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Respiratory > Investigations > Flashcards

Investigations Flashcards

1
Q

Coryza

A

Based on symptoms

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2
Q

Sinusitis

A

Based on symptoms

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3
Q

Acute Bronchitis

A

Symptoms based

Nothing on chest exam (maybe wheeze)

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4
Q

Pneumonia

A 
CURB65
CXR
Serology 
Blood Culture (moderate to severe CAP) 
ABG (Oxygen sat is <94%)
Blood Tests (FBC, U&amp;E, CRP) 
Sputum Culture and Gram Stain
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5
Q

Sarcoidosis

A

CXR

    • bilateral hilar lymphadenopathy
    • nodule along fissures

CT
– check for peripheral nodular infiltrates

Tissue Biopsy

Bloods
– raised calcium and increased inflammatory markers

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6
Q

Influenza

A

Symptom based

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7
Q

Epiglottitis

A

Laryngoscopy

Blood tests to detect WBC and bacteria

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8
Q

Croup

A

Symptoms based

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9
Q

Extrinsic Allergic Alveolitis

A

History: Allergen Exposure

CXR

    • Widespread infiltrates
    • fibrosis in upper zones

Lung Function Tests

    • Low FEV1 and FVC
    • High/normal ration
  • -Low TLCO

If in doubt- lung biopsy

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10
Q

Idiopathic Pulmonary Fibrosis

A

History: Occupation (in depth), pets, drugs

CXR

    • bilateral infiltrates
    • fine inspiratory crackles

HR CT scan

    • bilateral lower zone reticular fibrosis/ shadowing
    • presence of ‘ground glass’ = reversible alveoli’s

Pulmonary Function Tests

    • Restrictive
    • Reduced FEV1 and FVC
  • -Normal/ raised FEV1/FVC ratio
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11
Q

Coal Miners Pneumoconiosis

A

CXR
–Upper lobe reticular shadowing/ fibrosis

Lung function not impaired

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12
Q

Silicosis

A

CXR

    • Egg shell calcification of hilarity nodes
    • pulmonary fibrosis
    • upper lobe shadowing more than lower lobe

Pulmonary Function Tests
– Restrictive is chronic

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13
Q

Asbestosis

A

Pleural fluid aspiration
– low cytological yield

CXR and CT

    • Moderate/ Large effusion
    • Pleural nodularity
  • -Local invasion
  • -Lung entrapment
  • -Base of lung

Biopsy

  • -Under CT/ USS. direct vision
    • Asbestos fibres

Sputum Culture
– Asbestos bodies

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14
Q

Sleep Apnoea

A

Overnight sleep study

  • -Oximetry
  • -Airflow
  • -Thoracic movement
    • Full Polysomnography
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15
Q

Tuberculosis

A

PCR

Tuberculin Test
–Doesn’t distinguish between latent, cured or active

Interferon Gamma Release Assay

Ziehl-Neelson
–Stain positive for acid-fast bacilli

CXR

    • Latent: Ghon focus
  • -Consolidation/ Cavitation. Effusion

CT scan

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16
Q

Lung Cancer

A 
Symptoms Based 
Blood Test
Urinanalysis 
CXR
CT scan 
-- If CT scan shows cancer 
--> PET scan 
Bronchoscopy and biopsy
Percutaneous Needle Biopsy
17
Q

Asthma

A

Family history
Symptoms
Examination= Wheeze (crackles if infection)

Reversibility due to inhaled salbutamol over 15% 
Diurnal Variation in peak flow rate 
Normal gas exchange 
Reduced FEV1 to under 75%
Preseved FVC and TLC 
Provocation testing 
--exercise/ inhaled allergen (histamine)
18
Q

COPD

A

Spirometry

    • Decrease in PEFR, FEV1, FVC and TLC.
  • -FEV1/FVC ratio is below 75%

CXR
–lung infiltrates if infection

Blood test
–rule out other causes of dyspnoea

Sputum culture
–to grow organism causing exacerbation

19
Q

Pleural Effusion

A

Based on symptoms and signs
CXR
CT scan
Pleural Biopsy
pH: Normal ~7.6 and <7.2 drainage required
Glucose- low in empyema, rheumatoid, lupus , TB, malignancy

20
Q

Pulmonary Embolism

A 
CT 
ECG
--Acute right heart strain pattern 
--T wave inversion (V1 to V3) 
Isotope Lung Scan
-- V/Q
--Sensitive for small peripherals 
Consider leg and pelvic US for silent DVT
21
Q

Bronchiectasis

A

Examination
–Coarse crackles at base on inspiration

CXR
–Mid zone tram lines

22
Q

Pneumothorax

A

CXR

    • Small <2cm rim of air
  • -Large >2cm

ABG
–Hypoxia

CT scan
–Used to differentiate bullies lung disease

23
Q

Cystic Fibrosis

A

Heal prick test
Genetic Testing
Sweat test

24
Q

Adult respiratory distress syndrome

A

Chest X-ray
ABGs
Sputum Culture
Blood Culture

25
Q

Wegeners Granulomatosis

A

CXR

  • -Nodular masses
  • -pneumonia infiltrates with cavitation

Renal biopsy
–Necrotising microvascular glomerulonephritis

26
Q

Churg-Strauss Syndrome

A

CXR
–Pneumonic shadows (bilateral)
ANCA +ve

Respiratory (5 decks)

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