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Respiratory 3 Flashcards

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1
Q

when is ipratropium bromide contraindicated?

A

closed angle glaucoma

urinary retention eg BPH

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2
Q

side effects of ipratropium bromide / antimuscarinics?

A 
arrythmia
dizziness 
blurred vision
glaucoma 
G| upset
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3
Q

side effects of salbutamol?

A

tachycardia, arrythmia

hypokalaemia esp in diabetes

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4
Q

an example of a long acting beta 2 agonist?

A

salmeterol

oladaterol

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5
Q

what drugs interact syngerstically with steroids?

A

beta agonists
steroids = increased expr of beta2receptor
beta agonist = increased expression of steroid receptor

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6
Q

as well as relax smooth muscle, what else do beta 2 agonists do?

A

reduce histamine release

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7
Q

what is pirfenidone?

A

antifibrotic

for advanced resp conditions

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8
Q

what is theophylline?

A

phosphodiesterase inhibitor
bronchodilation
reduces reactivity to histamine

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9
Q

what is carbocysteine?

A

mucolytic

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10
Q

type 1 vs type 2 resp failure?

A

type 1 = low O2

type 2 = low O2 high CO2, resp acidosis

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11
Q

how can you tell if a respiratory acidosis is chronic?

A

the bicarbonate will be raised, kidneys trying to compensate, but this can’t happen immediately so you only see it in chronic

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12
Q

5 triggers for asthma?

A 
infection
exercise
cold air 
dust
damp
pollen
emotion
tobacco
beta blockers
aspirin
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13
Q

what kind of hypersensitivity reaction is asthma?

A

type 3 / type 1

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14
Q

what cells/molecules are involved in asthma?

A

cytokines = IgE and mast cells
mast cells release histamine, prostaglandins, leukotrienes
and attract eosinophils

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15
Q

what happens in the late response of asthma?

A

immune mediators damage the epithelium

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16
Q

why is airflow reduced in asthma?

A

bronchoconstriction & mucus

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17
Q

is asthma reversible?

A

initially, yes
over time inflammatory reactions mean the basement membrane becomes thicker and fibrosed, = permanently reduced diameter, then it is not reversible

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18
Q

what does an asthma attack look like?

A 
trigger
worsening SOB 
tachynoea 
using accessory muscles 
tachycardia
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19
Q

what is the wheeze like in asthma?

A

polyphonic
bilateral
widespread
episodic

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20
Q

what does spirometry show in asthma?

A

FVC fairly normal
FEV1 is low, less than 80% of expected
FEV1/FVC ratio less than 0.7
improves with bronchodilators eg salbutamol
- 12% increase in FEV1, 200ml increase in vol
worsens with histamine/metacholine challenge, which causes hyperreactivity

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21
Q

what is FENO, how is it used?

A

fractional exhaled nitrogen oxide
more than 40 is pos
can be used in investigation of asthma

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22
Q

what is first line for asthma?

A

SABA eg salbutamol

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23
Q

what is second line for asthma?

A

inhaled corticosteroid eg beclamethosone

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24
Q

what are some third line options for asthma?

A
  1. montelukast
  2. laba eg salmeterol (need to be taking saba too)

