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Year 4 part 2 > Respiratory > Flashcards

Respiratory Flashcards

(98 cards)

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1
Q

First line management of non-small cell lung cancer

A

Lobectomy

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2
Q

Management of Idiopathic pulmonary fibrosis

A

Pirfenidone (antibrinolytic)

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3
Q

What drugs can induce pulmonary fibrosis

A

Amiodarone
Cycylophosphamide
Methotrexate
Nitrofurantoin

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4
Q

What does co-amoxiclav not cover

A

Atypical bacteria

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5
Q

What does clarithromycin cover

A

Gram +ve and atypical

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6
Q

What does Clindamycin cover

A

Gram +ve and Anaerobes

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7
Q

What does cprofloxacin cover

A

Grame -ve and Atypical

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8
Q

What does doxycycline cover

A

Everything + anaerobes

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9
Q

What is a more sensitive inflammatory mediator: CRP or ESR

A

CRP

ESR i snormal in first 24 hours

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10
Q

Management of acute bronchitis

A

First line: Nothing

Second Line : Doxycycline

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11
Q

What blood result can guide if antibiotics are required or not for bronchitis

A

CRP >100

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12
Q

Symptoms of Bronchitis

A

Initial dry cough for 3-4 days -> productive cough

Resolves on own

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13
Q

What factors indicate the need for steroids in sarcoidosis

A

Hypercalcaemia
Uveitis
Nueorlogical or cardiac involvement
Parenchymal lung disease

Symptomatic

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14
Q

Name four obstructive lung diseases

A

Asthma
COPD
Bronchiectasis

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15
Q

Name some restrictive lung diseases

A

Sarcoidosis
PF
Asbestosis
ARDS
NMDs

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16
Q

Side-effect of amiodarone

A

Lung fibrosis

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17
Q

What paCO2 levels indicate the need for NIV in COPD

A

PaCO2 > 6Kpa

pH <7.35

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18
Q

When does the target saturation in COPD move to 94-98%, under what circumstances

A

If CO2 is normal on an ABG

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19
Q

What L/min is high flow oxygen

A

15 liters/min

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20
Q

When is the 40% venturi mask indicated in COPD exacerbation

A

Second line if ABG has not com eback.

First Line: 24-28%

Second Line: 40%. if sats have not improved

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21
Q

Management of COPD exacerbation

A

Prednisolone 30mg for 5 days

If pneumonia:

Pred + Amoxicillin

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22
Q

Most common cause of COPD exacerbations (infective)

