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Y3 MedEd > Cough > Flashcards

Cough Flashcards

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1
Q

Causes of acute dry cough (4)

A

Asthma
Drugs (ACE inhibitors)
Heart failure
URTI (laryngitis, pharyngitis)

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2
Q

Causes of acute productive cough (2)

A

Pneumonia (LRTI)

TB

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3
Q

Causes of chronic dry cough (4)

A

Asthma
Lung cancer
GORD
Mesothelioma

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4
Q

Causes of chronic productive cough (4)

A

COPD
Bronchiectasis
Lung cancer
Cystic fibrosis

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5
Q

RF for pneumonia (3)

A

Smoking
Travel
Immunocompromised

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6
Q

Causes of atypical pneumonia (4)

A

Mycoplasma pneumonia
Legionella pneumophila
Chlamydia psittaci
Chlamydia pneumoniae

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7
Q

Causes of CAP pneumonia (3)

A

Strep pneumoniae (AKA pneumococcus)
Haemophilus influenzae B
Moraxella catarrhalis

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8
Q

Causes of HAP pneumonia (3)

A

Staph aureus

Pseudomonas aeruginosa

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9
Q

Which organism causes a transverse myelitis pneumonia

A

Mycoplasma pneumoniae

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10
Q

Which organism causes a hyponatraemic pneumonia

A

Legionella pneumophila

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11
Q

Which organisms causes a cavitating lesions pneumonia (2)

A

Staph aureus

Klebsiella

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12
Q

Which organism causes air conditioning associated pneumonia

A

Legionella pneumophila

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13
Q

Which organism causes pet birds associated pneumonia

A

Chlamydia psittaci

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14
Q

What pneumonia is Chlamydia psittac associated with

A

Pet birds

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15
Q

What pneumonia is Staph aureus associated with

A

Cavitating lesions

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16
Q

What is pneumonia Klebsiella associated with

A

Cavitating lesions

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17
Q

What is pneumonia legionella pneumophilia associated with (2)

A

A/C

Hyponatraemia

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18
Q

What is pneumonia mycoplasma pneumonia associated with

A

Transverse myelitis causing pneumonia

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19
Q

What extra symptoms do atypical pneumonias cause (5)

A 
Dry cough
Headache
Diarrhoea
Myalgia
Hepatitis
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20
Q

What are the symptoms of typical pneumonia (5)

A 
Fever
SOB (dyspnoea)
Cough (with green sputum)
Chest pain (pleuritic)
Confusion
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21
Q

What is auscultated in pneumonia (3)

A

Coarse bibasal crackles
Bronchial breathing
Increased vocal resonance

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22
Q

Ix for pneumonia (8)

A 
Bloods
FBC
CRP
ABG
Blood cultures

Sputum MCS
Pleural fluid MCS (via thoracentesis)
CXR

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23
Q

Which extra Ix should you do if you suspect atypical pneumonia and which Ix suggests which pathogen (4)

A

Serology (all)
Urinary antigens (legionella, strep pneumo)
Blood film (mycoplasma – cold agglutins)
LFTs (legionella)

