resp extra notes Flashcards
1
Q
what is the most common cause of acute epiglottitis
A
haemophilus influenzae B
2
Q
what are the 3 main causes of HAP
A
pseudomonas aerginosa
SA/MRSA
Klebsiella
3
Q
how is acute bronchitis differentiated from pneumonia
A
chest XR clear in bronchitis
4
Q
what are the 3 main atypical pneumonias
A
mycoplasma
legionella
chlamydophilia pneumonia
5
Q
what is the most common cause of aspiration pneumonia
A
klebsiella
-ve enterococcus
6
Q
what microorganism is associated with farm/plants/harvest
A
aspergillus fumigatas
7
Q
what is the treatment for PE
A
LMWH e.g. dalteparin
warfarin for 3 months or LMWH for 3 months if secondary to malignancy
8
Q
what does bilateral lower zone reticulonodular shadowing show
A
fibrosis
9
Q
how is an empyema treated
A
US guided chest drain and antibiotics
10
Q
what does faecal elastase test test
A
assess exocrine pancreatic dysfunction in CF
11
Q
what microorganisms infect CF
A
SA H. influenzae LT - Pseudomonas Aeruginosa Burkholderia Cepecia ( less common)
12
Q
what are... amphotericin vonconazole itraconazole caspofungin
A
antifungals
13
Q
what should be measured in acute exac of COPD
A
ABGs
14
Q
32 YO LT asthma suspected pneumonia CXR - unusual pattern of changing infiltrates eosinophilia inflammatory markers raised biopsy of lung tissue - eosinophilic infiltrate, granuloma p-ANCA +ve
A
Chung Strauss - eosinophilic infiltration causing vasculitis of small arteries and veins
15
Q
tin miner
A
pneumoconiosis
16
Q
smoker haemoptysis SOB, tired inspiratory crackles throughout lungs impaired renal function raised anti-GBM antibody
A
Goodpastures syndrome
17
Q
long standing cough, multiple fits every day, cold 2 months ago
A
pertusis
18
Q
worked in coal industry
rheumatoid arthritis
worsening breathlessness
Xray - small nodules throughout lung fields
A
Caplans syndrome - rheumatoid pneumoconiosis
19
Q
early pregnancy
acetalasis on XR
resp assistance required
A
newborn respiratory distress syndrome
20
Q
SOB clubbing bibasal crepitations stiff hand joints lost weight CRP and ESR raised
A
rheumatoid
21
Q
SOB when active
non-productive cough
pmhx rheumatoid arthritis
takes methotrexate and folic acid
A
interstitial lung disease - possibly drug induced fibrosis
22
Q
chest pain worse in deep breaths/cough poorly localised rash across face fmhx: T1 diabetes, rheumatoid arthritis
A
pleuritis
23
Q
worked in ship yards weight loss night sweats worsening breathlessness imaging - extensive pleural disease and peritoneal deposits
A
mesothelioma
24
Q
what is the treatment for croup
A
nebulised adrenaline
25
what is a s/s SLE
pleurisy
26
inflamed sinuses, lungs, throat, kidney
haemoptysis
nose bleeds
wegners granulomas - granulomatous disease affecting small arteries
27
gradual onset SOB
reduced chest expansion
dullness on percussion
pleural effusion
28
what is a CF screening test that can be done in the GP
faecal elastase
29
what is seen in sweat test of CF
high sodium
30
what does CF show on spirometry
obstructive
31
what is the treatment of a tension pneumothorax
large bore cannula 2nd ICS MCL
then chest drain 4th/5th ICS MAL
recurrent - pleurodesis
32
how does a pneumothorax look on a CXR
straight line with no lung markings outside it
33
what is kartageners syndrome
AR disease
ciliary dyskinesia assoc. abnormal mucociliary clearance --> recurrent resp infections, infertility, pancreatic problems
dextrocardia
34
```
35 year old woman
chest pain
SOB
red rash across face (butterfly rash)
raised ds-DNA and ANA abs
```
SLE
35
14 month old baby
| sternal recession and indrawing
bronchiolitis
36
infection affecting distal airspaces usually accompanied by inflammatory exudate causing consolidation
pneumonia
37
fixed dilation of bronchi usually as a result of scarring or distal to a chronic obstruction
bronchiectasis
38
infection at 4 months old
| developing normally, after supportive treatment goes on to develop normally
transient hypogammaglobulinaemia of infancy
39
3 month old infections
family history early infant death
differential WBC - low T cell and raised B cell
diarrhoea
SCID
40
```
15 day old baby
severely unwell
febrile
difficult to settle
extensive oral ulcers
lost weight
low neutrophil count
```
AR - Kostmann syndrome
41
```
repeated infections
recurrent oral candidiasis
multiple facial features suggesting genetic cause
low T cell count and hypocalcaemia
abnormal CVS
```
DiGeorge syndrome
42
what can you test the function of with NBT
neutrophils
43
what is a test for haemophilus influenza
X and V test, chocolate agar
44
what are the most common microorganisms seen to infect in COPD
haemophilus influenza
strep. pneumonia
moraxella catarrhalis
45
what are 4 common causes of coryza
adenovirus
rhinovirus
RSV
coronavirus
46
what is a cause of pharyngitis
adenovirus
47
what is youngs syndrome
bronchiectasis + rhinosinusitis + reduced fertility
| AR
48
what is chronic bronchial sepsis
bronchial sepsis but no bronchiectasis on HRCT
| younger patients esp women in child care
49
what is the most common cause of brochiectasis
CF
50
what does inhalation of NO do to V/Q
improves
51
what happens in CF
Failed opening of Cl channel -> ↑cAMP, resulting in ↓Cl and ↑Na -> ↑viscosity of airway secretions.