A

H. influenzae

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23
Q

What zone gets fibrosed in TB

A

Upper zone fibrosis

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24
Q

What blood test is deranged in sarcoidosis

A

ACE level

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25
What does an X-Ray show for mesothelioma
Pleural Effusion/thickecning
26
After a Chest X-Ray for suspected mesothelioma, what should be done next
CT pleura
27
Diagnostic investigation for mesothelioma
Thoracoscopy + biopsy
28
What antibiotic prophylaxis is given for COPD
Azithromycine
29
Management of small cell lung cancer
Chemo therapy + Radiotherapy NO SURGERY
30
What FBC finding indicates lung cancer
Raised platelets
31
What surgery can be used to treat alpha 1 antritrypsin deficiency
Lung volume reduction surgery
32
Management of aspirtaion pneumonia
IV cephalosporins + IV metronidazole
33
What peak flow result indicates asthma
>20%
34
What FeNO result indicates asthma
>40 in adults, >35 in children
35
What stepwise approach is used for asthma
1. SABA 2. SABA + ICS 3. SABA + ICS + Leukotriene receptor antagonist 4. SABA + ICS + LABA 5. SABA + LTRA 6. SABA + LTRA + MART
36
In what patients is allergic bronchopulmonary aspergillosis associated with
CF
37
Stepwise management of asthma in children
1. SABA 2. SABA + low dose ICS 3. SABA + low dose ICS + LTRA 4. SABA + ICS + LABA
38
Name two conditions with bilateral hilar lymphadenopathy
Sarcoidosis TB
39
What infections can cause bronchiectasis
TB HIV Measles Pertussis Pneumonia
40
What congenital conditions cause bronchiectasis
CF Kartagener's syndrome
41
What haemotological condition causes bronchiectaiss
Hypogamaglobulinaemia
42
What is hypogammaglobulinaemia
Low IgG after an infection
43
Symptoms of bronchiectaiss
Productive cough Large sputum Haemoptysis Finger clubbing Wheeze
44
What part of the resp tract is affected in COPD caused by cigarrettes
Centriacinar(upper lobes)
45
What part of the resp treact is affected in COPD with alpha 1 antitrypsin deficiency
Pancacinar (lower lobes)
46
ECG findings in COPD
RIght atrial hypertrophy and right ventircular hypertrophy
47
What defines a hyperinflated chest
>6 ribs seen on x ray
48
When should someone with COPD be sent from surgery
FEV1 > 20% predicted PaCO2 < 7.3 Upper lobe emphysema
49
What species causes croup
Parainfluenza
50
Management of corup
Dexamethasone
51
Symptom of courp
Barking cough
52
What sweat test finding is indicative of Cf
Sodium or chloride >60 mmol
53
What test can check for pancreatic exocrine dysfunction
Faecal elastase
54
Name two causes of horner's syndrome
Pancoast tumour Carotid artery dissection
55
Surgical management of a lung abscess
Ct guided drainage
56
Gold standard investigation for obstructive sleep apnoea
Polysomnography
57
What sign is distinctive of staphylococcal pneumonia
Bilateral pneumonia
58
Outline the CURB-65 criteria
C- confusion U - Urea > 7 R - RR > 30 BP - <90 systolic or <60 65
59
Management of pleuritic chest pain
Paracetamol
60
ECG findings specific to PE
S1Q3T3 NOt common tho
61
What is Lofgren Syndrome
Acute sarcoidosis: Fever Polyarthralgia Erythema Nodosum Bilateral hilar lymphadenopathy
62
How long can NRt be used for
8 weeks
63
Management of TB
RIPE - 6 months Isoniazide + Rifampicin - further 6 months
64
Side effects of isoniazid
Peripheral neuropathy
65
Prevention of peripheral neuropathy from isoniazid
pyridoxine
66
Side effect of rifampicin
Red urine
67
Side effect of ethambutol
Visual distrubance
68
Side effect of pyrazinamide
LIver toxicity
69
Management of allergic bronchopulmonary aspergillosis
Oral Prednisolone (+ oral itraconazole as adjuvant)
70
What lung cancer is associated with hypertrophic pulmonary osteoarthropathy
Squamous cell carcinoma (bilateral wrist pain)
71
What bronchodilator reversibility is an indicator for asthma
An improvement of 12% or more
72
What prophylaxis must be given for patients with COPD
Azithromycin
73
How long is the dose of oral prednisolone given for COPD exacerbations
5 Days
74
What serum levels can be used to guide if prednisolone should be given in acute bronchitis
If CRP levels are elevated
75
IN what type of lung cancer are caveatting lesions seen in
Squamous cell carcinoma
76
What serum levels are elevated in sarcoidosis
ACE Calcium levels
77
What intervention is given for obstructive sleep apnoea
CPAP
78
What does a pleural fluid result show for an empyema
LDH > 1000
79
At what CRP level should a delayed prescription be given for acute bronchitis
20-100 mg/L
80
Where is alpha-1 antitryspin deficiency typically found in the lungs
Panacinar (lower lobes)
81
What causes benign pleural plaques
Asbestos-related lung disease
82
What zone of the lungs does asbestosis affect
Lower lobe fibrosis
83
Management of asbestosis
Supportive
84
Management of mesothelioma
Palliative chemotherapy
85
What is the most common cause of occupational asthma
Spray painting and foam moulding using adhesives
86
Diagnosis of occupational asthma
Serial PEFR at work and away
87
How do we step down asthma treatment
Push down by 25-50% at a time
88
Clinical features of atelectasis
Sudden dyspnoea after operation
89
Management of atelectasis
Refer to physio. + make them sit upright
90
What is the most common organism that causes infection in bronchiectasis
H. Influenzar
91
Name the safe triangle for chest drain insertion
Mid axillary line 5th intercostal space Bordered by lat doors and lateral border of the pectorals major
92
Most common cause of lobar collapse
Lung cancer
93
Signs of lobar collapse on an X-ray
Elevation of hemidiaphragm Tracheal deviation towards side of collapse
94
Where do cannonball mets commonly come from
Renal cell cancers
95
Where are fibrotic masses in Progressive Massive fibrosis found
Upper lobes of the lungs
96
Management of COPD
First line: SABA or SAMA Second Line: LABA + LAMA (no asthmatic features) Second Line: LABA + ICS (asthmatic features)
97
Protein level in exudative pleural effusions
> 30 g/L
98
Protein level in transudative pleural effusions
< 30 g/L

Year 4 part 2 (10 decks)

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