Flashcards in Respiratory Deck (47)
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31
What are the complications of sleep apnoea?
Pulmonary hypertension, T2 resp failure, hypertension
32
What are the two different types of pleural effusions, how are they different and what causes each of them?
Transudates vs Exudates
Transudates have 200 IU/l LDH
caused by pneumonia, carcinoma, TB, rheumatic diseases
due to increased leakiness of the pleural capillaries
33
What lung function tests suggest obstructive lung disease?
FEV1
34
What radiologically is hyperinflation?
>6 anterior ribs on the CXR in the mid clavicular line
35
What is the criteria for long term oxygen therapy in COPD?
PaO2 15hrs per day
non smokers clinically stable with Pa02
36
What treatment can help patients with COPD?
Ipratropium and B agonist and steroid inhalers
Theophyline has a role in advanced disease
37
How does the zone of fibrosis help you distinguish the cause?
Upper zone:
TB
Extrinsic allergic alveolitis
Ankylosing spondylitis
Radiotherapy
Sarcoidosis
Mid Zone:
Progressive massive fibrosis
Lower Zone:
Idiopathic pulmonary fibrosis
Asbestos
38
How can interstitial lung disease be classified?
Chronic inflammation/ fibrosis - dyspnoea, non productive cough, abnormal CXR and CT can be divided into:
Those with a know cause:
Occupational/ environmental
Drugs
Hypersensitivity
Infections
Those associated with systemic disorders:
Sarcoidosis
RA
SLE, systemic sclerosis, connective tissue diseases, sjogrens
UC, renal tubular acidosis, autoimmune thyroid disease
Idiopathic
Idiopathic pulmonary fibrosis
Cryptogenic organizing pneumonia
Lymphocytic interstitial pneumonia
39
How does the zone of fibrosis help you distinguish the cause?
Upper zone:
TB
Extrinsic allergic alveolitis
Ankylosing spondylitis
Radiotherapy
Sarcoidosis
Mid Zone:
Progressive massive fibrosis
Lower Zone:
Idiopathic pulmonary fibrosis (commonest cause)
Asbestos
40
How can interstitial lung disease be classified?
Chronic inflammation/ fibrosis - dyspnoea, non productive cough, abnormal CXR and CT can be divided into:
Those with a know cause:
Occupational/ environmental
Drugs
Hypersensitivity
Infections
Those associated with systemic disorders:
Sarcoidosis
RA
SLE, systemic sclerosis, connective tissue diseases, sjogrens
UC, renal tubular acidosis, autoimmune thyroid disease
Idiopathic
Idiopathic pulmonary fibrosis (commonest cause)
Cryptogenic organizing pneumonia
Lymphocytic interstitial pneumonia
41
What are the main causes of extrinsic allergic alveoltitis?
Bird fancier's lung and pigeon fancier's lung - the protein in the droppings
Farmers and mushroom worker's lung
Malt workers lung
Bagassosis or sugar workers lung
42
What does restrictive diseases show on lung function?
Low FEV1
Low FVC
Normal or high FEV1/FVC
Normal peak flow
43
What are the main causes of extrinsic allergic alveoltitis?
Bird fancier's lung and pigeon fancier's lung - the protein in the droppings
Farmers and mushroom worker's lung
Malt workers lung
Bagassosis or sugar workers lung
**Long term steroids can help, whereas in IPF they do not**
44
Name some risk factors for acute respiratory distress syndrome:
Sepsis
Hypovolaemic shock
Trauma
Pneumonia
DKA
Gastric aspiration
Pregnancy
Eclampsia
Amniotic fluid embolus
Drugs/ toxins
Pulmonary contorsion
Massive transfusion
Burns
Smoke inhalation
Near drowning
Acute pancreatitis
DIC
Head injury
Increased ICP
Fat embolus
Heart/ lung bypass
Tumour lysis syndrome
Malaria
45
What are the diagnostic criteria for ARDS?
1 acute onset
2 CXR: bilateral infiltrates
3 pulmonary capillary wedge pressure
46
What does exposure to asbestos do to the lungs?
Pulmonary fibrosis
Pleural plaques
increases risk of bronchial adenocarcinoma and mesothelioma
47
