Resp Flashcards
(122 cards)
1
Q
Pulmonary oedema may be associated with which heart murmur?
A
MR
2
Q
What is another name for Farmer’s lung?
A
Hypersensitivity pneumonitis
3
Q
What is the ratio for pleural protein: serum protein for an exudate?
A
> 0.5
4
Q
Describe Atoll’s sign
A
A region of ground glass opacity surrounded by denser lung tissue
5
Q
In which disease is Atoll’s sign most commonly seen?
A
Cryptogenic organising pneumonia
6
Q
In what class of patients is Pickwickian syndrome most commonly seen?
A
Obese patients
7
Q
What improves Pickwickian syndrome?
A
CPAP
8
Q
What is the immediate treatment for a tension pneumothorax?
A
Immediate needle thoracocentesis
9
Q
When would needle aspiration be contraindicated?
A
In trauma
10
Q
How is pericarditis treated?
A
NSAIDs
11
Q
What is the first and second line treatments in diabetic ketoacidosis?
A
1st = rapid rehydration with saline 2nd = insulin
12
Q
Which disease can aspergillosis present like?
A
Allergic asthma
13
Q
What can colorectal cancer predispose to?
A
DVT or PE
14
Q
At what position is a chest drain inserted?
A
5th ICS mid-axillary line
15
Q
Which syndrome develops secondary to an upper respiratory tract infection?
A
Guillain-Barre
16
Q
Patients with SLE may experience recurrent what?
A
Thromboembolisms
17
Q
Do the lungs receive a single or dual blood supply?
A
Dual
18
Q
In which types of worker’s lungs are giant cells found?
A
Those who work in the hard metal industry eg magnesium
19
Q
What can predispose epiglottitis?
A
Lack of childhood vaccinations
20
Q
How do pleural plaques present on CXR?
A
Holly leaf
21
Q
What disease causes an artificially high KCO?
A
Pulmonary haemorrhage
22
Q
How is chronic type II respiratory failure compensated?
A
Permanent increased HCO3-
23
Q
How can squamous cell carcinomas be described?
A
Cavitating
24
Q
How does silicosis present on CXR?
A
Egg-shell calcification
25
Which radiological sign is associated with aspergillosis?
Air-crescent sign
26
Hyponatraemia is associated with which lung cancer?
Small cell
27
Which type of sensitivity reaction is Grave's disease?
Type II
28
Which type of pleural effusion may constrictive pericarditis cause?
Transudative
29
Which type of cell is COPD associated with?
CD8+
30
Which two things are increased in SLE?
ANA antibodies and double-strand DNA
31
Which is the most common lung cancer?
Adenocarcinoma
32
Which bacteria most commonly causes acute epiglottitis?
Haemophilus Infleunzae B
33
What is a normal FEV1/FVC?
80%
34
What is a normal tidal volume?
500ml
35
Describe Fick's law
The amount of gas that moves across a sheet of tissue in unit time is proportional to the area of the sheet, but inversely proportional to its thickness
36
Describe Henry's law
The amount of given gas dissolved in a given type and volume of liquid is proportional to the partial pressure of the gas in equilibrium with the liquid
37
Describe Boyle's law
The pressure exerted by a gas varies inversely with container volume
38
What is the LENT score used for?
To estimate survival rate of malignant pleural effusions
39
What does LENT stand for?
Lactate dehydrogenase (estimates tissue damage)
ECOG performance score (patient's ability to look after themself)
Neutrophil:lymphocyte ratio in serum
Tumour type
40
What is the most common cause of CAP?
Strep pneumoniae
41
What is the total lung capacity?
5.7l
42
What effect does emphysema have on breath sounds?
Decreased
43
What is the pH of intrapleural fluid?
7.6
44
Which TB drug can render the contraceptive pill useless?
Rifampicin
45
What is the treatment for latent TB?
3 months of isoniazid and rifampicin
OR
6 months of isoniazid
46
What is the most common cause of glandular fever?
EBV
47
What bacteria is related to blindness in the developing world?
Chlamydia trachomatis
48
How does acute bronchitis present on a CXR?
Usually clear
49
What are the major causes of HAP?
Pseudomonas aeruginosa, E.coli, klebsiella
50
What is the commonest cause of empyema?
Strep. pneumoniae
51
Post-infection, how many months will it take a patient to fully recover?
6 months
52
What shape is the myoglobin dissociation curve?
Hyperbolic
53
What shape is the haemoglobin dissociation curve?
Sigmoidal
54
What happens if the rhythm of breathing comes from below the medulla?
Ventilation caeses
55
What is the value of residual volume?
1.2l
56
During inspiration, what happens to intrapleural pressure?
It falls
57
In which direction does the Bohr effect move the graph?
To the right
58
What does surfactant decrease?
Alveolar surface tension
59
What role do the kidneys play in altitude hypoxia?
Preserve acid
60
What does the Pre-Botzinger complex do?
Controls basic breathing rhythm
61
Where is myoglobin found?
In muscle tissue
62
Does compliance change with age?