theophylline
lama
more steroid

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25
what is montelukast?
a leukotriene antagonist
26
what is a problem with theophylline?
it has a very narrow TI
27
NICE treatment for severe asthma attack in hospital?
salbutamol (nebulised) ipratropium bromide nebulised oral predisolone or IV hydrocortisone
28
in asthma exacerbation what is the ABG like?
initially low pCO2, as trying to get enough oxygen in - alkalosis normal co2 means pt is getting tired of compensatory breathing, this is a bad sign
29
what are the two most common kinds of non small cell lung cancer?
``` squamous cell (central) adenocarcinoma (peripheral) - from mucus secreting cells ```
30
what cells is small cell lung cancer from?
``` kulchitsky cells (neuroendocrine) ```
31
which is generally worse, small cell or non small cell lung cancer?
small cell, as it tends to cause paraneoplastic syndromes
32
5 clinical presentations of lung cancer?
``` SOB cough haemoptysis clubbing recurrent infection lymphadenopathy - supraclavicular fever, weight loss, night sweats, lethargy pleuritic chest pain wheeze ```
33
what is the wheeze like in lung cancer?
fixed monophonic
34
a recurrent laryngeal nerve palsy could be caused by a ______ tumour and would result in __________
lung | hoarse voice
35
a phrenic nerve palsy caused by a lung tumour would cause ______ weakness and this would manifest as _______
diagphragm | SOB
36
what is pembertons sign?
bilateral arm elevation = facial oedema | shows the vena cava is being occluded by a lump in the neck, eg enlarged thyroid or lung cancer
37
what is Horners syndrome?
unilateral ptosis, anhydrosis, myosis | caused by pancoast tumour in the apex of the lung pressing on the sympathetic ganglion
38
what is lambert-eaton myasthenic syndrome?
the body produces antibodies against small cell cancer the antibodies also attack voltage gated calcium channels proximal weakness, diplopia, ptosis, dysphagia
39
what hormone does squamous cell lung cancer commonly release and what is the effect of this?
PTH hypercalcaemia osteomalacia
40
two molecules that small cell lung cancer commonly releases that cause paraneoplastic syndromes?
``` ADH = SIADH = hyponatraemia AcTH = cushings ```
41
what is an important cause of limbic encephalitis?
small cell lung cancer releases antibodies to the limbic system = memory loss, hallucinations and seizures anti Hu antibodies
42
3 features of lung cancer seen on a chest x ray?
hilar enlargement circular peripheral opacity unilateral pleural effusion lung collapse
43
how might you obtain a biopsy in lung cancer?
percutaneous | or with an ultrasound guide bronchoscopy
44
how can you scan the body to look for cancer?
PET-CT | higher uptake of glucose tracer where there is more cancer
45
treatment for non small cell lung cancer?
surgery can often be curative | adjuvant or palliative chemo/radio
46
treatment for small cell lung cancer?
generally not curative | platinum based chemo + radiotherapy
47
5 risk factors for pulmonary embolism?
``` immobility eg flight recent surgery pregnancy oestrogens malignancy polycythaemia thrombophilia eg antiphospholipid syndrome inflam conditions eg SLE ```
48
5 clinical manifestations of pulmonary embolism?
``` hypoxia -- cyanosis SOB haemoptysis tachycardiaa tachypnoea pleuritic chest pain hypotension pyrexial right parasternal heave syncope ```
49
investigations in ?PE?
CXR to exclude pneumothorax, pneumonia well's score - is PE likely? - yes -- do a CTPA - no -- do a d dimer -- if d dimer raised -- do a CTPA
50
if you want to do a CTPA for PE but it is contraindicated what can you do instead? when would CTPA be contraindicated?
ventilation-perfusion scan - shows good ventilation poor perfusion CTPA contraind if allergy to contrast or severe kidney failure
51
what would ABG show in PE?
low oxygen - as blood cannot get to the alveoli to pick up the oxygen resp alkalosis - as co2 is being blown off
52
management of PE? - 5
``` supportive - admission, analgaesia, oxygen enoxaparin alteplase - if PE is large surgical embelectomy vena cava filter ```
53
in pregnant patients at a high risk of PE, what is the best prophylaxis?/
heparin
54
where does lung cancer commonly metastasise to?
``` brain bone liver adrenals lymph ```
55
where does secondary lung cancer usually come from?
``` breast prostate colon bladder neuroblastoma ```
56
who is TB most common in?
people moving from outside of UK esp s asia, subsaharan africa immunocomp alcoholic homeless, ivdu
57
what is TB's waxy capsule made of?
mycolic acid
58
how does latent TB arise?
the immune system forms a granuloma around the bacteria | but the granuloma does not succeed in killing it and instead actually seals off the bacteria and protects it