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24
Q

What is used to score pneumonia

A

CURB-65

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25
Acute Mx of pneumonia (4)
Oxygen (+ sit up patient) IV fluids CPAP (if required) Surgical drainage (if abscess/empyema)
26
Mx of CAP pneumonia
Amoxicillin (co-amoxiclav if severe)
27
Mx of HAP pneumonia (2)
If staph: Flucloxacillin + gentamycin | If MRSA: Vancomycin
28
Mx of atypical pneumonia (2)
Clarithromycin
29
Mx of aspiration pneumonia (2)
Metronidazole
30
Which type of pneumonia is metronidazole used for
Aspiration
31
Which type of pneumonia is clarithromycin used for
Atypical
32
Which type of pneumonia is amoxicillin used for
CAP
33
Which type of pneumonia is co-amoxiclav used for
Severe CAP
34
Which type of pneumonia is flucloxacillin used for
Staph with gentamycin
35
Which type of pneumonia is gentamicin used for
Staph with flucloxacillin
36
Which type of pneumonia is vancomycin used for
MRSA
37
What do you generally give pneumonia (2)
amoxicillin + clarithromycin
38
Complications of pneumonia (5)
``` Pleural effusion Pneumothorax Lung abscess (often Staph aureus) Empyema Sepsis ```
39
Which complications of pneumonia do staph commonly do (4)
Lung abscess (often Staph aureus) Swinging fevers Persistent pneumonia Foul-smelling sputum
40
Which parts of the body can TB affect (8)
``` Lungs Brain Heart Spine Skin Testes GI Kidneys ```
41
What are the effects of TB on the skin (2)
Erythema Nodosum | Clubbing
42
What are the effects of TB on the brain
Meningitis
43
What are the effects of TB in the lungs (2)
TB pneumonia | Pleural effusion
44
What are the effects of TB on the GI system (2)
Peritonitis | Ascites
45
What are the effects of TB on the heart (3)
Pericardial effusion Constrictive pericarditis Normocytic anaemia
46
What are the effects of TB on the spine (3)
Pott’s disease Spinal cord compression Osteomyelitis
47
What are the effects of TB on the spine (2)
Epididymo-orchitis | Infertility
48
What are the effects of TB on the kidney (2)
Renal failure | Addison’s disease
49
Ix for TB not bloods (4)
Sputum MCS (x3 samples) (microscopy with Ziehl-Neelsen stain = enables visualisation of acid-fast bacilli) CXR Lymph node biopsy (caseating granuloma) Mantoux/tuberculin skin test (TST) IGRA
50
What stain is used to detent TB in sputum
Ziehl-Neelsen stain
51
What bloods do we take to detect TB and what are the results (2)
FBC High WCC CRP High
52
What is seen in the CXR of TB (5)
``` Consolidation (patchy/heterogenous) Bi-hilar lymphadenopathy Upper lobe scarring (Cavitating lesions) (Pleural effusions) ```
53
What is seen in the CXR of miliary TB
Nodular shadowing
54
Define bronchiectasis
chronic condition that causes permanent dilation of the airways, alongside increased mucus production
55
Congenital causes of bronchiectasis (3)
CF Primary ciliary dyskinesia (AKA Kartageners syndrome) Youngs syndrome
56
What is the triad in primary ciliary dyskinesia (Kartagener's syndrome)
Triad: PCD Sinusitis Situs inversus
57
What is the triad in Youngs syndrome
Bronchiectasis Sinusitis Infertility
58
Acquired causes of bronchiectasis (6)
``` Pneumonia TB Measles Pertussis Allergic bronchopulmonary aspergillosis (ABPA) Immunocompromised (e.g. HIV) ```
59
Symptoms of bronchiectasis (6)
``` Chronic cough (+green sputum) Haemoptysis SOB Chest pain Fever Weight loss ```
60
Signs of bronchiectasis (2)
Clubbing | Bibasal crackles
61
Ix for bronchiectasis (not bloods, 4)
Sweat test (Cystic fibrosis) Sputum MCS CXR HR-CT chest (best method
62
How do you test for CF
Sweat test
63
What is the classic sign seen on CT of bronchiectasis
Classic feature | Signet ring sign
64
Conservative Mx of bronchiectasis (4)
Exercise Good diet Good hydration Airway clearance
65
How can you practise airway clearance for bronchiectasis (3)
Chest physiotherapy High frequency oscillation devices Nebulised hypertonic saline
66
Medical Mx of bronchiectasis (4 and 1 more acute)
Inhaled salbutamol Inhaled ABx (prophylactic) (Oral azithromycin) Influenza flu vaccine ``` IV ABx (acute) (IV levofloxacin – if pseudomonas) ```
67
Complications of bronchiectasis (3)
Persistent infections Cor pulmonale (RHF) Respiratory failure
68
Surgical Mx of bronchiectasis
Localised resection
69
What type of cell is small cell lung cancer
Endocrine cells
70
What type of cell is adenocarcinoma lung cancer
Goblet cells
71
What type of cell is squamous cell carcinoma
Squamous epithelial cells
72
What type of cell is large cell carcinoma
Epithelial cells
73
Associations of small cell lung cancer (2)
SIADH, ectopic ACTH
74
Associations of adenocarcinoma
Peripheral lung
75
Associations of SqCC
PTHrp
76
Which lung cancer is associated with PTHrp
SqCC
77
Which lung cancer is associated with SIADH
Small cell lung cancer
78
Which lung cancer is associated with ectopic ACTH
Small cell lung cancer
79
RF of lung cancer (3)
Age Smoking Asbestos exposure (particularly SqCC)
80
Which lung cancer is the most associated with asbestos exposure
SqCC
81
Symptoms of a primary lung cancer (6)
``` Cough (dry or productive) Haemoptysis SOB Weight loss Loss of appetite Night sweats ```
82
Symptoms of a local invasion of a lung cancer (2)
``` Nervous system (Horner’s syndrome) (left recurrent laryngeal nerve = bovine cough) Superior vena cava (SVC obstruction) ```
83
Where do lung cancers usually metastasise (4)
Bone (bone pain, fractures) Brain (headaches, blurry vision) Liver (hepatomegaly) Lymphadenopathy
84
What is heard on auscultation of a lung cancer (4)
Wheezing Increased vocal resonance (Pleural effusion =decreased vocal resonance) Crackles
85
Lung cancer blood tests and results (4)
FBC Calcium ALP LFT
86
Lung cancer blood tests results: Ca ALP LFT
``` High (bone mets)(PTHrp) May be high (bone metastases) Deranged (liver metastases) ```
87
What is seen in primary lung cancer CXR (5)
``` Consolidation (usually heterogenous) (Bi-hilar lymphadenopathy) (Upper lobe scarring) (Cavitating lesions – usually SqCC) (Pleural effusions) ```
88
What is seen in primary lung cancer CXR (5)
``` Consolidation (usually heterogenous) (Bi-hilar lymphadenopathy) (Upper lobe scarring) (Cavitating lesions – usually SqCC) (Pleural effusions) ```
89
Define mesothelioma
malignant neoplasm of mesothelial cells of the pleura (rare condition)
90
RF of mesothelioma
Asbestos exposure
91
Symptoms of mesothelioma (5)
``` Cough (dry) SOB Weight loss Loss of appetite Night sweats ```
92
What is heard on auscultation of mesothelioma that is a dead give away
Pleural friction rub
93
Which bloods do you take for mesothelioma (4)
FBC Calcium ALP LFT
94
Mesothelioma results: Calcium ALP LFT
High PTHrp ALP may be high LFT may be deranged if liver mets
95
Main Ix for mesothelioma (2)
CXR | CT chest
96
Ix for mesothelioma (4)
CXR CT chest ``` Pleural fluid (cytology)(via thoracentesis) Pleural biopsy ```

Y3 MedEd (34 decks)

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