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YEAR 4 > Respiratory > Flashcards

Respiratory Flashcards

(96 cards)

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1
Q

CNs supplying phrenic nerve?

A

C3,4,5

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2
Q

Where do sympathetic pre-ganglionic neurones arise from?

A

T1 - L2

Thoracolumbar outflow

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3
Q

What nerves carry parasmpathetic neurones?

A 
Cranio sacral outflow
Occulomotor
Facial
Glossopharyngeal
Vagus
S2-S4
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4
Q

Definition of restrictive lung disease?

A

harder to get air into the lungs
decreased FEV1
decreased FVC
FEV1/FVC ratio >80% (FEV1 decreases less than FVC)

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5
Q

2 main causes of restrictive lung disease?

A

interstitial lung disease

chest wall abnormalities (e.g. obesity)

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6
Q

What is interstitial lung disease and what impact does this have?

A

fibrosis of the interstitium (tissue around the air sacs)

Thickening of the barrier for gas exchange and decreased lung filling ability

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7
Q

What are the 3 main types of interstitial lung disease?

A

Idiopathic pulmonary fibrosis
Pneumoconioses (occupational interstitial lung disease)
Sarcoidosis

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8
Q

Secondary causes of idiopathic pulmonary fibrosis?

A

bleomycin, amioderone, radiation therapy

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9
Q

Does idiopathic pulmonary fibrosis increase your risk of lung cancer?

A

yes

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10
Q

What is honeycombing a sign of?

A

advanced diffuse pulmonary fibrosis seen in idiopathic pulmonary fibrosis

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11
Q

How do interstitial lung diseases present?

A

progressive dyspnoea, cough

cyanosis, fine end inspiratory crackles

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12
Q

Pathology of pneumoconioses?

A

small particles are inhaled into small airways and picked up by macrophages that activate fibroblasts to deposit connective tissue. Chronic local immune activation and inflammation.

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13
Q

4 main pneumoconioses?

A

asbestosis
berylliosis
silicosis
coal workers pneumoncoises

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14
Q

What is asbestos and who was at risk?

A

insulation material used until 70s

construction workers, plumbers, shipyard workers

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15
Q

What is more harmful chrysotile (white) or crocidolite (blue) asbestos?

A

blue

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16
Q

What does asbestosis increase your risk of?

A 
pleural plaques (fibrosis of the pleura)
lung cancer (non small cell)
mesothelioma
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17
Q

Who is at risk for beryllium inhalation?

A

miners

workers in aerospace

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18
Q

Does berylliosis increase your risk of lung cancer?

A

yes

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19
Q

What is the pathological feature of berylliosis?

A

non caseating granulomas

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20
Q

What is anthracosis and who gets it?

A

carbon laden macrophages, clinically insignificant exposure to carbon e.g. living in a city

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21
Q

Pathology of coal worker’s pneumoconiosis?

A

black shrunken lung with massive fibrosis

round nodules on CXR

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22
Q

What is caplan’s syndrome?

A

RA and pneumoconiosis

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23
Q

Who is at risk of silicosis?

A

sand blasters, silica miners

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24
Q

Why does silicosis increase risk of TB?