52
what is there a deficiency of in bronchiectasis
IgA
53
what cells do glucocorticoids act on
Th2
54
what is seen in bronciectasis
tram track signs
| signet ring signs?
55
what is seen in a ghon focus
epithelial cells
| langhans giant cells
56
where does TB tend to stay
apices of lungs
| - fibrosing and cavitating apical lesions
57
what is IGRT
specific test for M. tuberculosis - but doesn't differentiate latent, active or previously treated TB
58
what is the main side effect of Rifampicin
orange urine and tears
| hepatitis
59
what is the main side effect of isoniaside
pins and needles
| hepatitis
60
what is the main side effect of pyrazinamide
gout
| hepatitis
61
what is the main side effect of ethambutol
arthralgia
| retrobulbar neuritis
62
what does steeple sign on CXR indicate
croup
63
egg shell calcification in hilar region
silicosis
64
heart failure cells in alveolar spaces
chronic pulmonary oedema/LV failure/LT pulmonary hypertension
65
assman focus
secondary TB
| top of lung
66
coin lesion
primary/secondary cancer
granuloma
abscess
67
thumbprint sign of head Xray
epiglottitis
68
snow storm appearance on X ray
baritosis/silicosis
69
large PE tx
thrombolysis
70
small PE tx
LMWH
71
child with barking cough
croup
72
right sided chest pain
probably pneumonia
73
CT scan showing bronchiole wider than neighbouring arteriole
| signet ring sign
bronchiectasis
74
CXR showing tram line
bronchiectasis
75
what are some job causes of silicosis
glass working
mining
stone working
foundry working
76
what causes a spontaneous pneumothorax
rupture of sub pleural air cysts (blebs)
77
what causes secondary pneumothorax
secondary to resp disease
78
how can resp distress syndrome be prevented
steroids to expectant mother
79
what mothers are more prone to children with resp distress syndrome
diabetics
80
what is treatment for severe resp distress syndrome
artificial surfactant
| oxygen
81
what is the blue inhaler
salbutamol
82
in obstructive lung disease there is trouble with
exhaling
83
what is stridor
inspiratory wheeze
84
what are some causes of cor pulmonale
COPD
PE
sleep apnoea
CF
85
what are some s/s cor pulmonale
```
cyanosis
tachycardia
raised JVP
RV heave
Pan systolic murmur (tricuspid regurg)
```
86
what is the treatment of croup
single dose of prednisolone
87
what is a complication of coryza
bronchitis
88
what is the treatment of whooping cough
erythromycin
89
how is whooping cough diagnosed
pernasal swab
| serology for bordetella pertussis
90
what is the treatment for obstructive sleep apnoea
lose weight
reduce alcohol
CPAP
91
what is the treatment for central sleep apnoea
treat cause
| NIPPV
92
Cheyne-Strokes respiration
central sleep apnoea
93
what is the treatment for ARDS
ICU ventilation
94
what breathing is seen in ARDS
rapid shallow breathing
95
what are some s/s of a lung abscess
```
Swinging Fever
Foul Smelling Sputum
Pleuritic Chest Pain
Haemoptysis
Malaise
Weight Loss
FBC - anaemia and neutrophilia
CXR - walled cavity with fluid level
```
96
what is the expansion in pneumonia
diminished
97
what is the resonance in pneumonia
increased
98
what is seen on XR of pneumonia
new shadowing
99
what breathing is seen in pneumonia
bronchial breathing
100
patient with resolving pneumonia gets a fever
| what do you suspect
empyema
101
what are some s/s empyema
chest pain on inspiration
pleural rub
CXR
drainage
102
A one year old child, caucasian with loose oily stools and failure to thrive presents. They have had persistent chest infections. Cause?
CF
103
what is the treatment for CF
- ABs given early, high dose, for longer
- salbutamol to relieve symptoms
- corticosteroids to reduce inflammation
- pancreatic enzymes, vitamins, high calorie diet
104
what is seen on the CXR of fibrosis
reduced lung volume
honeycombing
bilateral lower zone reticulonodular shadows
105
what are some s/s asthma
diminished air entry
audible wheeze
hyper inflated chest
106
what are some s/s bronchiectasis
lower lobes
course crackles
clubbing
107
what is the treatment for drug induced asthma e.g. by aspirin
montelukast
108
what do mast cells in asthma secrete
histamine
LTC4
PGD2
109
what is the pathophysiology of coal worker pneumoconiosis
Coal dust enters the lungs which cannot be removed or destroyed
It is ingested by macrophages and causes the macrophages to release inflammatory mediators
Causes inflammation and fibrosis
110
what is seen in massive fibrosis of coal worker pneumoconisos
Very large, nodular, fibrinotic masses in the upper lungs
| Shortness of breath, chronic cough, Black sputum, lung dysfunction
111
what is the general order of treatment for asthma
```
SABA
ICS
LABA
CysLTA (oral)
prenisolone
```
