Resp Flashcards
(132 cards)
1
Q
Stony dull to percuss
A
Pleural Effusion
2
Q
Right sided pleuritic chest pain
A
most likely pneumonia
3
Q
Alveolar bat’s wings, Kerley B lines, cardiomegaly, dilated prominent upper lobe vessels, pleural effusion
A
Pulmonary oedema
4
Q
Ground-glass appearance on X-ray
A
Pulmonary fibrosis
OR Respiratory Distress
Syndrome (in newborn)
5
Q
Ziehl-Neelsen stain positive for acid fast bacilli
A
TB
6
Q
Caseous necrosis
A
TB
7
Q
Assmann focus
A
Apical lesion of secondary TB infection
8
Q
Apical TB
A
most likely secondary TB
9
Q
Miliary TB
A
spread of organism into bloodstream
10
Q
If TB spread via pulmonary artery, it spreads to ———
A
the lung
11
Q
If TB spread via pulmonary vein, it spreads to ———
A
liver, spleen and kidneys
12
Q
Positive anti-glomerular basement membrane antibodies (anti-GBM)
A
Goodpasture’s syndrome
13
Q
Chest infection with a parrot/pigeon as pet
A
caused by chlamydophila psittaci
14
Q
Dry cough and diarrhoea after holiday abroad, some indication of water spread
A
Legionella pneumophila (test urine for antigens)
15
Q
“Very tall, thin young man who indulges in marijuana”
A
probably pneumothorax (Marfan’s)
16
Q
Bilateral hilar lymphadenopathy, erythema nodosum, granulomas, fatigue, uveitis and weight loss
A
Sarcoidosis
17
Q
Signet ring sign (bronchiole wider than neighbouring arteriole on CT)
A
Bronchiectasis
18
Q
D sign on x ray
A
Empyema
19
Q
“Steeple” sign on x ray
A
croup
20
Q
laryngotracheobronchitis
A
croup
21
Q
Child with barking cough
A
croup
22
Q
Pneumocystis pneumonia
A
HIV
23
Q
Pneumocystis pneumonia is treated with ———
A
Co-tramoxazole (± prednisolone if
severe)
24
Q
Asthma + nasal polyps + salicylate sensitivity
A
Samter’s triad
25
Alcoholic (danger of aspiration pneumonia)
Klebsiella pneumoniae
26
Red Jelly sputum
Klebsiella Pneumoniae
27
Mucoid sputum
Chlamydia psittaci
28
Rusty sputum
Pneumococcal pneumonia
29
Cannonball metastases
Primary renal cell carcinoma
| also weight loss and haematuria
30
Morning headache
Hypercapnia OR
| side effects of organic nitrates
31
ACTH secreting lung tumour
Small cell lung cancer
32
PTH secreting lung tumour
Squamous cell lung cancer
33
Small-cell carcinoma
neuroendocrine, highly malignant, may be associated with ectopic endocrine syndromes
34
Female, heavy smoker - lung cancer
Small cell lung cancer
35
Young black female
probably sarcoidosis
36
Non-smoker + lung cancer
(peripheral) adenocarcinoma
37
Increased serum ACE and Ca2+
Sarcoid
38
Eggshell calcification at hilar region
Silicosis
39
Haemosiderin
In ‘heart-failure cells’ seen in alveolar spaces.
Macrophages absorb haemosiderin (found in chronic pulmonary oedema, associated with severe LVHF, or long-standing pulmonary hypertension)
40
Ghon Focus
TB - caseous necrosis at periphery of lung,
| beneath the pleura
41
‘Coin lesion’ found on chest radiographs
rounded solitary lesion, commonly primary cancer, metastatic tumour (esp of kidney), bronchial hamartoma, granulomatous inflammation, or lung abscess.
