Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Internal medicine > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Signs or cardiomegaly/cardiac tamponade

A

“Pericardial silhouette enlarged” if more than half of lung width

Better than cardiomegaly cos it may be enlarged due to pericardial effusion/tamponade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Types of pneumothorax

A

Primary spontaneous pneumothorax/PSP:no underlying lung issues

Vs secondary spontaneous pneumothorax(secondary to lung disease eg asthma,COPD)

Traumatic
-iatrogenic(eg from ventilator,central line too far from SCA,biopsy,thorascopy)
-non iatrogenic(eg from stab wounds)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Objective ways to identify a pneumothorax on XR

A

ACCP:distance from apex to cupola >3cm(threshold higher cos of gravity)A for Apex

BTS:interpleural distance at level of hilum> 2cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How does the lung USUALLY collapse in a pneumothorax

A

The lung usually collapses towards the hilum:unless scarring causee it to collapse un-uniformly(eg scarring in the upper lobe caused by chronic smoking causes it not to collapse towards hilum)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Risk factors for a nodule being benign vs malignant

A

-Size >20mm 50% chance of malignancy

-Borders(spiculations): poorly circumscribed borders more likely to be malignant

-Growth rate(too fast or too slow unlikely)except Small cell carcinoma and lymphoma

-attenuation:solid vs non solid(solid more common but non solid more likely to be malignant)

-calcifications:eccentric most dangerous(tumour grows out from the calcification) vs popcorn central etc

-Location:apex tends to collect more smoke in lung,higher chance of malignant lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Signs of Pulmonary Embolism on CXR

A

-Hamptons Hump(wedge shaped infarct)

-Westermark sign(oligaemia:a clarified area distal to a large vessel occluded by a pulmonary embolism,caused by reflex vasoconstriction and impaired vascular is still bc obstruction
-Pallas’s sign:enlarged descending pulmonary artery

-Fleischner sign: Dilated central pulmonary artery

-Meniscus sign: blunting of costophrenic angle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Criteria for differentiating transudative and exudative pleural effusion

A

Lights criteria

Exudative if:
Effusion protein/Serum protein >0.5
OR Effusion LDH/Serum LDH >0.6
OR Effusion LDH > 2/3 laboratory upper limit of serum LDH reference range

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Causes of transudative effusion

A

1)Congestive Heart Failure
2)Nephrotic syndrome
3)Chronic Liver disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Causes of exudative effusion

A

1)Infections
2)Neoplasm

Increased inflammation causes more protein to leak out of pulmonary vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Types of interstitial lung disease(restrictive)

A

1.Idiopathic Pulmonary Fibrosis:diagnosis of exclusion
2.Hypersensitivity pneumonitis(chronic)
3.Pneunoconiosis
4.Sarcoidosis
5.Asbestosis:caused by asbestos fibres
6.SLE
7. Rheumatoid arthritis associated ILD
8.Silicosis
9. Drug fibrosis:AMIODARONE BROMOCRIPTINE CYCLOPHOSPHAMIDE METHOTREXATE NITROFURANTOIN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

4 Ts of anterior mediastinal masses

A
  1. Thyroid
  2. Thymus
  3. Teratoma
  4. Terrible lymphoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Medial mediastinal masses

A
  1. Esophageal
  2. Bronchial cysts
  3. Hernia(hiatus?)
  4. Lymph nodes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Posterior Mediastinal masses

A
  1. Aortic Aneurysm
  2. Germ Cell Tumors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which main bronchus do foreign bodies usually enter and why

A

Right main bronchus as it is oriented more vertically, has a larger diameter and is shorter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Impt qns to ask in any suspected asthma case

A

Interval Symptoms, personal and family history of Atopy, past HD/ICU admissions or invasive intubation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Complications of pneumonia

A

Parapneumonic effusion
Sepsis
Spread to other sites eg meningitis,osteomyelitis
Hemolytic Uremic Syndrome with strep pneumo
Necrotising pneumonia

Long term:
Lung fibrosis
Bronchiectasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Pathogens in atypical pneumonia

A

Mycoplasma and chlamydia pneumoniae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Causes s of bronchiectasis

