Respiratory Flashcards
(132 cards)
1
Q
Treatment for tension pneumothorax
A
Large bore cannula in 2nd ICS at midclavicular
2
Q
Triangle of safety
A
Ant axillary line
Mid axillary line
5th ICS
3
Q
Tracheal deviation
Reduced air entry on affected side
Kinking of vessels
Inc resonance on affected side
Hemodynamic instability
A
Pneumothorax
4
Q
Hypoxia
Cyanosis
Raised JVP
Peripheral edema
Pansystolic murmur
Pulsatile hepatomegaly
Third heart sound
A
Cor pulmonale
5
Q
Diagnostic test for COPD
A
Pulmonary function test
Fev/fvc ratio <70
6
Q
Severity of COPD
A
Fev1
7
Q
Xray finding of COPD
A
Hyperinflated lungs
8
Q
Persistent asthma with transient infiltrates
A
ABPA
9
Q
Best diagnostic modality for COPD
A
CT chest
10
Q
Treatment of COPD
A
SABA
LABA
INHALED CORTICOSTEROID
11
Q
Video assissted thoracoscopic surgery is done when
A
In recurrent pnuemothorax
12
Q
Causes of COPD
C4-GAS
A
Coal
Cadmium
Cement
Cotton
Grains
A1Atd
Smoking
13
Q
Bacteria causing exacerbation of COPD
A
H. INFLUENZA
M. CATARRHALIS
S. PNEUMONIA
14
Q
Virus causing exqcerbation of COPD
A
Rhinovirus
15
Q
Copd with consolidation
A
Strepto
16
Q
Copd with no consolidation
A
H. Influenza
17
Q
Last treatment for Copd
A
NIV
18
Q
Last treatment for asthma
A
Intubation
19
Q
A
20
Q
A
21
Q
A
22
Q
Why CPAP prreferred over BiPAP
A
CPAP is used first line in HF because it’s better than BiPAP at achieving oxygenation (it just continuosly keeps the airways patent) and it increases intrathoracic pressure (lowering preload
23
Q
What nrt should be used with caution in patients with a history of depression or self-harm
A
varenicline
24
Q
Nrt contraindicated in pregnancy and breastfeeding
A
Verinicline
25
Nrt contraindicated in epilepsy, pregnancy and breast feeding. Having an eating disorder is a relative contraindication
Bupropion
26
asthma
blood eosinophilia (e.g. > 10%)
paranasal sinusitis
mononeuritis multiplex
renal involvement occurs in around 20%
pANCA positive in 60%
Churg straus
27
asthma
blood eosinophilia (e.g. > 10%)
paranasal sinusitis
mononeuritis multiplex
renal involvement occurs in around 20%
pANCA positive in 60%
Churg straus
28
Non caseating granuloma with epitheloid cells
Sarcoidosis
29
30
31
Isocyanates associated with
Occupational asthma
32
Productive cough for more than 3 months in last 2 years
Chronic bronchitis
33
Alveoli lined by
pseudostratified ciliated columnar epithelium
34
35
Hypertrophy and hyperplasia of mucinous glands and goblets cells
Chronic bronchitis
36
located on chromosome 14
inherited in an autosomal recessive / co-dominant fashion*
A1at def
37
Type of emphysema in a1at def
Panacinar emphysema
38
Investigation for a1at
Serum a1at levels
Genotype
Cxr
Ct scan
Pft
Spirometry obstructive picture
39
Asbestosis typically affects which lobe
causes lower lobe fibrosis.
40
Management of asbestosis
Conservative management
41
Most dangerous form of mesothelioma
Crocidolite(blue) asbestosis
42
dyspnoea and reduced exercise tolerance
clubbing
bilateral end-inspiratory crackles
lung function tests show a restrictive pattern with reduced gas transfer
Asbestos
43
Extrapulmonary causes of restrictive gaseous exchange
Obesity
Pleural effusion
Pleural thickening
Neuromuscular weakness
Kyphoscoliosis
44
Gold standard for ILD
HRCT without lung biopsy
45
Causes of digital clubbing
Diffused lung disease
Cystic fibrosis
Cyanotic heart disease
46
function of IL5
Attract and activate eosinophills
47
helper cells involved in asthma
helper T calls 2
48
cytokines involved in asthma
IL5 AND IL8(from neutrophils)
49
Curshman spirals in sputum
asthma
50
Charcot leyden crystals
asthma
51
worsening dyspnoea, wheeze and cough that is not responding to salbutamol
maybe triggered by a respiratory tract infection
Acute attack of asthma
52
ipratropium bromide:
in patients with severe or life-threatening asthma, or in patients who have not responded to beta‚‚-agonist and corticosteroid treatment, nebulised ipratropium bromide, a short-acting muscarinic antagonist
53
Most common organism in ARDS
E.coli
54
Definitive management for ARDS
PEEP
55
Prevention of acute mountain sickness
Acetazolamide
56
Why there is saline nebulization
For mucus production
57
Causes of b/l hilar lymphadenopathy
Tb
Sarcoidosis
58
Causes of bronchiestasis
Tb
Cystic fibrosis
59
Causes of COPD
Smoking
A1AT deficiency
60
Long term control of patients with b/l bronchiectasis
postural drainage
61
Normal vital capacities
M 4500ml
F 3500ml
62
Vital capacity decreases with age (True or False)
True
63
CI for lung transplantation in pt with CF
Colonisation with Burkholderia capacia
64
Antibiotics for acute exacerbation of COPD
oral antibiotics first-line: amoxicillin or clarithromycin or doxycycline.
