroids
84
what is pertussis
"whooping cough"
85
baby from developing country, irritable, no fever, neck rigidity
mycobacterium TB
86
what is common causes of bronchiolitis in the young
Respiratory Syncytial Virus (RSV) hMPV adenovirus
87
symptoms of bronchiolitis in the young
tachypnoea, poor feeding, irritating cough, | apnoea in small babies
88
symtoms and features of pneumonia in small children
cough, sputum, fever | dullness on percussion, increased vocal fremitus and resonance, bronchial breathing
89
microorganisms causing pneumonia in neonates
E.coli, Klebsiella, Staph aureus
90
microorganisms causing pneumonia in infants
strep pneumonia, chlamydia,
91
microorganisms causing pneumonia at school age
strep pneumonia, Staph aureus, legionella, mycoplasma
92
what type of chest pain is worse on inspiration
pleuritic

Respiratory SB (14 decks)

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