A

Focal
1.Post infectious
2. Mechanical
3. Aspiration
4. Tumor
5. Lymph nodes

Systemic
Immunodeficiency acquired and congenital
Cystic fibrosis
Ciliary abnormalities eg kartegener
Congenital lobar emphysema
Idiopathic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Coryzal symptoms

A

Fever, rhinorrhea, cough, sore throat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Croup triad

A
  1. Loss of voice/laryngitis
  2. Barking cough
  3. Strider
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Ideal method for administering high flow O2 in acute respiratory distress

A

Non rebreather mask> venturi and nasal prongs

22
Q

Causes of ILD

A

Idiopathic
Rheumatological
Drug related
Pneumoconiosis

23
Q

Function of incentive spirometer

A

Patient to breathe in as deeply and as slowly aa possible-> helps expand the lungs and prevent atelactasis

24
Q

How to ddx between pleural effusion and fibrothorax

A

Tracheal deviation in pleural effusion?

25
Q

Causes of upper lobe lung fibrosis

A

STAR

Sarcoidosis
TB
ABPA
Radiation

26
Q

Causes of lower lobe lung fibrosis

A

RADIO

Rheum(RA, scleroderma, Dermatomyositis, systemic sclerosis)
Asbestosis
Drugs
Idiopathic
Others

27
Q

Treatment of interstitial lung disease

A

Non pharm
-pt education
-smoking cessation
- vaccinations

Pharm
-Fibrinolytics eg perfenidone, nintedanib

Non pharm
-Lung transplant

28
Q

Key invx in case of interstitial lung disease

A
  1. CXR
  2. HRCT
  3. ABG
  4. Lung function test
29
Q

3 common pathogens causing COPD exacerbation

A
  1. Strep pneumo
  2. HIB
  3. Moraxella Catarrhalis
30
Q

eosinophilia count cutoff for starting ICS in COPD exacerbation

A

> 300

31
Q

GOLD grade vs ABE

A

Grade is for prognosis

ABE is for management

32
Q

2 causes of white out lung

A

Pleural effusion(trachea pushed contralateral) and lung collapse(trachea pushed ipsilateral)

33
Q

Paraneoplastic syndromes a/w small cell lung ca

A

SIADH, Lambert Eaton, Cushings

34
Q

Common sites of lung mets

A

Liver, adrenals, bone and brain

35
Q

Malignancy most associated with asbestosis

A

Malignant Mesothelioma

36
Q

Things to send for pleural fluid studies

A

Cytology - cancer cells
Cell counts - neutrophilic or lymphocytic
ADA - local context can be TB or some tumours
Culture & sensitivity
Protein
LDH
pH, glucose
pH <7.2, glucose > 2.2 means complicated parapneumonic effusion → need chest tube insertion

37
Q

Ddx of massive pleural effusion

A

1) Malignancy
2) Parapneumonic
3) Tuberculous
4) Transudate eg hepatoc hydrothorax

38
Q

Definitive treatment of massive hemoptysis

A

Bronchial Artery Embolization

39
Q

cutoff for complicated pleural effusion

A

pH <7.2

40
Q

ai

A
41
Q
A
42
Q
A
43
Q

n invx for suspected pulmonary embolism depending on suspicion

A

CTPA(high sus)
D Dimer(low sus)
US Lower Limbs

44
Q

Diagnosis of pulmonary arterial hypertension(PAH)

A

Via Swan Ganz catheter

> 25mm at rest
35mm during exercise

45
Q

mx of asthma exacerbation

A

nebs in 1:2:1 ratio(salb NS ipratropium)
PO or IV corticosteroids
Magnesium sulphate

46
Q

Common cause of hypoK in asthma patients

A

Iatrogenic due to beta agonist

47
Q

pulmonary hypertension treatment

A

ambrisentan and sildenafil
Oxygen therapy

48
Q

Rheumatological causes of ILD at bases

A

RA, Systemic sclerosis, dermatomyositis

49
Q

Causes of upper Lobe ILD: STAR

A

Sarcoidosis
Tuberculosis
ABPA/Ankylosing Spondylitis
Radiation

50
Q

Causes of lower lobe ILD: RAID

A

Rheumatological( RA, Scleroderma, Dermatomyositis)
Asbestosis
Idiopathic Pulmonary Fibrosis
Drugs( Methotrexate, Cyclophosphamide, Azathioprine)

51
Q
A

Internal medicine (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions