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resp high yield Flashcards

1
Q

which lung cancer is paraneoplastic (SIADH, Cushing’s, lamert-eaton)

A

small cell lung cancer

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2
Q

where are small cell lung cancers

A

centrally around the lobar or main bronchi

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3
Q

which lung cancer causes gynaecomastia

A

adenocarcinoma

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4
Q

which lung cancer is found peripherally

A

adenocarcinoma

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5
Q

which lung cancer causes hypercalcaemia and why

A

squamous cell
-associated with parathyroid hormone

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6
Q

which lung cancer is found centrally near large airways

A

squamous cell

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7
Q

which lung cancer is found in the pleura

A

mesothelioma

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8
Q

what is horner’s syndrome and what is it caused by

A

ptosis, anhidrosis and miosis
pancoast tumour

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9
Q

top cause of pneumonia

A

streptococcus pneumonia

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10
Q

pneumonia cause in COPD

A

haemophilus influenza

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11
Q

pneumonia in immunocompromised

A

moraxella catarrhalis

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12
Q

pneumonia in CF and bronchiectasis

A

pseudomonas aeruginosa

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13
Q

pneumonia in alcoholics

A

klebsiella pneumonia

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14
Q

CURB 65

A

Confusion
Urea > 7mmol/l
Respiratory rate > 30
Blood pressure < 90 systolic or <=60 diastolic
65 - age >=65

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15
Q

treatment of CAP

A

1) amoxicillin
2) doxycyline
3) clarithromycin

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16
Q

when should patients with pneumonia get a repeat chest x-ray

A

6 weeks after diagnosis

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17
Q

investigation of asthma

A

1) eosionophil count OR FeNO
diagnose if: high eosinophil
FeNO > 50

2) bronchodilator reversibility
3) PEF (diagnose if variability > 20%)

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18
Q

diagnosis in 5-16 years asthma

A

1) FeNO > 35
2) bronchodilator reversibility (FEV1 increase)
3) PEF (variability > 20%)
4) eosinophil count and total IgE level or skin prick to dust mite

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19
Q

management of asthma

A

1) low dose ICS/LABA
2) low dose MART
3) moderate dose MART
4) check FeNO and eosinophil - neither improved? - add LTRA or LAMA (then switch if still no improvement)
5) refer to asthma team

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20
Q

what is formeterol

A

LABA

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21
Q

what is MART

A

ICS and formeterol

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22
Q

example of a lama

A

tiotropium

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23
Q

example of a LRTA

A

Montelukast

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24
Q

children aged 5-11 asthma management

A

ICS + SABA

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25
management of acute asthma attack
Oxygen - 15L non-rebreather mask SABA Corticosteroid - prednisolone for 5 days Ipratropium bromide - if severe/life threatening IV magnesium sulphate - severe life threatening IV aminophylline OSCIMA
26
PEFR for asthma attacks
50-75 - moderate 33-50 - severe < 33- life threatening
27
raised pCO2 in asthma attack?
near fatal and requires mechanical ventilation
28
management of COPD
1) general advice 2) SABA or SAMA 3) determine if asthmatic features (atopy, high eosinophils, variation in FEV1, diurnal variation in PEF) 4) add LABA and LAMA (if on SAMA change to SABA) 5) oral theophylline
29
who gets azithromycin prophylaxis in copd
- non-smokers - optimised treatments - continued exacerbations - CT thorax and sputum culture done - LFTs and ECG done (azithromycin causes long QT)
30
treatment of COPD exacerbation
1) increase bronchodilator 2) prednisolone 3) antibiotics if purulent sputum: amoxicillin or clarithromycin or doxycycline
31
investigation of choice for idiopathic pulmonary fibrosis
high resolution CT
32
what causes upper lobe fibrosis
C - coal workers pneumonoconiosis H - Histiocytosis/hypersensitivity pneumonitis A - ankylosing spondylitis R - radiation (radiotherapy then 6-12 months later) T - tuberculosis S - silicosis/sarcoidosis
33
exudative vs transudative
exudative - high protein content -related to inflammation transudative - low protein content -fluid shifting
34
treatment of pneumothorax
symptomatic? NO = conservative care YES = assess for high risk characteristics
35
what are the high risk characteristics that prompt pneumothorax treatment
-haemodynamic compromise -significant hypoxia -bilateral pneumothorax -underlying lung disease ->50 w/smoking history -haemothorax
36
no high risk characteristics and safe to intervene in pneumothorax?
-conservative care -ambulatory device -needle aspiration
37
if there are high risk characterisitics and safe to intervene?
CHEST DRAIN
38
treatment of tension pneumothorax
needle thoracostomy -5th intercostal space mid axillary line
39
non-caeseating granulomas
sarcoidosis
40
- Erythema nodosum - Bilateral hilar lymphadenopathy Polyarthralgia
sarcoidosis
41
indications for steroids in sarcoidosis
- Patients with CXR stage 2 or 3 who are symptomatic (if stable with only mild abnormal lung function tests then no treatment) - Hypercalcaemia Eye, heart or neuro involvement
42
lung transplant contraindication for CF
infection with burkholderia cepacia
43
bronchiolitis virus
RSV
44
management of bronchiolitis
supportive
45
zeihl-neelsen stain turns red
TB
46
Ghon focus
primary TB
47
latent TB treatment
* 3 months of isoniazid (with pyridoxine) and rifampicin or 6 months of isoniazid (with pyridoxine)
48
active TB treatment
2 months of RIPE Rifampicin Isoniazid Pyrazinamide Ethambutol then 4 months of RI Rifampicin Isoniazid
49
what are people with silicosis at risk of developing
TB
50
COPD exacerbation, when should they get NIV
respiratory acidosis despite maximum standard medical treatment
51
what level of protein is exudative
> 30
52
pleural protein: serum protein ratio >0.5
exudative
53
what interventions improve survival in COPD
smoking cessation long term oxygen therapy
54
management of pleural plaques
benign -do not need follow up
55
Pneumothorax: persistent air leak or recurrent episodes
consider referral for VATS for pleurodesis
56
abnormal bronchial breathing and dull to percuss
pneumonia
57
cannonball mets "large round well circumsized masses in lungs"
renal cell carcinoma mets
58
COPD - still breathless despite using SABA/SAMA and asthma/steroid responsive features
add a LABA + ICS
59
if needle aspiration of a pneumothorax is unsuccessful
CHEST DRAIN
60

fourth year (17 decks)

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