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Symptom Words, Abbreviations, Good Random Questions > Random Ass Facts For Resp > Flashcards

Random Ass Facts For Resp Flashcards

1
Q

When does surfactant production begin in foetal development?

A

Around week 22

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2
Q

What is the most common gene causing cystic fibrosis and how does it lead to mucus accumulation?

A

DeltaF508 (Phe508del) - the gene encoding the cystic fibrosis transmembrane conductance regulator, an ion channel involved in the transport of chloride ions in the respiratory and pancreatic epithelium, leading to mucus accumulation

This gene is on chromosome 7 at CFTR gene

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3
Q

What are sign to look out for in a baby’s and young children for undiagnosed cystic fibrosis?

A

wheeze, poor feeding and failure to gain weight, frequent chest infections
Failure to pass meconium (stool) - new borns
Failure to thrive, pancreatic insufficient (loose greasy stool due to lack of lipases)

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4
Q

What does a heel prick test confirm?

A

Cystic fibrosis

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5
Q

Lung cancer can present with ipsilateral elevation of the hemidiaphragm due to compression of what nerve?

A

Phrenic nerve

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6
Q

What does methaemoglobin do to the oxygen dissociation curve?

A

Shifts it to the left

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7
Q

What is methaemoglobinaemia?

A
  • Where is iron molecule is F3+ and not F2+ so can not bind to oxygen
  • occurs due to environmental agents or medications (e.g. lidocaine and trimethoprim) or genetic conditions such as G6PD deficiency and pyruvate kinase deficiency
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8
Q

What causes Bird fanciers lung?

A

Avian proteins from bird droppings

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9
Q

What causes tobacco workers lung?

A

Aspergillus spp.

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10
Q

What causes farmers lung?

A

Thermophilic actinomycetes

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11
Q

What is responsible for hot tub lung?

A

Mycobacterium avium

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12
Q

How can cystic fibrosis lead to infertility in men?

A

Cystic fibrosis is associated with absent vas deferens

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13
Q

What is the investigation of chronic to confirm the diagnosis of bronchiectasis?

A

High resolution computed tomograpahy (although a chest x-ray is normally carried out first)

Characteristic feature include:
- Bronchial wall dilation
- Lack of bronchial tapering

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14
Q

What are the characteristic features of bronchiectasis on chest x-ray?

A
  • Thickened bronchial walls (tramlines)
  • Cystic lesions with fluid levels
  • Collapsed areas with crowded pulmonary vasculature
  • Scarring
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15
Q

What is Kartageners syndrome?

A

Defect in the cilia which reduces the ability of the lungs to clear mucus - this progresses to bronchiectasis as repeated infections and inflammation cause the airways to become widened and oedematous

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16
Q

Which physiological changes do occur following a tracheostomy?

A
  • alveolar ventilation increased
  • anatomical dead-space is reduced by 50%
  • proportion of ciliates epithelial cells in the trachea may decrease
  • splinting of the larynx may lead to swallowing difficulties
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17
Q

What is the pathogen in the majority of cases of Bronchiolitis?

A

Respiratory syncytial virus (75-80% of cases)
Other causes: adenoviruses, mycoplasma or secondary to a bacterial infection

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18
Q

What is bronchiolitis?

A

Condition characterised by acute bronchiolar inflammation

Features:

  • common cold symptoms (including mild fever)
  • dry cough
  • increasing breathlessness
  • wheezing, fine inspirations crackles (not always present)
  • feeding difficulties associated with increasing dyspnoea are often the reason for hospital admission
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19
Q

What is Ménière’s disease>

A

Disorder of the inner ear of unknown cause. It is characterised by excessive pressure and progressive dilation of the endolymphatic system

Features:

  • recurrent episodes of vertigo, tinnitus and hearing loss (sensorineural). Vertigo is usually the prominent symptom
  • a sensation of aural fullness or pressure is now recognised as being common
  • other features include nystagmus and a positive Romberg test
  • episodes last minutes to hours
  • typically symptoms are unilateral but bilateral symptoms may develop after a number of years
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20
Q

What are the 3 bones in the ear?

A
  • malleus
  • incus
  • stapes
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21
Q

Foreign bodies lodges in the piriform recess ma damage what nerve?

A

The internal laryngeal nerve

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22
Q

What is the mechanism of action of aminophylline?