59
what is it called when latent TB reactivates?
secondary TB
60
what is milliary TB?
Disseminated infection
61
what is a 'cold abscess'?
``` TB forms a colony in the lymph this is often what allows it to spread painless lump in lymph usually in the neck no surrounding inflammation ```
62
how does TB usually spread between people?
through inhaled drops oof infected saliva
63
5 presentations of pulmonary TB?
``` fatigue, night sweats, weight loss, fever cold abscess cough/haemoptysis dyspnoea clubbing crackles ```
64
how does the mantoux test work?
inject tuberculin if there is more than 5mm induration of skin after 72 hours it is pos the person has had TB and the imune system has generated a response against the ag
65
what alternative to mantoux test checks for immune response to TB?
IGRA - interferon gamma release assay looks to interferon alpha in response to tb antigen (quantiferon is an igra test)
66
tb on a chest x ray: - 3 features of primary TB? - 2 features of reactivated TB?
``` GHON COMPLEX Primary: pleural effusion patchy consolidation lymphadenopathy dense homogenous opacity ``` secondary: nodular consolidations cavitations at the top of the lung
67
what are TB on culture?
acid fast bacilli | red on ziehl-neilson stain
68
what is the usual management of TB and what are some side effects?
R - rifampicin - red tears/urine, cyp induction - 6 months I - isoniazid - lupus, peripheral neuropathy - 6 months P - pyrazinamide - gout, hepatitis - 2 months E - ethambutol - eye probs eg colour blind - 2 months steroids
69
is TB a notifiable disease?
yes
70
what is the most common cause of community acquired pneumonia?
strep pneumoniae
71
what is the second most common cause of community acquired pneumonia?
haemophilus influenzae
72
pseudomonas causes pneumonia in who?
cystic fibrosis | bronchiectasis
73
what syndrome can legionella pneumophilia cause, alongside pneumonia?
SIADH
74
what extra-respiratory syndromes does mycoplasma pneumoniae present with?
``` erythema multiformae (target rash) neuro symptoms ```
75
in exams a bird owner with a cough and infection is usually infected with
chlamydia psittaci
76
what is 'lung consolidation'?
lung is full o stuff (water, mucus) not air
77
what is aspiration pneumonia caused by?
foreign material in the lungs
78
'q fever' is most often seen in farmers, what is it caused by?
coxiella burnetti
79
5 symptoms of pneumonia?
``` SOB productive cough haemoptysis pleuritic chest pain delirium sepsis - fever tachycardia tachypnoea hypotension etc ```
80
5 signs of pneumonia?
``` fever, tachycardia, tachypnoea hypotension bronchial/harsh breath sounds equally loud on inspiration/expiration dullness to percuss crackles ```
81
what system is used to consider how risky a patients pneumonia will be? what does it consider? what score warrants admission?
``` CURB-65 C - confusion U - uraemia R - resp rate high B - bp less than 90/ or /60 over 65 ``` consider admit if score of 2 or more 3 or more -- intensive care
82
3 antibiotics commonly used in pneumonia?
co amoxiclav amoxicillin doxycycline clarithromycin - -mycin = macrolide. usually co amoxiclav + -mycin for hosp treatment ceftriaxone
83
what antibiotic works against MRSA?
Vancomycin
84
what is an empyma?
infected pulmonary effusion
85
3 complications of pneumonia?
``` ARDS sepsis lung abscess pleural effusion empyma death ```
86
where is the division between the upper and lower respiratory tract?
vocal chords
87
5 parts of the upper resp tract (that might get infected!)
``` nasal passages sinuses pharynx larynx, above vocal cords tonsils eustachian tube ```
88
is tonsilitis usually caused by a bacteria or virus?
virus
89
3 features that suggest a tonsilitis is bacterial, not viral?
fever tonsillar exudate no cough tender anterior cervical lymph nodes
90
some microbiology of strep pyogenes?
lancefield group a beta haemolytic catalase neg
91
presentation of tonsilitis?
``` usually associated with pharyngitis red inflamed sore tonsils sore throat pain on swallowing fever malaise headache ```
92
first line drug for bacterial tonsilitis?
penicillin V
93
what is otitis media?
inflammation of the 'middle ear' | commonly infection of the eustachian tube following urt inf
94
4 bacteria that cause most upper resp tract infections?
strep pneumoniae h influenzae moraxella catarrhalis staph aureus
95
5 presenting signs/symptoms of otitis media?
``` ear pain hearing loss loss of balance inflamed/perforated tympanic membrane middle ear effusion otorrhea (discharge) ```
96
1st and 2nd line treatments for otitis media and sinusitis?
1 - amoxicillin | 2 - co amoxiclav
97
what could you use instead of penicillin/amoxicillin if pt is allergic to penicillin?
clarithromycin
98
is sinusitis usually bacterial or viral?
