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1
Q

what does amiodarone do to the lunges

A

lower zones lung fibrosis

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2
Q

mast cell tryptase

A
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3
Q

discharge post anaphylaxis attack

A

2 epipens

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4
Q

steroid dose kids asthma attack

A

10mg oral pred <2
20mg 2-5yo
30-40mg >5yo

3 days

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5
Q

silicosis CXR

A

mining occupation

upper zone fibrosis
egg shell calcification of hilar nodes

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6
Q

acute bronchitis tx

A

usually self resvolves

consider abx if
systemically super unwell
pre existing comorn
CRP 20 -100 = delayed prescripti
CRP>100 = doxycycline

if preg or child = amox

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7
Q

CF contraindication to lung transplant

A

burkholderia cepacia

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8
Q

pharm tx CF

A

if homozygous for delta F508 mutation =

lumacaftor/ivacaftor (Orkambi)

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9
Q

SAMA example

A

ipratropium

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10
Q

atypical pneumonia causes

A

legions of psittaci MCQs

legionella
chlamydia psittaci
mycoplasma pneumoniae
chlamydophilia pneum
q fever - coxiella burnetii

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11
Q

indications for surgery in bronchiectasis

A

localised disease
uncontrollable haemptysis

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12
Q

life threa attack

A

PEFR <33%
spO2<92%
‘normal’ CO2

CHEST

Cynaosis
hypotenson
exhaustion/confusion
silent chest/poor resp effort
tachy/brady/arthythmia

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13
Q

occupational asthma is
mc cause

A

exposure following chemicals at work

mc: isocyanates ie spray painting and foam moulding using adhesives

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14
Q

pattern of asthma on spirometry

A

obstructive

reduced FEV1:FVC

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15
Q

asthma diagnosis on spirotmetry

A

15% improvement post bronchodilatir

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16
Q

how does salbutamol work

A

b2 receptors in resp tract stimulated
= inc sympathetic activity
= relaxes bronchial smooth muscle