A

Binds to adenosine receptors and blocks adenosine-mediated bronchoconstriction

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23
Q

What is Cholesteatoma?

A

A non-cancerous growth of squamous epithelium that is ‘trapped’ within the skull base causing local destruction. It is most common in patients aged 10-20 years. Being born with a cleft palate increases the risk of cholesteatoma around 100 fold.

Main features

  • foul-smelling, non-resolving discharge
    hearing loss

Other features are determined by local invasion:

  • vertigo
  • facial nerve palsy
  • cerebellopontine angle syndrome

Otoscopy

  • ‘attic crust’ - seen in the uppermost part of the ear drum
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24
Q

What to chemoreceptors respond to to increase ventilation?

A

Respond to increased H+ in BRAIN INTERSTITIAL FLUID

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25
Q

How does the body control ventilation?

A
  • Control of ventilation is coordinated by the respiratory centres, chemoreceptors, lung receptors and muscles.
  • Automatic, involuntary control of respiration occurs from the medulla.
  • The respiratory centres control the respiratory rate and the depth of respiration.
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26
Q

What would normal rebuts be when the Rinne and Weber tests are carried out?

A
  • Rinne result: Air conduction > bone conduction bilaterally
  • Weber result: same in both ears
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27
Q

What are the causes of increase anion acidosis?

A

MUDPILES

M - Methanol
U - Uraemia
D - DKA/AKA
P - Paraldehyde/phenformin
I - Iron/INH
L - Lactic acidosis
E - Ethylene glycol
S - Salicylates

28
Q

Asthma is associated with what type of hypersensitivity reaction

A

Type 1 hypersensitivity

29
Q

What is functional residual capacity?

A

Expiratory reserve volume + residual volume

30
Q

What bacteria is a common cause of acute bacterial otitis media?

A
  • Haemophilus influenzae
  • Streptococcus pneumoniae
  • Moraxella
31
Q

What nerve roots contribute nerve fibres to the ansa cervicalis?

A

C1, C2 and C3

Ansa cervicalis muscles:

GHost THought SOmeone Stupid Shot Irene

GenioHyoid
ThyroidHyoid
Superior Omohyoid
SternoThyroid
SternoHyoid
Inferior Omohyoid

32
Q

A 35-year-old man presents with fever, malaise, weight loss, dyspnoea, and pain in the shoulder & hip joints. He has raised erythematous lesions present on both legs. Blood tests show raised calcium levels and raised serum ACE levels. A chest x-ray shows bilateral hilar lymphadenopathy.

What is the most likely diagnosis?

A

Raised serum ACE levels - think sarcoidosis

33
Q

What is sarcoidosis?

A

A multisystem disorder of unknown aetiology characterised by non-caseating granulomas. It is more common in young adults and in people of African descent

Features:
- acute: erythema nodosum, bilateral hilar lymphadenopathy, swinging fever, polyarthralgia
- insidious: dyspnoea, non-productive cough, malaise, weight loss
- skin: lupus pernio
- hypercalcaemia: macrophages inside the granulomas cause an increased conversion of vitamin D to its active form (1,25-dihydroxycholecalciferol

34
Q

What are the syndromes associated with sarcoidosis?

A
  • Lofgrens syndrome
  • Mikulicz syndrome (outdated name??)
  • Heerfordts syndrome
35
Q

How to measure vital capacity?

A

Inspiratory reserve volume + tidal volume + expiratory reserve volume

36
Q

Which area of the brain stem coordinates the basic rhythm of breathing?

A

Medulla oblongata

37
Q

Causes of raised TLCO (total gas transfer)?

A
  • asthma
  • pulmonary haemorrhage (Wegener’s, Goodpasture’s)
  • left-to-right cardiac shunts
  • polycythaemia
  • hyperkinetic states
  • male gender, exercise
38
Q

Causes of a lower TCLO (total gas transfer)?

A
  • pulmonary fibrosis
  • pneumonia
  • pulmonary emboli
  • pulmonary oedema
  • emphysema
  • anaemia
  • low cardiac output
39
Q

At which vertebral level would the diaphragm be encountered when inserting an IVC filter?

A

T8

40
Q

When should legionella pneumophilia be suspected?

A
  • where multiple otherwise fit people contract pneumonia in an air conditioned space
  • hyponatraemia and lymphopenia are features associated with legionella pneumophilia
41
Q

What causes a normal anion gap acidosis?