42
Ptosis (drooping of eyelid), small pupils, unilateral loss of sweating on one side
Horner’s Syndrome
43
Horner’s Syndrome
Pancoast’s tumour OR local spread of cancer to the
| intrathoracic nodes
44
Pancoast tumour
Tumour at lung apex
45
Moderate asthma attack
PEF > 50-75%
| Speech normal, oxygen sats above 92%, RR/HR normal
46
Moderate asthma attack management
Salbutamol via spacer, oral prednisolone
47
Acute severe asthma attack
PEF > 33-50%
| Can't complete sentences, oxygen sats above 92%, RR > 25, HR > 110
48
Acute severe asthma attack management
Oxygen, salbutamol nebulised, oral prednisolone (OR IV hydrocortisone)
49
Life-threatening asthma attack
PEF < 33%
Loss of consciousness, exhaustion, silent chest, cyanosis, hypotension, arrhythmia etc...
oxygen sats below 92%, RR > 25, HR > 110
50
Life-threatening asthma attack management
Oxygen, salbutamol (+ ipratropium) nebulised, oral prednisolone (OR IV hydrocortisone)
51
Life-threatening asthma attack - unresponsive to treatment
consider continuous nebulised salbutamol, or single dose magnesium sulphate.
consider ventilation
52
Thumbprint sign on head x ray
Epiglottitis
53
Inspiratory whoop/barking cough
Pertussis (whooping cough)
54
6 month-old with wheeze, cough and signs of respiratory distress (e.g. subcostal recession)
Bronchiolitis
55
Bronchiolitis infecting organism
Respiratory syncytial virus (RSV) in 70% of cases
56
Trauma resulting in tachycardia, tachypnoea and bilateral alveolar shadowing
Acute respiratory distress syndrome (ARDS)
| non-cardiogenic pulmonary oedema leads to acute respiratory failure
57
ARDS first-line treatment
CPAP
| also low-dose NO for pulmonary hypertension and conservative fluid management improve outcome
58
Eosinophilic inflammation
asthma
59
Neutrophilic inflammation
COPD
60
Episodic SOB, cough and wheeze that improves when the pt. is on holiday
Occupational asthma
61
Saddle Nose deformity
Granulomatosis with polyangiitis (GPA)
Syphilis
Cocaine abuse
62
Haemoptysis, fever, night sweats
suspect TB
63
Gradual onset SOB, reduced chest expansion, and dullness on percussion
Pleural effusion
64
Reduced FEV1, FVC, and FEV1/FVC ratio
COPD
65
Reduced FEV1, normal FVC
Asthma
66
Reduced FEV1 and FVC, normal FEV1/FVC ratio
Restrictive pattern
67
CF chest x-ray
bronchiectasis and hyperinflation
68
Human Faecal Elastase (FE-1)
Screening test for CF
69
Legionnaire’s is diagnosed with -------
urine antigen test
70
Snow storm appearance on x ray
baritosis, silicosis
71
Management of COPD
SABA or SAMA (use when needed)
>>> LABA + LAMA (if pt. has asthmatic features, consider LABA + ICS)
>>> LABA + LAMA + ICS
72
Management of infective exacerbation of COPD
```
iSOAP
ipratropium
Salbutamol (+ theophylline IV if poor response)
Oxygen (sparingly)
Amoxicillin (if bacterial infection)
Prednisolone
```
73
First-line investigation of infective exacerbation of COPD
CXR
| then blood gases, ECG, FBC, U&Es
74
Central lung cancer
Squamous or small-cell
75
High d-dimers
Suspect PR
| send for CTPA and V/Q scan
76
Low d-dimers
Exclude PE
77
Large PE, haemodynamically unstable pt.