viral | eg rhinovirus
99
presentation of sinusitis? 4
``` purulent rhinorrhoea face pain headache fever voice changes change in smell/taste cough ```
100
what is the most common interstitial lung disease?
idiopathic pulmonary fibrosis
101
what kind of spirometry does silicosis and aspestosis have?
restrictive
102
presentation of silicosis and asbestosis?
dry cough dyspnoea generally quiet, not crackly chest
103
what systems are affected by granulomatosis with polyangiitis?
``` ELK ENT - conjunctivitis, ear infections (ent involvement separates it from goodpastures) Lung - cough/dyspnoea/wheeze Kidney - haematuria general malaise, fever etc ```
104
what investigation for staging lung cancer?
CT chest, liver, adrenals
105
on CXR what is the difference between the consolidation inn tb and pneumonia?
TB - in the middle | pneumonia - at the bottom
106
what are the most common causes of hosp acquired pneumonia?
aerobic gram neg bacilli eg pseudomonas klebsiella e coli
107
first line imaging for ?lung cancer or ?TB?
chest x ray
108
in a non smoker what lung cancer is most common??
adenocarcinoma
109
What is the most common form of pulmonary fibrosis?
idiopathic
110
5 aetiologies of pulmonary fibrosis?
``` idiopathic ra/sle/annkylosing spondylitis/other connective tissue diseases vasculitis eg goodpastures aspergillus/TB infection drugs eg amiodarone, methotrexate aspiration sarcoidosis ```
111
presentation of pulmonary fibrosis?
dry cough SOB fine bilateral crackles when you listen to chest ``` wheeze haemoptysis chest pain clubbing cor pulmonale ```
112
what kind of spirometry is seen in pulmonary fibrosis?
restrictive - so reduced fvc | because fibrosis prevents the lung from expanding
113
what investigation for pulmonary fibrosis?
chest CT is best but can do x ray if not available | ground glass appearance - irregular peripheral opacities
114
how is DCLO affected in pulmonary fibrosis?
reduced | as gas exchange is impaired
115
2 drugs for pulmonary fibrosis?
pirfenidone/nintendinab - anti fibrotic
116
what is the epidemiology of sarcoidosis?
female black and scandinavian young adults/60+
117
what is the pathophysiology of sarcoidosis? | & what type of hypersensitivity?
type 4 hypersensitivity unknown antigen granuloma pulmonary fibrosis and nodules
118
what cells make up the granulomas in sarcoidosis?
macrophage in the center | t cells on the edges
119
what is the most common location for the granulomas in sarcoidosis?
the hilar lymph node, where the bronchi meets the lung
120
symptoms of pulmonary sarcoidosis?
cough gradual onset progressive dyspnoea mediastinal lymphadenopathy
121
5 extrapulmonary effects of sarcoidosis?
``` systemic - fever, weight loss, fatigue skin - erythema nodosum, lupus pernio joints - polyarthralgia eye - uveitis, conjunctivitis heart - bundle branch block hypercalcaema liver - nodules, cirrhosis, cholestasis nervous system - diabetes insipidus, bells palsy ```
122
treatment for sarcoidosis?
generally resolves spontaneously 1st line = prednisolone 2nd line = methotrexate/azathiopurine
123
blood tests in sarcoidosis? - 3
raised serum ACE raised serum calcium raised serum soluble il2 receptor
124
what is gold standard investigation for sarcoidosis and what will you see?
ultrasound guided biopsy of mediastinal lymph nodes | non caseating granuloma with epitheloid cells
125
on a chest x ray in sarcoidosis what would you see?
hilar lymphadenopathy | bilateral lung exudate
126
what is lofgrens syndrome and what condition is it most commonly associated with?
sarcoidosis | triad of bilateral hilar lymphadenopathy, polyarthritis and erythema nodosum
127
what is bronchiectasis?
widening of the bronchioles and build up of mucus
128
5 aetiologies of bronchiectasis?
``` young syndrome cf infection eg tb, pneumonia, hiv, pertussis bronchial obstruction eg tumour rheumatoid arthritis/uc alpha 1 antitrypsin deficiency copd ```
129
why is there increased risk of infection in bronchiectasis?
because the cilia are damaged so cannot clear the mucus+infection as easily
130
is bronchiectasis an obstructive or restrictive disease?
obstructive, the main problem is that mucus obstructs the airways
131
why is there pulmonary hypertension in bronchiectasis?
in response to hypoxia the pulmonary vessels constrict in an attempt to divert flow to somewhere with better airflow
132
5 clinical presentations of bronchiectasis?
``` persistent productive cough purulous sputum which is foul smelling and dark green (usually has been sat around in the lung for a long time before it can be coughed up) intermittent haemoptysis SOB clubbing wheeze coarse inspiratory crepitations prone to respiratory infections ```
133
what does the chest x ray show in bronchiectasis?
