Hana Buzzwords - Respiratory

Question 1

Stony dull to percuss

Answer 1

Pleural Effusion

Question 2

Right sided pleuritic chest pain

Answer 2

Most likely pneumonia

Question 3

Alveolar bat’s wings, Kerley B lines, cardiomegaly, dilated prominent upper lobe vessels

Answer 3

Pleural effusion → Pulmonary oedema

Question 4

Ground-glass appearance on X-ray

Answer 4

Pulmonary fibrosis and Respiratory Distress Syndrome of the newborn

Question 5

Ziehl-Neelsen stain positive for acid fast bacilli

Answer 5

TB

Question 6

Caseous necrosis

Answer 6

TB

Question 7

Miliary Tuberculous

Answer 7

Spread of organism into bloodstream. If organism spread via pulmonary artery, miliary dissemination into the lung occurs. If organism spread via pulmonary vein, there is systemic dissemination to the liver, spleen, and kidneys.

Question 8

Positive anti-glomerular basement membrane antibodies

Answer 8

Goodpasture’s syndrome

Question 9

Chest infection with a parrot/pigeon as pet

Answer 9

Caused by chlamydophila psittaci

Question 10

Dry cough and diarrhoea after holiday abroad, some indication of water spread

Answer 10

Legionella pneumophila (test urine for antigens) - hyponatraemia

Question 11

Tall, thin young man who indulges in marijuana

Answer 11

Probably pneumothorax (Marfan’s)

Question 12

Bilateral hilar lymphadenopathy, erythema nodosum, granulomas, fatigue, uveitis and weight loss

Answer 12

Sarcoidosis

Question 13

Bronchiole wider than neighbouring arteriole (on CT)

Answer 13

Bronchiectasis (signet ring sign)

Question 14

D sign on X ray

Answer 14

Empyema

Question 15

Steeple sign on X ray

Answer 15

Laryngotracheobronchitis/croup (pencil shaped)

Question 16

Child with barking cough

Answer 16

Croup

Question 17

Pneumocystis pneumonia

Answer 17

HIV (treat with Co-trimoxazole [± prednisolone if severe])

Question 18

Asthma + Nasal Polyps + Salicylate/Aspirin sensitivity

Answer 18

Samter’s Triad

Question 19

Alcoholic (danger of aspiration pneumonia)

Answer 19

Klebsiella pneumoniae

Question 20

Red Jelly sputum

Answer 20

Klebsiella Pneumoniae

Question 21

Mucoid sputum

Answer 21

Chlamydia psittaci

Question 22

Rusty sputum

Answer 22

Pneumococcal pneumonia

Question 23

Cannonball metastases (also weight loss and haematuria)

Answer 23

Classically from primary renal cell carcinoma

Question 24

Morning headache

Answer 24

Hypercapnia or side effects of organic nitrates or ICP etc.

Question 25

ACTH secreting lung tumour

Answer 25

Small cell carcinoma of the lung

Question 26

PTHrP secreting lung tumour

Answer 26

Squamous cell carcinoma of lung

Question 27

Small-cell carcinoma

Answer 27

Neuroendocrine, highly malignant, and may be associated with ectopic endocrine syndromes.

Question 28

Increased serum ACE and Ca2+

Answer 28

Sarcoid Think this was just sarcoidosis

Question 29

Eggshell calcification at hilar region

Answer 29

Silicosis

Question 30

Heart-failure cells seen in alveolar spaces

Answer 30

Macrophages that have absorbed haemosiderin - found in chronic pulmonary oedema, and associated (severe) left-ventricular heart failure. Also, seen in long-standing pulmonary hypertension.

Question 31

Ghon Focus

Answer 31

An area of infection and caseous necrosis at the periphery of the lung, beneath the pleura - found in tuberculosis infection.

Question 32

Assmann Focus

Answer 32

Apical lesion of secondary tuberculous infection

Question 33

Coin lesion found on chest radiographs

Answer 33

A rounded solitary lesion. The common lesions are: Primary bronchial or lung carcinoma, Metastatic tumour (esp. of kidney), Bronchial hamartoma, Carcinoid tumour, Granulomatous inflammation, Lung abscess.

Question 34

Horner’s Syndrome

Answer 34

Can occur when there is a local spread of cancer to the intrathoracic nodes or a Pancoast’s tumour. Signs include: ptosis (drooping of the eyelid), enophthalmos (sunken eye), miosis (small pupil), and lack of sweating on the ipsilateral (same side as invasion) side of the face.

Question 35

Acute management of Asthma: OSHIT MAN

Answer 35

Oxygen 100% through a non-rebreather mask, Salbutamol (5mg) Nebulised back-to-back, Hydrocortisone (100mg) IV or Prednisolone(40mg) PO, Ipratropium Bromide (0.5mg) Nebulised hourly, Theophylline IV or aminophylline IV, Magnesium and call an Anaesthetist

Question 36

Thumbprint sign on head x ray

Answer 36

Epiglottitis

Question 37

Inspiratory whoop/barking cough

Answer 37

Pertussis

Question 38

Snow storm appearance on x ray

Answer 38

Baritosis, silicosis

Question 39

Management of infective exacerbation of COPD

Answer 39

iSOAP: ipratropium, Salbutamol, Oxygen, Amoxicillin, Prednisolone

Question 40

Non-smoker + lung cancer

Answer 40

(Peripheral) adenocarcinoma

Question 41

Squamous + Small-cell Lung cancers

Answer 41

CENTRAL

Question 42

High d-dimers

Answer 42

Suspect (but not diagnose) Pulmonary Embolism (send for CTPA or V/Q scan)

Question 43

Low d-dimers

Answer 43

Exclude Pulmonary Embolism

Question 44

Large PE

Answer 44

Thrombolysis

Question 45

Small PE

Answer 45

Low Molecular Weight Heparin (or NOAC e.g. Rivaroxaban)

Question 46

Honeycomb lung

Answer 46

Fibrosing alveolitis