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17
Q

physiological measurement to determine COPD severity

A

FEV1

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18
Q

when is LTOT Ci in copd

A

if still smokes

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19
Q

bronchiectasis mc organism

A

haam . influenxa

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20
Q

pneumonia cx

A

resp failure
af
empyema
effusion
lung abcess
pericarditis

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21
Q

empyema tap and mx

A

turbid
ph<7.2
reduced glucose
inc LDH

US guided chestdrain/asp

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22
Q

legionella sx

A

lymphopenia
siadh-> low na
deranged LFTs

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23
Q

klebsiella who

and fx

A

pneum in alcholic

cavitating pneumonia
esp upper lobes

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24
Q

parrots pneumonia

extra pulm fx

A

chlamydia pstacci

horders spots - rose spots
splenomegaly
epistaxis
hep nephritus
meningoenceph

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25
bronchectasis cxr
thickened bronchial walls tramlines n rings
26
bronchiescasis spiro
obstructive
27
bronchiectasis ix
initial sputum, cxr, post brochodil spirometry gold high res CT
28
allergic bronchopulm aspergillous
T1HS reaction cxr= bronchiectasis sputum = black on silver stain skin test = aspergillous or IgR RAST inc IgE and eosinophills
29
consolidation percussion breath sounds vocal resonance chest expansion
dull bronchial increased reduced
30
effusion percussion breath sounds vocal resonance
stony dull reduced reduced
31
pembertons sign
hold arm over head = facial plethora insp stridor inc jvp SVC obstruction
32
local cx llung ca
recurrent laryngeal palsy phrenuc palsy SVC obstruction horners af
33
endo cx lung ca
ADH -> SIADH (euvol low na) ACTH -> cushings syndrome serotonin -> carcinoid (flushing, diarrhoa) PTHrP -> primary HPT (incca, bone pain) -SCC
34
transudate (low protein) inc capillary hydrostatic pressure causes
ccf iatrogenic fluid overload renal failure
35
transudate reduced cap oncotic pressure
liver failure nephrotic syndrome malnut,malabsorb
36
MRC dysponia scale
1 sob on vigorous exertion 2 SOB hurrying/ stairs 3 walk slowly or stop for breath 4 stops for beath <100m/few mins 5 too breathless to leave house or SOB ondressing
37
transudate conten
<25 protein
38
exudate
>35 protein
39
effusion fluid protein between 25-35
LIGHTS criteria
40
lights criteria
Light's Criteria An exudate has one of: 1 .Effusion : serum protein ratio >0.5 Effusion : serum LDH ratio >0.6 Effusion LDH is 0.6 × ULN
41
exudate causes
inc cap permeability pneumonia, TB bronchial ca lymphoma, mesothilioma RA, SLE infarction
42
empyema causes
ca TB RA SLE
43
Interstitial lung disease upper zone causes
A PENT Aspergillosis : ABPA Pneumoconiosis: Coal, Silica Extrinsic allergic alveolitis Negative, sero-arthropathy, TB
44
interstitial lung disease lower zone causes
STAIR Sarcoidosis (mid zone) Toxins: BANS ME Asbestosis Idiopathic pulmonary fibrosis Rheum: RA, SLE, Scleroderma, Sjogren's, PM/DM
45
interstitial lung disease dug causes
BANS ME Bleomycin, Busulfan Amiodarone Nitrofurantoin Sulfasalazine MEthotrexate,
46
complicaions idiopathic pul htn
inc risk ca lung type 2 resp failure and core pulmonale
47
pneumonia ix
Bloods ABG URine pneumoccocal and legionella ag sputum MC&S CXR
48
MC HAP
pseudomonas aerunginosa staph aureus
49
statins and macrlides
macrolide inhib CYP3A4 = inc serum statin = risk of myositosis/rhabdo
50
pneumothorax percussion breath sounds chest expansion
hyperesonant percuss reduced breath sounds reduced chest expan
51
why might TB be on rise
HIV/AIDS prevelance immunosupressive drugs inc immig from areas of high prev poor socioecon conditions and overcrowding
52
TB Dx
RI 6 mths PE 2 mths
53
why 4 drugs in tb
combat multidrug resistance
54
erthythema nodosum causes
idiopathic RA UC/Crohns TB sarcoidosis strep infxn chlamydia oral contracept
55
TB dx pul bone meningeal
6 mths 9 mths 12 mths
56
CF prev
1 in 2500 live births
57
bronchiectasis path
chronic infxn and inflam of large airways causing their abnormal permenant dilitation
58
bronchiectasis cause
idiopathic recur ifxn , pertusiss Tb measles RA UC alpha 1 antitripsin
59
bronchiectasis cx
recurrent pneumonia resp failure massive haemoptysis pneumothroax cor pulmonale septicaemia
60
type 1 resp fail path
vq mismatch or diffusion failure
61
type 2 respfail path
alveolat hypoventilation +/- vq mismatch
62
PE Ix
2 level wells CTPA or VQ scan
63
Lung Ca ix
CXR CT PET bronchoscopy
64
non small cell lung ca staging
TNM
65
lung ca types
small cell non small cell = - scc - adenocarcinoma - Large cell
66
idio pulmonary fibrosis CXR
red lung vol bilat lower zone reticnod shadowing honeycomb lung
67
restrictive spiro
low fev 1 low fvc normal/high ratio
68
causes extrinsic allergic alveolitis
bird fanciers lung farmers lung mushroom worker winemakers malt workers lung (aspergillus clavatus)
69
extrinsic allerguc alveolitis
inhalation of allergerns that cause hypersensitv rxn acute = Type 3 (4-6hrs fevecoughsob) over time repeat exposure chronic = type 4 ie granuloma formation and obliterative bronchiolitis
70
OSA tools
epworth sleepiness scale multiple sleep latency test (MSLT)
71
OSA RF
obesity smoking alochol nasal polyps enlarged tonsils/adenoids
72
OSA dx
sleep studies polysomnography
73
OSA mx
stop smoking wt loss avoid alcohol sleep upright mandib advancement device CPAP surgery
74
cor pulmonale cxr
enlarged r atrium n ventricle prominent pul arteries
75
cor pulmonale ecg
RAD p pulmonale
76
sarcoidosis fx
GRANULOMAS gen - fever wt loss lymphad resp - BHL arthralgia neuropathy urine - hypercalcaemia = renal stones low hormones - pitdysfxn = amenorhea optha - ant. uve myocard - restrictive cardiomyop pericardi effusion abdo - hepsplemeg skin = EN and lupus pernio
77
BHL causes
sarcoidosis TB bronchial ca extrinsic allerg alveo lymphoma
78
sarcoid granuloma
non caseating
79

finals (28 decks)

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