cystic shadows | dilated and thickened bronchi and bronchioles
134
how to manage the mucus in bronchiectasis?
mucolytic eg carbocysteine | flutter valve for mucus drainage
135
what population is at greatest risk of cystic fibrosis?
caucasian
136
what is the mutation in cf and what is the effect of it?
mutation in CFTR protein = lack of cl- into mucus secretions = thick and sticky mucus
137
5 clinical presentations of CF?
``` Failure to thrive cough - haemoptysis/thick sputum wheeze recurrent resp inf bronchiectasis pancreatic insufficiency = steatorrhoea and diabetes gall stones, cholestasis male infertility nasal polyps cyanosis clubbing bilateral coarse crackles ```
138
what is the test for CF in newborns? how does it work?
Guthrie detects raised trypsinogen trypsinogen raised in response to pancreatic damage
139
what is the gold standard CF test?
sweat test inject pilocarpine to stimulate sweat production salty sweat = cf, sweat glands are opposite so cl- cannot be absorbed from the sweat
140
two methods of genetic testing for CF during pregnancy?
amniocentesis | chorionic villus sampling
141
management for CF?
chest physio antibiotics - acute or prophylactic mucolytics eg dornase alpha bronchodilators eg salbutamol fat soluble vitamin supplement ursodeoxycholic acid to improve bile flow ivacaftor or lunacaftor depending on mutation
142
what is a pleural effusion?
fluid in the pleural cavity
143
exudative vs transudative effusion?
``` transudative = low protein, less than 3 exudative = high protein, more than 3 ```
144
3 aetiology of transudative pleural effusion?
transudative is caused by movement of fluid eg congestive heart failure low albumin hypothyroid peritoneal dialysis
145
3 aetiologies of exudative pleural effusion?
exudative caused by inflammation, which means both fluid and proteins can move ``` lung cancer pneumonia tb RA SLE and other autoimmune pulmonary embolism ```
146
clinical presentation of pleural effusion?
``` SOB cough pleuritic chest pain stony dull to percussion reduced chest expansion superior raspy breathing tracheal and mediastinal deviation, if severe ```
147
investigation for pleural effusion?
chest drain/pleural effusion, test the fluid for culture, protein/LDH, appearance, cell count chest xray
148
what does the chest x ray in pleural effusion show?
blunting of the costophrenic angle fluid in the lung fissures meniscus at the bottom tracheal and mediastinal deviation
149
management of pulmonary effusion?
antibiotics diuretics pleural aspiration or chest drain small may spontaneously resolve
150
2 complications of pulmonary effusion?
empyema | trapped lung
151
in exams what is a common epidemiology/type of patient for pneumothorax?
a tall young male with sudden onset shortness of breath while playing sport
152
what conditions is spontaneous pneumothorax more likely in?
marfans rheumatoid arthritis etc
153
some causes of iatrogenic pneumothorax?
central line insertion mechanical ventillation lung biopsy
154
presentation of pneumothorax?
``` sudden onset SOB / pain / cough cyanosis tachycardia tachypnoea reduced breath sounds hyper resonance pleuritic chest pain ```
155
first line investigation for pneumothorax?
erect chest x ray - see a visible rim with no lung markings
156
gold standard investigation for pneumothorax?
ct thorax | allows you to see smaller pneumothorax and measure them more effectively than a cxr
157
when would a pneumothorax not need management?
less than 2cm with no SOB
158
management of pneumothorax? 3
high flow oxygen insert a chest drain at 5th intercostal space on the mid axillary line aspiration
159
what can you do for recurrent pneumothorax?
surgery to remove the pleura or stick the visceral and parietal layers together
160
where is the air in pneumothorax?
in the pleural space (between visceral and parietal pleura)
161
what is a tension pneumothorax caused by?
trauma | one way valve
162
clinical presentation of tension pneumothorax?
``` decreased air entry unequal lung expansion tachycardia hypotension trachial deviation hyperresonance ```
163
management of tension pneumothorax?
large bore canula 2nd intercostal space mid clavicular line
164
at what pressure is pulmonary hypertension diagnosed?
25mmHg
165
what are the 5 groups of aetiology of pulmonary hypertension?
1. primary - eg SLE 2. left sided heart failure - eg MI, systemic hypertension 3. chronic lung disease - eg COPD - reactive vasoconstriction 4. pulmonary vascular disease eg PE 5. miscellaneous eg sarcoidosis, vasculitis
166
what is the effect on the lungs of hypertension?
thickening of alveolar and capillary membranes | = reduced gas exchange
167
what is cor pulmonale?
``` increased pressure in the lung vessels backs up into right ventricle = rv hypertrophy = backpressure into veins = systemic oedema ```
