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Respiratory Y3 > Resp - general > Flashcards

Resp - general Flashcards

1
Q

Causes of flash pulmonary oedema

A
  • Use of ACEi in renal artery stenosis
  • acute MI
  • ARDS
  • Heroine + cocaine use
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2
Q 
Organisms that cause
CAP
HAP
Atypical pnuemonia + which is the commonest
pneumonia in people with COPD
A

CAP - Streptococcus pneumoniae, Haemophilus influenza, Moraxella catarrhalis, Legionella (middle aged, old), mycoplasma (children, young)

HAP - Staphylococcus aureus (cavitating lesions), Pseudomonas aeruginsa, Klebsiella (cavitating lesions)

Atypical pneumonia - Legionella pneumonia (hypoNa), Chlamydia pscittaci (birds at home), Chlamydia pneumoniae, Mycoplasma pneumoniae (assosciated with transverse myelitis, erythema multiforme)

  • commonest is Mycoplasma pneumoniae

COPD - haemophilus influenza

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3
Q

Organisms that cause bronchiectasis

A

Haemophilus influenzae
Strept pneumoniae
Staph aureus
Pseudomonas aeruginosa

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4
Q

Causes of clubbing

A

CLabcdefUBBING
Cyanotic heart disease
Lung Disease

Abscess
Bronchiectasis
CF
Don't say COPD
Empyema
Fibrosis
UC/Crohn's
Birth defects
Biliary cirhossis
Infective Endocarditis
Neoplasm (lung cancer, mesothelioma
Gastrointestinal malabsorption syndrome (coeliac disease)
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5
Q

In asthma exacerbations, pulse pressure falls on inspiration because of

A

Decreased atrial filling pressures on inspiration

500 SBAs in medicine, sukhpreet singh, Resp Q21

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6
Q

Complications of Aspergillus infection if not treated with anti-fungals

A
  1. Type 1 hypersensitivity rxn causing atopic asthma through inhalation of fungal spores
  2. ABPA (allergic bronchopulmonary aspergillosis) - Type 3 hypersensitivity reaction to A. fumgates
  3. Aspergilloma (mycetoma) - fungal ball in pre-existing cavity
    Often caused by TB and sarcoidosis
  4. Invasive aspergillosis - immunocompromised patients, SLE, burns, after broad-spetrum therapy
  5. Hypersensitivity pneumonitis
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7
Q

Pulmonary hypertension definition

A

Haemodynamic + pathophysiological condition defined as an increase in mean PAP >25 mmHg at rest (assessed by R heart catheterisation)

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8
Q

What is the Haladane effect

A

Oxygenation of blood in the lungs displaces carbon dioxide from hemoglobin which increases the removal of carbon dioxide

Consequently, oxygenated blood has a reduced affinity for carbon dioxide.

In a COPD patient if you aim for saturations of 100%, yu are going to reduce the affinity of Hb for CO2 –> less CO2 excreted, more CO2 retention, more CO2 acidosis

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9
Q

Conditions that predispose to spontaneous pneumothorax (5)

A
  • COPD
  • Smoking
  • HIV/AIDS with pneumocystis jiroveci
  • Marfan’s syndrome
  • CF
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10
Q

Causes of the pulmonary-renal syndrome

A
  • Goodpasture’s syndrome

Vasculitides

  • Granulomatosis with polyangiitis (wegeners)
  • Microscopic polyangiitis
  • Polyarteritis nodosa
  • Hereditary hemorrhagic telangiectasia - Osle Weber Rendu syndrome
  • SLE
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11
Q

Cancers that commonly metastasise to the lungs (4)

A
  • Breast
  • Colorectal
  • Renal
  • Female genital tract (ovaries, cevix)
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12
Q

Complications of pneumonia

A
  • Pleural effusion
  • Pneumothorax
  • Emyema
  • Sepsis
  • Lung abscess (commonly Staph aureus) - swinging fevers, persistent pneumonia, foul smelling sputum
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13
Q

Different types of lung cancer buzzwords

NSCLC (85%)- squamous cell carcinoma, adenocarcinoma, large cell carcinoma
SCLC (15%)