A

HARD UP

H - Hyperalimentation/hyperventilation
A - Acetazolamide
R - Renal tubular acidosis
D - Diarrhoea
U - Ureteral diversion
P - Pancreatic fistula/parenteral saline

42
Q

Causes of hoearsness

A
  • voice overuse
  • smoking
  • viral illness
  • hypothyroidism
  • gastro-oesophageal reflux
  • laryngeal cancer
  • lung cancer
43
Q

What is the most common cause of Malignant otitis

A

Pseudomonas aeruginosa

44
Q

What is the treatment for benign paroxysmal positional vertigo?

A

Epley manoeuvre - aims to dislodge otoliths by promoting movement of fluid in the semi-circular canals of the inner ear.

45
Q

What vertebral levels is the larynx found?

A

Larynx is found in the anterior neck at the level of the C3–C6 vertebrae

46
Q

Which adverse consequence may occur as a result of chest drain insertion?

A

Winging of the scapula - Long thoracic nerve is susceptible to damage during chest drain insertion

47
Q

What is Chylothorax?

A

A type of pleural effusion where lymphatic fluid accumulates in the pleural cavity

48
Q

What is a pyothorax?

A

Type of pleural effusion where pus accumulate in the pleural cavity

49
Q

What is the most common type of lung cancer?

A

Adenocarcinoma

50
Q

Almost exclusively related to asbestos exposure. This is an aggressive and incurable cancer related to the pleura. It would not be noticeable as an upper lobe mass. A loss of lung volume or pleural opacity is more likely in the first instance.

A

Mesothelioma

51
Q

A rare subtype of lung cancer and is less likely to occur than adenocarcinoma. The classic presenting features are cough, haemoptysis, and recurrent chest infections.

A

Bronchial adenoma

52
Q

A rare subtype of lung cancer and is less likely to occur than adenocarcinoma. The classic presenting features are cough, haemoptysis, and recurrent chest infections.

A

Small cell carcinoma

53
Q

A 65-year-old man visits his GP after a diagnosis of stage III lung cancer. He asks the doctor about the complications he might expect from his condition.

What is he at increased risk of developing?

A

Pneumothorax

54
Q

What vertebral levels does the phrenic nerve start at? What does the phrenic nerve supply?

A
  • C3,4,5
  • supplies:
    • diaphragm, sensation central diaphragm and pericardium
55
Q

What crosses the diaphragm at T12?

A

Aorta, thoracic duct, azygous vein

56
Q

What crosses the diaphragm at T10?

A

Oesophagus and the vagal trunk

57
Q

At what level does the trachea bifurcate? The carina

A

T5 (or T6 in tall subjects)

58
Q

Clubbing (hypertrophic pulmonary osteoarthropathy, HPOA) is associated with squamous cell carcinoma

A

True

59
Q

What is the commonest cause of empyema?

A

Streptococcus pneumoniae - also the most commonest cause of pneumonia

60
Q

Which sensory nerve branches off the superior laryngeal nerve?

A

The internal laryngeal nerve

61
Q

What is a cervical rib due to?

A

Elongation of the transverse process of the 7th cervical vertebra. It is usually a fibrous band that attaches to the first thoracic rib

62
Q

How does Myasthenia gravis lead to a restrictive pattern of lung disease?

A

Myasthenia gravis leads to muscle weakness of the chest wall resulting in incomplete expansion during inspiration

63
Q

Peritonsillar abscess (quinsy)

A

A peritonsillar abscess typically develops as a complication of bacterial tonsillitis.

Features include:
- severe throat pain, which lateralises to one side
- deviation of the uvula to the unaffected side
- trismus (difficulty opening the mouth)
- reduced neck mobility

64
Q

What is the definition of this lung volume?

A

Maximum volume of air that can be expired at the end of a normal tidal expiration

65
Q

How can COPD occur in a young non-smoker?

A
  • A-1 antitrypsin deficiency,
  • a relatively common autosomal co-dominant genetic condition
  • This protein would normally protect the lung cells against the destructive action of neutrophil elastase that destroys alveolar walls causing emphysema and thereby COPD.
66
Q

Treatment of Ramsay Hunt syndrome

A

Oral aciclovir (7 days) and corticosteroids (prednisolone-5 days)

Symptom Words, Abbreviations, Good Random Questions (5 decks)

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