168
clinical presentation of pulmonary hypertension?
``` SOB worse when flat / on excercise - orthopnoea syncope tachycardia raised jvp hepatomegaly peripheral oedema chest pain heart murmur ```
169
what does an ECG show in pulmonary hypertension?
large R waves on the right V1-V3 large S waves on left V4-V6 right axis deviation right bundle branch block
170
a blood test that would show heart pathology in pulmonary hypertension?
NT - pro - BNP
171
3 drugs for primary pulmonary hypertension?
IV prostanoid eg epoprostenol endothelin receptor antagonist eg macitenan pde-5 inhibitor eg sildenafil
172
3 complications of pulmonary hypertension?
resp failure heart failure arrythmia
173
how many points do you need on the well's score for pe to be likely?
if wells is more than 4 PE could be likely
174
gold standard test for pulmonary hypertension?
right heart catheterisation | this is a way of measuring the pulmonary BP
175
Bird fanciers lung, farmers lung and malt workers lung are all examples of
hypersensitivity pneumonitis
176
what type of hypersensitivity reaction is hypersensitivity pneumonitis?
type 3 | over time -- type 4
177
what happens to the lung in hypersensitivity pneumonitis?
fibrosis -- impaired gas exchange, loss of elasticity | non caseating granulomas
178
what part of the lung is most affected in hypersensitivity pneumonitis?
top
179
presentation of acute hypersensitivity pneumonitis?
fever, rigors cough dyspnoea headache
180
presentation of chronic hypersensitivity pneumonitis?
``` progressive cough progressive dyspnoea fatigue cyanosis resp failure weight loss clubbing ```
181
what do you see on biopsy with hypersensitivity pneumonitis?
non caseating granuloma
182
management of hypersensitivity pneumonitis?
steroids | remove trigger
183
what do you see on imaging in hypersensitivity pneumonitis?
diffuse infiltrate ground glass (fibrosis) bronchiectasis
184
what are the antibodies to in goodpastures?
type 4 collagen | which is in glomerular basement membranes
185
presentation of goodpastures? - 5
``` cough SOB haemoptysis haematuria proteinuria oliguria ``` ``` hypertension anorexia myalgia/arthralgia lethargy fever ```
186
best investigation for goodpastures, what do you see?
kidney biopsy immunoflorescence - iGg associated with glomerulus crescents inflammation
187
what is DCLO in goodpastures?
high
188
management of goodpastures?
plasmaphoresis steroids cyclophosphamide
189
what is the most common ANCA vasculitis?
granulomatosis with polyangiitis
190
which ANCA antibody is usually associated with granulomatosis with polyangiitis?
cANCA
191
what do you see on chest imaging of granulomatosis with polyangiitis?
nodules fluffy alveolar haemorrhage cavitating lesions consolidation
192
mesothelioma is associated with
asbestos!
193
what is mesothelium?
epithelium that forms lining ie pleura, peritoneum, pericardium etc
194
what molecule does mesothelioma express?
calretinin
195
presentation of mesothelioma?
``` history to suggest clubbing sob pleuritic chest pain harmoptysis fever, weight loss etc ```
196
which part of the lung is fibrosed in mesothelioma?
lower
197
polo mint sign on CT is associated with what condition?
PE
198
bronchus sign on CT indicates what lung pathology?
bronchogenic cancer
199
tree in bud sign on CT indicates what lung pathology?
pneumonitis, bronchiolitis
200
split pleura sign on CT indicates what lung pathology?
exudative, malignant or infected pleural effusion
201
signet ring sign on CT indicates what lung pathology?
bronchiectasis
202
what is the most common type of lung cancer?
squamous
203
what is the most common lung cancer in non smokers?
adenocarcinoma
204
complications of bronchiectasis?
empyema respirator failure repeated inf = worsening lung function pneumothorax from repeated coughing
205
what is the microbiology of h influenzae?
small gram neg cocco-bacillus
206
risk factors for pneumothorax?
smoking trauma previous pneumothorax mechanical ventilation
207
how long after admission is it called hospital acquired pneumonia?
48hrs
208
what type of hypersensitivity is goodpastures?
type 2
209
what is gold standard for TB diagnosis?
sputum culture
210
what is the most common cause of pneumonia in bronchiectasis?
h influenzae
211
which sinus is most prone to infection and what are the symptoms of that?
maxillary, because it drains from the top forehead and cheek tenderness worse when leaning forward
212
3 Indicators of good asthma control?
``` no night time symptoms inhaler used no more than 3x per week no breathing difficulties, cough or wheeze on most days able to exercise without symptoms normal lung function test ```

Respiratory (9 decks)

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