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Clinical Pathology > Core Respiratory > Flashcards

Flashcards in Core Respiratory Deck (77):
1

Type 1 respiratory failure = PC02 > 6.3

T/F?

F

PC02 less than 6.3 kPa

2

Name general respiratory symptoms that you would ask in OSCE.

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

3

Classification of lung Ds?

Neoplasms
Infections
Obstructive
Restrictive
Vascular
Pleural D
Interstitial D
Occupational

4

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

Centrally

- near main bronchioles

5

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

immunohistochemistry

6

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

NSCLC - 85%

SCLC

7

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

Squamous cell carcinoma (central)

PTH --> hypercalcaemia

8

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

Adenocarcinoma

9

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

Large cell neuroendocrine carcinoma

10

What lung tumours are neuroendocrine?

Large cell neuroendocrine carcinoma

SCLC

Carcinoid tumours

11

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

How aggressive is it?

ACTH, ADH

Rapidly progressive &; invasive

12

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

Typical

Chronic cough
Unresolved pneumonia
Haemoptysis

13

Other malignant tumours in lungs could be?

Lymphomas
Sarcomas

14

Lymphangitis Carcinomatosa is a rare presentation of what?

Lung cancer

= inflammation of lymph nodes from lunG mets

15

Treatment of lung cancer uses Gefitinib, Tarcera, Crizotinib

= inhibit EGFR-TK

- GF in lung tumours

16

Paraneoplstic effects of lung cancer happen causing?

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

Lambert Eaton myasthenic syndrome
- autoimmune attack of NMJ

17

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

18

Fibroma of pleura is rare. What tumour is common?

2" Adenocarcinoma


- mets from lung/breast

19

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

1" Malignant Mesothelioma

Fatal: 1-3 yrs

20

Are fibrous plueral plaques pre-malignant or not?

NOT

common - low asbestos exposure

21

In URTI, what are the 3 usual suspects?

Haemophilus Influenzae
Streptococcus pneumoniae
Moraxella Catarrhalis

22

URTI are most common in whom?

Children/Teens

Usual viral/bacterial

23

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

Rhino-sinusitis.

3 usual suspects

24

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

Glandular fever

25

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

How would you investigate?

Pharyngitis (S.pyrogenes)
Tonsilitis

Throat swab

26

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

Penicillins

27

Which antibiotics are safe for those with penicillin allergies?

Monobactams - Aztreonam (AZT)

28

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

Epiglottis

Cefotaxime

29

Acute larngitis presents as...?

Hoarse voice
Fever
Globus pharyngeas
Dysphagia
Myalgia

30

What is another word for Acute Laryngotracheobronchitis?

Common in whom?

Croup


children after URTI

31

What are the two phases of whooping cough?

Treatment?

1. Catarrhal phase: runny nose, malaise, fever

2. 1 week later: dry whooping cough

Erythromycin

32

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

Otitis Externa

33

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

Pain
Swelling
Redness
Itching
Otorrhoea

34

Who are most suspectible to malignant Otitis externa?

Elderly
Diabetics
Immunocompromised

35

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

If well: symptomatically

if unwell: Amoxiciillin

36

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

Treatment?

Mastoiditis

Co-amoxiclav

37

Name common investigations done in URTI.

Throat/pus swabs
blood culture
Serology: Ig
Sensitivity testing

38

Common antibiotics used in URTI?

Erythromycin - Whooping Cough, Diphtheria

Amoxicillin - Otitis media

Penicillin - Step A, Diphtheria

39

LRTI include?

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

40

1" LRTI occur n healthy people, whereas 2" infections occur in...?

Those with weakened defence:
- immunocompromised
- Mucociliary dysfunction
- pulmonary oedema

41

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

What are tthe symptoms?

Croup
Dry Cough
SOB
Tachypnoea

42

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

Chronic Bronchitis

43

Cause of chronic bronchitis?

Irritation from foreign particles

- smoking
-pollution
-allergens

44

What virus commonly causes Bronchiolitis in kids?

RSV

45

How would you diagnose bronchiolitis?

Chest x-ray
FBC
Snot sample

46

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

Pneumonia

47

Which type of pneumonia is the most commonly acquired?

How is it assessed?

Commuity acquired Pneumonia (CAP)

CURB-65 score

48

What organisms tend to cause CAP?

3 usual suspects
S. Aureas
Atypical bacteria (4)

49

Name the 2 pneumonias based on anatomical site.

Which is more common?

Bronchopneumonia*

Lobar pneumonia
- S. pneumonia

50

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

Apsiration Pneumonia

51

Signs of CAP?

High RR
High pulse
Low BP
Low SATS

52

Symptoms of CAP?

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

53

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

Legionella pneumophillia

54

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

Cough
SOB
Cyanosis

55

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

T

56

State 2 conditions that are caused by mycobacteria?

TB
Leprosy

57

What are the 2 clinical forms of leprosy?

Tuberculoid

Lepromatous

58

Whats the most common site of TB?

Lung

59

TB has 3 phases/manifestations. What are they?

Flu-like

Dissesminated D

Latent phase

60

State the treatment for TB.

6 months DOTS:
2 months - 1 tablet
4 months

61

What investigations are neccessary in moderate/severe CAP?


(OBS, Blood, Chest x-ray)

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

62

State the standard treatment for CAP

If low severity: PENICILLIN

If high: PENICILLIN + CLARITHROMYCIN

63

What fraction of world are INFECTED with TB?

1/3

64

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

CHRONIC INTERSTITIAL LUNG D

65

Pneumoconiosis is also called what and a common occupational D?

Dust D

66

Define Sarcoidosis

= non-caseating granulmoas

- hypercalcaemia
- Inceased serum ACE
- Reanl dysfunction
- Neurological

67

Silicosis causes lung fribrosis by inhalation of what?

Silica in sand/dust

68

Asbestosis causes lung oedema. T/F?

False

Causes lung fibrosis

69

CF presents as..?

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

70

Whats the management of CF?

Mucolytics

Physio

Digestive enzymes

Heart/Lung Transplant

71

Define interstitial lung D.

= inflammation/fibrosis of alveolar-capillary wall

A/C

72

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

Sarcoidosis

73

A P02 of less than what signifies respiratory failure?

P02 less than 8 kPa

74

Cynanosis = ?

Decreased oxygenation of Hb

75

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

Mycobacteria

76

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

Epidermal GF receptor

77

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

Good pastures syndrome