65
Central bronchiectasis is particularly characteristic of
ABPA
66
ABGs of salicylate poisoning
Mixed resp alkalosis and metabolic acidosis
67
severity of COPD categorised by
FEV1
68
Drug to be avoided in CSS
LTRA (montelukast)
69
widely used to prevent AMS and has a supporting evidence base
acetazolamide (carbonic anhydrase inhibitor)
70
HAPE
pulmonary vasoconstriction
71
HACE
cerebral vasodilation
72
Management of HACE
descent
dexamethasone
73
Management of HAPE
descent
nifedipine, dexamethasone, acetazolamide, phosphodiesterase type V inhibitors*
oxygen if available
74
asthma, eosinophilia, presence of mono-/polyneuropathy, flitting pulmonary infiltrates, paranasal sinus abnormalities and histological evidence of extravascular eosinophils.
CSS
75
pulmonary and renal symptoms with cANCA positive and epistaxis and hemoptysis no asthma with no raised eosinophil
Wegners
76
pANCA positive and focal segmental glomerulosclerosis and weight loss, lethargy and low-grade fever, though in advanced disease it can progress to haemoptysis and renal failure.
Microscopic polyangiitis
77
Samter's triad.
asthma, nasal polyposis and salicylate sensitivity
78
What is the most appropriate test prior to starting azithromycin?
ECG (to rule out QT prolongation) and LFT (as it is hepatotoxic)
79
radiological findings such as bilateral symmetric hilar lymphadenopathies with the presence of non-caseating granulomas
sarcoidosis
80
Radiological findings can include lobar consolidation, cavitation, caseating granulomas (tuberculomas)which eventually calcify.
TB
81
treatment for extrinsic allergic alveolitis
avoid precipitating factors
oral glucocorticoids
82
Silent chest, normalisation of pCO2 and fall in pH are all indicators of
life-threatening asthma.
83
A rising pCO2 is indicative of
type 2 respiratory failure.
84
Rising CO2 and silent chest
INTUBATEEE!
85
responsible for malt workers' lung?
Aspergillus clavatus
86
Radiologically, it presents with diffuse interstitial infiltrates, and histologically with granulomatous inflammation
malt workers lung (aspergillus clavatus)
87
primarily linked to humidifier lung or air conditioner lung
Thermoactinomyces candidus
88
Treatment for ABPA
Oral glucocorticoids
89
progressive exertional dyspnoea
bibasal fine end-inspiratory crepitations on auscultation
dry cough
clubbing
IPF
90
investigation of choice and required to make a diagnosis of IPF
HRCT
91
non caseating granulomas
sarcoidosis
berryliosis
hypersensitivity pneumonitis
92
drugs for dpression and anxiety
SSRI
93
Drugs used for smoking cessation
Bupropion
Verinacline
94
erythema nodosum with cough
Sarcoidosis
95
most specific autoantibody used in diagnosis of sarcoidosis
ACE levels
96
Confirmatory for sarcoidosis
CT
97
erythema nodosum, bilateral hilar lymphadenopathy, swinging fever, polyarthralgia, hypercalcemia
acute onset sarcoidosis
98
bilateral hilar lymphadenopathy (BHL), erythema nodosum, fever and polyarthralgia.
Lofgren's syndrome
99
parotid enlargement, fever and uveitis secondary to sarcoidosis
Heerfordt's syndrome (uveoparotid fever)
100
anti depressant contraindicated in patients with epilepsy
Bupropion
101
COPD infective exacerbation organism
H.influenza
102
COPD common organism
Haemophillus (most common)
Strep pneu
Moraxella
103
Mesothelioma treatment
palliative chemotherapy
104
best or predicted is considered as a sign of a life-threatening asthma attack
peak expiratory flow rate (PEFR) of less than 33%
105
Hypercalcaemia + bilateral hilar lymphadenopathy → ?
sarcoidosis
106
rash, photosensitivity, ulcers and arthritis.
systemic lupus erythematosus,
107
SLE diagnostic antibody
Anti-dsDNA antibodies
108
Over rapid aspiration/drainage of pneumothorax can result in
re-expansion pulmonary oedema
109
Heroin overdose ABGs show
Respiratory acidosis
110
treatment of choice for allergic bronchopulmonary aspergillosis
oral glucocorticoids
111
investigation of choice for upper airway compression
flow volume loop
112
fever, joint pain, erythema nodosum, lymphadenopathy and bilateral hilar lymphadenopathy.
Lofgren's syndrome
(sarcoidosis)
113
'red-currant jelly' sputum
Klebsiella
114
Causes of bilateral hilar lymphadenopathy
Fully LOST
Fungi, Lymphoma, Other Malignancy, Occupational dust (berryliosis), Sarcoidosis, TB
115
Dyspnoea, obstructive pattern on spirometry in patient with rheumatoid → ?
bronchiolitis obliterans
116
Chronic sinusitis + nephritic syndrome → ?
granulomatosis with polyangiitis
117
key diagnostic criteria for ARDS
b/l chest infiltrates
118
Cherry red lesion is pathognomic of
Lung carcinoid
119
Increased risk of TB infection with what mineral
Silica
120
BP changes regarding secondary polycythemia
Hypertension
121
causes of macroglossia
acromegaly
hypothyroidism
amyloidosis
122
Management for non small cell cancer of lung
Radiotherapy mainly
20% effective with surgery
Chemo poor response
123
124
colonising bacteria in patients with bronchiectasis
pseudomonas aeruginosa
125
investigation to determine underlying cause of pleural effusion
CT
126
pustular or vesiculopustular rash
gonococcal arthritis
127
arthritis, conjunctivitis, and urethritis.
Reiter's syndrome (now termed reactive arthritis)
128
129
proximal muscle weakness and rashes
Dermatomyositis
(Anti- Mi 2 antibodies)
130
131
pulmonary involvement and erythema nodosum
Sarcoidosis
132