No
63
What impact does dorsal neuron activation have on inspiratory muscles?
Causes contraction
64
Impulses from where prolong inspiration?
Apneustic centre
65
Hypoxia stimulates what kind of chemoreceptors?
Peripheral
66
When does hypoxia stimulate chemoreceptors?
When saturations fall below 8kPa
67
What two structures innervate peripheral chemoreceptors?
Carotid sinus then glossopharyngeal nerve
68
Where is rhythm generated (and where can it be modified)?
Generated in the medulla and modified in the pons
69
Which reflex is a good preventor of hyperinflation?
Hering-Breur
70
Which type of cancer can cause lobar pneumonia?
Squamous cell carcinoma
71
Where in the lungs are adenocarcinomas usually found?
Peripherally
72
Where in the lungs are small cell cancers usually found?
Centrally
73
What are the three main symptoms of Horner's syndrome?
Ptosis (droopy eyelid)
Anhydrosis (ipsilateral sweating loss)
Miosis (pupil constriction)
74
What hormone is secreted by squamous cell carcinomas (and what does this cause)?
PTH causes hypercalcaemia
75
Which type of small cell cancer causes Horner's syndrome?
ACTH secreting
76
At which stage in pregnancy is surfactant produced?
30-32 weeks
77
What are the 4 most common causes of pneumonia in neonates?
Group B Strep.
E.coli
Klebsiella pneumoniae
Staph. aureus
78
What are the 2 most common causes of pneumonia in infants?
Chlamydophila pneumoniae
| Strep. pneumoniae
79
Describe the Haldane effect
Removal of oxygen from haemoglobin increases the affinity of Hb for CO2
80
Do the Haldane and Bohr effects work together or against each other?
Together
81
What name is given to difficulty in expiration in obstructive disease?
Dynamic airway compression
82
In what order (from most to least) is CO2 carried in the blood?
Bicarbonate>carbamino compounds>solution
83
What is apneusis?
Prolonged inspiration with brief expiration
84
What is alveolar dead space?
Alveoli which are not adequately perfused
85
What is the most common cause of COPD exacerbations?
Haemophilus influenzae
86
What compound is naturally present in tea, coffee and chocolate?
Methylxanthine
87
What size of airways are defined as 'large'?
2mm
88
How many levels of branching are there within the respiratory tree?
23
89
What is non-atopic asthma mediated by? (2)
Macrophages and IgG
90
Contraction in smooth muscle involves what?
Ca2+ binding to calmodulin
91
Neutrophils in airways due to smoking cause what?
Mucous hypersecretion
92
Through what does mucous hypersecretion occur?
Neutrophil elastase
93
Which two types of drugs may cause asthma?
NSAIDs and beta blockers
94
What is breakdown of connective tissue in alveoli?
Emphysema
95
Calcium entry to mast cells causes release of what (2)?
Preformed histamine
| Production of leukotrines
96
Asthma-COPD overlap syndrome can be described how?
COPD with >3% blood eosinophilia
97
Which IL causes TH2 to activate and differentiate eosinophils?
IL5
98
Which IL causes TH2 cells to active B cells?
IL4
99
Which receptors do SAMAs block?
M1, M2, M3
100
Are cromones strong or weak?
Weak
101
Which two types of cells produce Cys-leukotrines?
Mast cells and inflammatory cells
102
What feature of muscarinic antagonists cause them to have low systemic absorption?
Their quaternary ammonium group
103
How long do SABAs work for?
3-5 hours
104
What % risk of pneumothorax is associated with CT guided biopsy?
10%
105
What causes Horner's syndrome?
Sympathetic chain disruption
106
What are 3 symptoms associated with squamous cell carcinoma?
Headache, thirst, confusion
107
Which type of cancer comes from the spread of neoplastic cells along the alveolar wall?
Adenocarcinoma
108
What are 3 symptoms of SVC invasion?
Headache
Distended external jugular vein
Puffy eyelids
109
Where are bronchial gland carcinomas most commonly seen?
Salivary glands
110
What type of cancer is bronchial cancer (usually)?
Squamous
111
What condition are cancer patients predisposed to, due to having hypercoaguable blood?
Thrombophlebitis
112
Describe the incidence and prevalence of lung cancer
High incidence but low prevalence
113
Invasion of the brachial plexus gives hand weakness due to which root infiltration?
T1
114
How close to the carina must a tumour be to be inoperable?
2cm
115
What are the thee components of the asthma triad?
Airway hyper-responsiveness
Airway inflammation
Reversible airflow obstruction
116
Which bacteria will only grow on lysed blood agar?
Haemophilus influenzae
117
Out of asthma and COPD, which is reversible?
Asthma
118
What is the treatment for severe CAP?
Doxycycline + co-amoxiclav
119
How many times per day is amoxicllin usually taken?
3
120
Which antibiotic can you not drink whilst taking?
Metronidazole
121
Gentamicin is only used against gram (negative/positive)?
Negative
122
With which antibiotic should renal function be monitored?
Gentamicin
