more resp Flashcards by Lucy Miller

diagnosis of copd

Fev1

FEV1/FVC <

80% and 0.7

(FEV1 < 30% is in severe copd)

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if pleural fluid to serum ratio is less than 0.5

transudate

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most common cause transudative pleural effusion is

congestive heart failure

-CGH is most common cause of bilateral pleural effusion but can also cause uniltaeral plueral effusion

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transudate causes

cirrhosis

nephrotic syndrome

heart failure

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risk factors for bronchiecatsis

rheumatoid arthritis and immunosupressive therapy

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coarse crackles is

fine crackles is

bronchiectasis

pulmonary fibrosis

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—are causes of finger clubbing

chronic suppurative respiratory infections

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– is a well recognised cause of finger clubbing

bronchogenic carcinoma

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PULMONARY FIBROSIS 3C’S

CLUBBING

CYANOSIS

COUGH

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on ct embolus appears

grey

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Ct of aortic dissction

linear flap within the lume of aorta

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CT of malignnancy

irregular mass and enlarged lymph nodes and localised spread

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-nosebleeds, nagal congestion, joint pains, cxr-nodules, positive p-ANCA

granuolmatosis with polyangiitis

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21y/o difficulty breathing and swallowing, drooling, fever not rccieve any immunisations as a kid

epiglottitis

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12y/o sore throat, no cough general malaise, swollen neck lymph nodes

Pharyngitis so do throat swab

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CF patient with acute chest pain, breathlessness and hypoxia

pneumothorax

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Cf patient with hypoxia, tachcardia and chest pain, onset not so sudden and accompanied with increased sputum , fever

pulmonary exacerbation of CF

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subclavian line insertion is highly associated with

iatrogenic pneumothorax

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costochondritis

chest pain worse on inspiration, chest wall tenderness

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where does needle aspirate go

chest drain go

2nd intercostal space mid clavicular line, side of decreased breath sounds

5th intercostal space mid axillary, side of decreased breath sounds

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tension pneumothorax first treatment

needle aspirate -2nd intercostal

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hypercalcaemia is associated with

squamous cell carcinoma

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cancer in hilar mass common of

squamous ?not 100% sure

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Pulmonary alveolar proteinosis

typically in male smokers aged 20-50

bilateral perihilar alveolar opacities similar to pulmonary oedema
needs repeated intevention therapies
end inspiratory crackles, cough , restrictive pattern,SOB

bopisy-granular eosinophillic material with PAS positive

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alcoholic and lower zone consolidation

aspiration pneumonia

first line mamanegement of severe asthma attack

salbutamol by oxygen driven nebuliser

The volume of air that can be forcibly be blown out after full inspiration

Forced Vital capacity not vital capacity!

measure of the carbon monoxide uptake by the lungs from a single inspiration over a set period of time

Diffusing capacity (DLCO)

what is common post bone marrow transplant, with cough and wheeze on auscultation, obstructive on spirometry

bronchiolitis obliterans

drug induced lung disorderss have -- patterns

restrictive

fine crackles in lung bases indicates

fluid in the lung and not in the pleural spaces

pericardial effusion would cause

decrease cardiac output, distant heart sounds, hypotension and distended neck veins

history of hyperlipidaemia and hypertension(risk factors) new audible systolic murmur at apex(most likely mitral valve regurg) fine crackles in bilateral lung bases

pulmonary oedema

differentials for nocturnal cough

asthma, gord, sinusitia with post nasal drip and congestive heart failure

gord is exacerbated by

stress and lying flat

small numerous opacities in upper lung zones with hilar lymphadenopathy. hilar lymph nodes may show egg shell calcification

silicosis

cxr of tension pneumothorax

tracheal deviation to the contralateral side and depression of the hemidiaphgram ipsilaterally

FeNo\> x is indicative of asthma

40ppb

x% increase in fev1 post bronchodilator is indicative of asthma

greater than - FEv1 follwing bronchodilator supports diagnosis of aasthma greater than x% variability in PEFR suports diagnosis of asthma

200ml 20

factory worker

asbestos

most patient have what type of resp failure

type 1

cause of low sodium in small cell lung cancer

syndrome of inappropriate antidiuretic hormone secretion

may cause increased air trapping and increased thoracic pressure or irritation of the bronchioles worsening symptoms but it can be used carefully in ICU but need to watch so not always best

CPAP

clubbing, fine end inspiratory crackles, bibasal reticular nodular shadowing

idiopathic pulmonarry fibrosis

type 2 resp failure low 02 and high c02

COPD

tesnion pneumothorax may present with

asymetrical chest moveemnt hyper resonant hemithroax absent breaths sounds tracheal deviation

transudate effusionn is caused by

increased capilllary hydrostatic pressure or decreased oncotic pressure

exudate effusion caused by

increased capillary permeability

renal failure causes what effusion

transudate

surface landmark bewteen middle and lower right rib= oblique fissure

rib 6

smoker, chronic dyspnea, shpyeard worker, copd treatment not working, cxr- fine reticular opacitieis in lower zones, ct- interstitial thickening and ground glass opacity in upper lungs asbestosis, pneumoconisosis, respiratory bronchiolitis associated lung disease ?

RB-ILD not asbestosis as absence of pleural plaques pneumocconiosis occurs in coal miners and those exposed to coal dust

exposed to pigeon droppings, pulmonary nodules and mediastinal lymph nodes

Histoplasmosis

large pneumothorax sponatenous w no trauma

14F chest drain insertion over a seldinger wire

what gives bilateral perihilar consolidations

pneumocytis jirovecii

post chemo and low neuttrophils

neutropenic sepsis

first line treatment for neutropenic sepsis

antibiotic eg tazocin ( pipperacilin and tazobactam)

- recurrent chest infection - crackles and wheeze in left upper zone of chest - CXR- mass w irregular border in left upper zone

adenocarcinoma PERIPHERIES of. lung squamous are more central and associated w smokers

asbestosis dont particularly present with

chest pain

thickening of pleura

mesothelioma

white completely opacificed lung after chest drain from penumothorax

iatrogenic haemothorax as bleeding

- sudden SOB that come without warning - tightness in chest - resolves within a few mins

Panic attack

holly leaves on CXR

calcified pleural plaques- not asbestosis- generally considered benign but are related to asbestos exposure

more resp Flashcards

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