Flashcards in Core Respiratory Deck (77):
Type 1 respiratory failure = PC02 > 6.3
PC02 less than 6.3 kPa
Name general respiratory symptoms that you would ask in OSCE.
SOB = dyspnoea
Pleuritic pain - worse on inspiration
Classification of lung Ds?
Lung cancers have a HIGH MORTALITY in the UK. Where are they mostly found in the lung?
- near main bronchioles
Lung tumours are often 2", How would you distinguish it from a 1" tumour in tests?
Lung tumours can either be Carcinomas, Carcinoid tumours or other malignant tumours. What are the subgroups of the carcinomas?
NSCLC - 85%
The most common lung carcinoma is...? What hormone does it often secrete?
Squamous cell carcinoma (central)
PTH --> hypercalcaemia
Which other NSCLC apart from Squamous carcinoma is seen more peripherally?
Whats the name of the worst NSCLC which has severe atypia and is neuroendocrine?
Large cell neuroendocrine carcinoma
What lung tumours are neuroendocrine?
Large cell neuroendocrine carcinoma
99% of those with SCLC are smokers. What hormones does this neuroendocrine release?
How aggressive is it?
Rapidly progressive &; invasive
Carcinoid tumours consist of typical and atypical groups. Which one has low malignnt potential? Presentation?
Other malignant tumours in lungs could be?
Lymphangitis Carcinomatosa is a rare presentation of what?
= inflammation of lymph nodes from lunG mets
Treatment of lung cancer uses Gefitinib, Tarcera, Crizotinib
= inhibit EGFR-TK
- GF in lung tumours
Paraneoplstic effects of lung cancer happen causing?
Skin - darkened/thick
Endocrine effects - PTH in SCC, ACTH/ADH in SCLC
Lambert Eaton myasthenic syndrome
- autoimmune attack of NMJ
Pneumonia, TB, Lung infarct or Lung tumour can cause Pleurisy. Which pleural effusion has high protein content?
Exudate - inflammatory
(trasudate - non-inflammatory e.g CHF
Fibroma of pleura is rare. What tumour is common?
- mets from lung/breast
What rare cancer of pleura can be acquired from high asbestos exposure?
1" Malignant Mesothelioma
Fatal: 1-3 yrs
Are fibrous plueral plaques pre-malignant or not?
common - low asbestos exposure
In URTI, what are the 3 usual suspects?
URTI are most common in whom?
A patient presents with facial pain, nasal blockage and decreased smell. What do they have? Cause?
3 usual suspects
A patient has a sore throat, fever, cervical lymphadenopathy. You find Ig in there blood for EBV. Diagnosis?
Symptoms of dysphagia, fever, headache, red uvula +/- exudate is characteristic of what?
How would you investigate?
Group A Strep URTI can cause complications such as rheumatic fever, scarlet fever and acute glomerularnephritis. What is the treatment?
Which antibiotics are safe for those with penicillin allergies?
Monobactams - Aztreonam (AZT)
What MEDICAL EMERGENCY is assoicated with "hot potato speech" and "cherry red" look? Treatment?
Acute larngitis presents as...?
What is another word for Acute Laryngotracheobronchitis?
Common in whom?
children after URTI
What are the two phases of whooping cough?
1. Catarrhal phase: runny nose, malaise, fever
2. 1 week later: dry whooping cough
State the name given to infammation of the external acoustic canal?
Otitis externa can be acute/chronic/malignant. However, they all present the same. How?
Who are most suspectible to malignant Otitis externa?
Otitis media is common in children and can be viral/3 usual suspects. how would you treat it?
If well: symptomatically
if unwell: Amoxiciillin
What condition presents the same as Otitis media + pain/swelling over mastoid?
Name common investigations done in URTI.
Common antibiotics used in URTI?
Erythromycin - Whooping Cough, Diphtheria
Amoxicillin - Otitis media
Penicillin - Step A, Diphtheria
Bronchitis - A/C
Pneumonia ( diff types)
1" LRTI occur n healthy people, whereas 2" infections occur in...?
Those with weakened defence:
- Mucociliary dysfunction
- pulmonary oedema
Acute bronchitis often occurs in kids and during winter. Its self-limting
What are tthe symptoms?
What condition is defined as productive cough + sputum > 3 months > 2 consecutive years?
Cause of chronic bronchitis?
Irritation from foreign particles
What virus commonly causes Bronchiolitis in kids?
How would you diagnose bronchiolitis?
What condition is defined as infection of distal airways and alveoli forming inflammatory exudate --> CONSOLIDATION?
Which type of pneumonia is the most commonly acquired?
How is it assessed?
Commuity acquired Pneumonia (CAP)
What organisms tend to cause CAP?
3 usual suspects
Atypical bacteria (4)
Name the 2 pneumonias based on anatomical site.
Which is more common?
- S. pneumonia
State the type of pneumonia caused often by those who have impaired cough/swallow reflex/elderly.
Signs of CAP?
Symptoms of CAP?
rapid onset + fever + productive cough + mucopurulent sputum + pleuritic chest pain + malaise
Which atypical mycobacteria is associated with water outbreaks and abnormal LFT/na+ in CAP?
1" viral pneumonia is often seen in patients with pre-exisitng heart/lung D. What are the symptoms?
Mycobacteria are gram -VE intraceullar organisms. T/F?
State 2 conditions that are caused by mycobacteria?
What are the 2 clinical forms of leprosy?
Whats the most common site of TB?
TB has 3 phases/manifestations. What are they?
State the treatment for TB.
6 months DOTS:
2 months - 1 tablet
What investigations are neccessary in moderate/severe CAP?
(OBS, Blood, Chest x-ray)
Sputum gram stain/culture
Pneumococcal urinary antigen
State the standard treatment for CAP
If low severity: PENICILLIN
If high: PENICILLIN + CLARITHROMYCIN
What fraction of world are INFECTED with TB?
Sarcoidosis, Pneumonconiosis, Silicosis, Asbestosis and Hypersensitivity Pneumonitis are examples of what?
CHRONIC INTERSTITIAL LUNG D
Pneumoconiosis is also called what and a common occupational D?
= non-caseating granulmoas
- Inceased serum ACE
- Reanl dysfunction
Silicosis causes lung fribrosis by inhalation of what?
Silica in sand/dust
Asbestosis causes lung oedema. T/F?
Causes lung fibrosis
CF presents as..?
Failure to thrive (child)
Abnormal viscous secretions
Whats the management of CF?
Define interstitial lung D.
= inflammation/fibrosis of alveolar-capillary wall
Which chronic interstitial lung D is more common in women and presents with hypercalcaemia?
A P02 of less than what signifies respiratory failure?
P02 less than 8 kPa
Cynanosis = ?
Decreased oxygenation of Hb
Ziehl-neelsen is a specific stain used to detect what organism?
Gene mutation giving sensitivity to new lung cancer drugs codes for..?
Epidermal GF receptor