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RESPIRATORY - RIA > lung ting > Flashcards

lung ting Flashcards

1
Q

what is interstitial lung disease?

A

conditions that affect lung parenchyma & fibrosis with replacement of normal elastic tissue with stiff scar tissue

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2
Q

causes of drug induced pulmonary fibrosis?

A
  • Amiodarone
  • Methotrexate
  • Sulfasalazine
  • Cyclophosphamide
  • cytotoxic agents (Bleomycin & Busulphan)
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3
Q

lung damage and release of inflammatory mediators causing increased capillary permeability & non cardiogenic pulmonary oedema

A

Acute respiratory distress syndrome

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4
Q

4 diagnostic criteria for ARDS?

A

1) Acute onset
2) CXR shows bilateral infiltrates
3) PCWP < 19 mmHg/lack of CCF
4) Refractory hypoxaemia

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5
Q

pulmonary fibrosis spirometry?

A

restrictive picture

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6
Q

outline the acute & chronic phase of extrinsic allergic alveolitis

A

acute = infiltration of alveoli with acute inflammatory cells

chronic = granuloma formation

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7
Q

specific occupations with allergens causing extrinsic allergic alveolitis

A

Mushrooms workers lung (reaction to specific mushroom antigens)

Malt workers lung (mould on barley)

Bird fanciers lung (reaction to bird droppings)

Farmers lung (mouldy spores in hay)

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8
Q

sleep apnoea severity scale?

A

Epworth sleepiness scale

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9
Q

what happens in obstructive sleep apnoea

A

collapse of pharyngeal airway causing apnoeic episodes during sleep lasting a few minutes

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10
Q

symptoms patients with obstructive sleep apnoea may present with

A
  • morning headache
  • daytime sleepiness
  • feel unrefreshed from sleep
  • partner reports loud snoring
  • reduced sats during night
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11
Q

investigations for sleep apnoea

A
  • ENT referral
  • Pulse oximetry
  • sleep studies
  • video recording
  • Polysomnography
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12
Q

management of sleep apnoea

A
  • weight reduction
  • reduce tobacco & alcohol
  • CPAP via nasal mask
  • surgery e.g. UPPP
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13
Q

prophylaxis for PE (2)

A

low weight molecular heparin (enoxaparin)
&
Compression stockings (work by increasing blood flow out of capillaries to prevent pooling of blood in deep veins)

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14
Q

wells score: high & low - what is investigation of choice

A

likely: CTPA & CXR
unlikely: D-dimer

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15
Q

supportive management of PE

A
  • analgesia
  • admission
  • oxygen
  • monitoring
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16
Q

2 causes of trachea deviation towards a white out

A
  • pneumonectomy

- complete lung collapse

17
Q

3 causes of tachea deviation away from a white out

A
  • massive pleural effusion
  • diaphragmatic hernia
  • large thoracic mass
18
Q

deviation of trachea in a tension pneumothorax

A

trachea deviates away from affected side

19
Q

difference between primary and secondary pneumothorax?

A

primary occur spontaneously in a previously non pathological lung - typically a tall thin young male

secondary - occur in previously diseases lung e.g. COPD/asthma

20
Q

management of

  • primary pneumothorax
  • < 2 cm
  • not SoB
A
  • consider discharge

- follow up in 2-4 weeks

21
Q

management of

  • primary pneumothorax
  • < 2 cm
  • SoB
A

Fine needle aspiration

if aspiration fails then insert a chest drain

22
Q

location of Percutaneous needle aspiration for pneumothorax

A

2nd ICS, mid clavicular line

23
Q

management of primary pneumothorax if > 2 cm

A

Percutaneous needle aspiration

24
Q

location of chest drain insertion?

A

5th intercostal space, mid axillary line in safe triangle bordered by lateral edge of pec major

25
Q

management of secondary pneumothorax in:

  • > 50 year old
  • > 2 cm or SoB
A

insert a chest drain

26
Q

management of secondary pneumothorax if < 2cm or no symtptoms

A

aspiration

27
Q

CXR findings in pleural effusions (3)

A
  • dense homogenous shadows
  • meniscus signs
  • blunting of costophrenic angle
28
Q

examination findings in pleural effusions (3)

A
  • stony dull percussion
  • decreased breath sounds
  • decreased vocal/tactile fremitus
29
Q

how to investigate a pleural effusion

A

diagnostic thoracocentesis with a 21G needle in 1 or 2 intercostal spaces below the point of percussion of upper border of pleural effusion

30
Q

investigation of the pleural effusion sample

A
  • pH
  • protein concentration
  • LDH
  • cytology & microbiology
31
Q

3 differentials for pleural effusion aspirate - blood stained

A
  • TB
  • PE
  • Mesothelioma
32
Q

3 causes of exudative pleural effusion

A
  • pneumonia
  • TB
  • Lymphoma
  • Mesothelioma
  • RA
  • Malignant mets
33
Q

triad of Meig’s syndrome

A
  • ascites
  • pleural effusion
  • ovarian tumour
34
Q

protein level in exudative pleural effusion

A

> 3g/L

35
Q

protein level in transudative pleural effusion

A

< 3g/L

36
Q

Fluid LDH to serum LDH level in exudative pleural effusion

A

> 0.6

37
Q

3 differentials for transudative pleural effusion

A
  • Heart failure
  • Liver cirrrhosis
  • Nephrotic syndrome
38
Q

how is M.Bovis spread

A

through infected milk & post mortem

39
Q

what is the treatment for pulmonary TB

A

RIPE: 6 month course of RI & 2 months of PE

  • Rifampicin
  • Isoniazid
  • Pyrazinamide
  • Ethambutol

RESPIRATORY - RIA (8 decks)

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