A 
NSCLC
Squamous cell carcinoma - squamous epithelial cells
- Smokers
- PTHrp 
- Cavitating lesions

Adenocarcioma - goblet cells

  • Non smokers
  • Hypertrophic osteoarthroapthy
  • Most common type of lung cancer

Large cell carcinoma - epithelial cells

Small cell carcinoma - endocrine cells

  • Smokers
  • Ectopic hormone production (ACTH, ADH)
  • Lambert Eaton syndrome - paranyoplastic syndrome assosciated with SCLC
  • Not assosciated with cavitating lesions
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14
Q

Define obstructive sleep apnoea OSA

A

Defined by 5 or more respiratory events (apnoeas, hypopnoeas, arousals) per hour
+
Symptoms of SDB (sleep disordered breathing)

Recurrent collapse of pharyngeal airway and apnoea (cessation of airflow for >10s) during sleep; followed by arousal from sleep

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15
Q

CXR

homogenous vs alveolar vs reticulonodular shadowing

A

Homogenous –> block solid, pleural effusion

Alveolar –> fluffy –> pulmonary odema

Reticulonodular –> lines and dots –> fibrosis

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16
Q

Hilar enlargement
Bilateral, symmetrical
Unilateral, asymmetrical

A

Bilateral, symmetrical = sarcoidosis, TB, lymphoma, lung infections
Unilateral, asymmetrical = underlying malignancy

17
Q

Lights criteria

A

Light’s Criteria – a pleural fluid is likely exudate if ONE of the following two is met:

Ratio [pleural protein: serum protein] >0.5

Ratio [pleural LDH: serum LDH] >0.6

extra info
Pleural LDH >2/3 upper limit of normal serum LDH - exudate

18
Q

Which organism causes pneumonia after influenza?

A

Staph aureus

19
Q

Which organisms can cause lung abscesses

A

Staph aureus
Klebsiella
TB

20
Q

Which type of cancer releases

ACTH
ADH
PTHrp

A

Small cell lung cancer - ACTH, ADH

Squamous cell cancer - PTHrp

21
Q

What can cause flash pulmonary oedema? (+ symptoms + signs)

A 
Flash pulmonary oedema
   Cough
   Dyspnoea
   Othropnoea
   Bilateral fine inspiratory crackles
Causes of flash pulmonary oedema
ACEi in RAS
Acute MI
ARDS
Heroin + cocaine use
22
Q

What kind of pleural effusion do

Pulmonary infarction
RA
SLE

cause?

transudative or exudative?

A

Exudative

23
Q

Which neuromuscular conditions can cause cor pulmonale?

A

MG
MND
polio

24
Q

What is an empyema?

A

Pus in the pleural space which can occur in patents with resolving pneumonia

pH <7.2
Increased LDH
Low glucose

25
Q

How to differentiate + treat

s aureus pneumonia
mycoplasma pneumonia
pseudomonas spp

A

S aureus
young, elderly, IVDU, underlying diseases, post influenza
flucloxacillin

mycoplasma
erythema multiforme, AIHA from the build up of cold agglutinins, transverse myelitis
clarythromycin

pseudomonas spp
nosocolmial pneumonia, bronchiectasis, CF
ciprofloxacin, carbapenems, cephalosporins

26
Q 
Commonest cause of CAP 
Another cause of CAP
Cause of HAP
Cavitating lesions 
Post-influenza pneumonia 
COPD pneumonia
A

Commonest cause of CAP – step pneumoniae
Another cause of CAP - haemophilus influenza
Cause of HAP - E coli, Staphylococcus aureus (cavitating lesions), Pseudomonas aeruginsa, Klebsiella (cavitating lesions)

Cavitating lesions – Staph aureus, Klebsiella, TB, squamous cell carcinoma, RA, granulomatosis with polyangiitis

Post-influenza pneumonia – staph aureus
COPD pneumonia – Haemophilus influenzae

27
Q

Which neurological conditions can cause respiratory alkalosis?

A

MG

GBS

Respiratory Y3 (4 decks)

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