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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

What is cor pulmonale?

Right heart failure caused by chronic pulmonary arterial hypertension.