thrombolysis
78
Small PE
LMWH
| Dalteparin/Fragmin
79
Tenecteplase
thrombolysis drug
80
Reverse warfarin with ---------
vitamin K
81
Respiratory alkalosis
panic attack
82
Frank pus on aspiration
empyema
83
Pickwickian disease
Obesity hypoventilation syndrome
| body fat prevents air getting in, causing sleep apnoea + hypercapnia
84
Overnight nasal ventilation
Obesity hypoventilation syndrome
| Pickwickian disease
85
Guillian-Barre disease
causes paralysis a.k.a polyneuritis
| normally preceeded by strep. throat or resp/GI tract infection
86
Coal worker
Coal workers pneumoconiosis (simple disease, or progressive massive fibrosis)
Lung apex
87
TLCO
how well oxygen can diffuse into the blood
88
Asbestosis
problems found at the base of the lung
89
Type 1 diabetic, vomiting and not taking her insulin
metabolic acidosis (diabetic ketoacidosis)
90
young woman, tender well defined nodules on shins bilaterally
( + weight loss, night sweats, sputum)
erythema nodosum
91
Farmer
Farmer's lung
| EAA
92
Extrinsic allergic alevolitis
granulomatous inflammation of lungs
93
Pigeons, parrots
Bird-fancier's lung, exposure to avian proteins
94
cANCA positive
| joint pain, nasal congestion and recurrent nosebleeds
granulomatosis with polyangitis (GPA)
95
exudate
protein >30g/l
96
transudate
protein <30g/l
97
Parathyroid hormone causes -----
Hypercalcaemia
| bones, stones, groans, moans
98
Smoker, cavitating hilar tumours
Squamous cell
99
Lung cancer causing gyneocomastia
Large cell
| releases sex hormones
100
Hypertrophic pulmonary osteoarthropathy
| finger clubbing, periosteal inflammation a.k.a. ankle pain
Lung cancer, commonly adenocarcinoma
101
Chemo-sensitive lung cancer
Small cell
102
"moon face", acne, high BP
Cushing's
| ACTH (small cell lung cancer)
103
Lung cancer with finger tingling, arm pain
Brachial plexus lesions
104
Type 1 respiratory failure
low oxygen
105
Type 2 respiratory failure
low oxygen, high carbon dioxide
| COPD
106
TB drugs
2 RIPE
| 4 RI
107
Rifampicin side effects
red-orange urine and tears, rashes, hepatotoxicity
108
Isoniazid side effects
peripheral neuropathy, hepatitis
109
Pyrazinamide side effects
gout
| also joint pain, rash, yellow skin/eyes
110
Ethambutol side effects
colour blindness, vision changes
111
Mycobacterial infection
TB
112
Small Ghon focus, large hilar nodes
Primary TB
| immune activation
113
TB with fibrosing, cavitating apical lesion
Secondary TB
| reactivation/reinfection - associated with immunosuppressed
114
Q fever
coxiella burnetti
| sheep/farm
115
Dry cough in young people
Mycoplasma pneumoniae
116
Haemophilus influenzae
COPD/alcoholics/elderly
117
Pseudomonas aeruginosa
Gram neg bacilli
| CF
118
Causes of pulmonary fibrosis
```
BREAST CA
Bleomycin
Radiation
EAA
Anklylosing spondylitis
Sarcoidosis
TB
Cryptogenic fibrosing alveolitis (IPF)
Asbestosis
```
119
Chest hyperexpansion
COPD
120
Stridor
Upper airway obstruction
121
Early onset emphysema
alpha-1 antitrypsin deficiency
122
Positive sweat test
| > 60mmol/L NaCl
CF
123
Swinging fever, copious foul smelling sputum
Lung abscess
124
Left-shift of oxyhaemoglobin dissociation curve
Reduced 2,3-DPG, hypothermia, alkalosis, CO
125
Right-shift of oxyhaemoglobin dissociation curve
Hyperthermia, hypercapnia, acidosis, sickle-cell diseases
126
Lung cancer of neuroendocrine cells
small cell
127
Lung cancer with lymph node involvement
Lymphoma
128
Lung cancer, asbestos exposure
Mesothelioma
129
COPD first-line treatment
SMOKING CESSATION
| then drugs
130
Honey-comb appearance on X-ray
Late fibrosis
131
Mucin-producing lung cancer cells
Adenocarcinoma
132
Rheumatoid arthritis + pneumoconiosis
Caplan's syndrome