A

impairs the formation of phygolysosome in macrophages

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25
Pathology in sarcoidosis?
non caseating granulomas in multiple organs
26
What is sarcoidosis?
systemic disease with formation of granulomas | body in overdrive attacking own tissues
27
What substances are raised in sarcoidosis?
hypercalcemia (granulomas have 1 alpha hydroxalase activity that activates vit D) raised serum ACE
28
Common presentation of sarcoidosis?
``` pulmonary fibrosis (dyspnoea, cough) bilateral hilar lymphadenopathy erythema nodosum, conjunctivitis ```
29
How is sarcoidosis definitively diagnosed?
bronchial or lymph node biopsy
30
Pharyngitis organism?
adenovirus
31
Epiglottitis organisms?
HIB | strep pyogenes
32
Thumbprint sign?
epiglottitis
33
Management of epiglottitis?
ITU with endotracheal intubation | IV ceftriaxone
34
Croup organism?
parainfluenza
35
Management of croup?
dexamethasone
36
Assman focus
reactivated foci of TB in the apex of lungs
37
most common location for aspirated pneumonia
lower right lobe
38
Pulmonary oedema CXR signs
``` Alveolar bat wings kerley b lines cardiomegaly dilated upper lobe vessels pleural effusion ```
39
ground glass appearance on XRY
respiratory distress of the newborn | pulmonary fibrosis
40
TB identification
ZN stain positive for acid fast bacilli
41
caseated granulomas
Caseated means necrosis is present | TB
42
Antiglomerular basement membrane antibodies (against type 4 collagen)
good pastures (pulmonary haemorrhage and rapidly progressive glomerulonephritis)
43
chlamydophilia psittaci
pigeons/parrots chest infection
44
dry cough and diarrhoea after holiday abroad
legionella (urine antigen test)
45
afrocaribean, bilateral hilar lymphadenopathy, erythema nodosum, non-caseating granulomas, uveitis, weight loss
sarcoidosis
46
signet ring sign on CT (bronchiole wider than neighbouring arteriole)
bronchiectasis (widening of the airways usually due to chronic inflammation and infection)
47
obesity hypoventillation syndrome
pickwickians (restrictive lung disease due to difficulty expanding chest wall)
48
what is an empyema
pus in the pleural space
49
D sign on CXR
empyema
50
steeple sign on CXR
croup (laryngotracheal narrowing)
51
Pneumocytis pneumonia
HIV treat with co-trimoxazole
52
sameters triad
asthma, nasal polyps, NSAID sensitivity
53
pneumonia in alcoholic
klebsiella
54
red jelly sputum
klebsiella
55
mucoid sputum
chamydia psittaci
56
rusty sputum
pneumococcal
57
canonnball mets
from primary renal cell carcinoma
58
ACTH secreting tumour
small cell lung ca (causes hypernatremia and hypokalemia)
59
PTH secreting tumour
Squamous cell ca (causes hyperparathyroidisim)
60
Increased serum ACE and Ca
sarcoidosis
61
Eggshell calcification at hilar regions
silicosis
62
pancoast tumour
a tumour in the upper apex of the lung (can cause horners syndrome)
63
thumbprint sign on XRAY
epidlottitis
64
where are squamous and small cell lung cancers commonly found
centrally
65
what kind of lung cancer so non smokers get and where are they found
adenocarcinoma | periperal
66
coxiella burnetti
sheep/farm
67
pleaural plaques
asbestosiss
68
Using SABA and ICS step up
ICS + LABA (beclamethasone + formoterol)
69
ABGs in heroin overdose
heroin is diamorphine overdose causes pinpoint pupils and respiratory depression respiratory acidosis
70
ABGs in COPD stable and infective exacerbation
respiratory acidosis with complete compensation respiratory acidosis with partial compensation (T2 resp failure happening in both, hypoxic drive)
71
ABGS in hyperventillation
respiratory alkalosis
72
ABGs in acute asthma
respiratory alkalosis initially then progresses to respiratory acidosis and T2 failure as exhaustion kicks in
73
ABGs and resp failure in pulmonary fibrosis
ABGs normal | T1 resp failure
74
ABGs in PE
resp alkalosis and t1 resp failure
75
ABGs in vomitting
metabolic alkalosis
76
stony dull to percuss
pleural effusion
77
sever CAP
IV co-amox and clarithromycin (CURB65 3-5)
78
bronchus inhaled foreing object likely to pass into
right main bronchus
79
what cells produce surfactant
type 2 pneumocytes
80
croup virus
parainfluenza
81
bronchiolitis virus
RSV
82
pneumonia in CF
psudomonnas | staph aurus
83
4 cs of idiopathic pulmonary fibrosisq
clubbin, cough, cyanosis, crackles
84
obstructive disease with raised eosinophils or neutrophils
asthma | COPD
85
horners triad
ptosis miosis anhydrosis
86
most common pneumonia
strep pneumonia
87
TB treatment
RIPE for 2 months then RI for 4 months
88
middle aged Asian presents with weight loss, night sweats and productive cough. CXR shows multiple small discrete nodules throughout both lung fields
TB
89
Side effects of TB drugs
r - orange tears, rash, hepatotoxicity i - tingling and parathesia of extremities p - joint pain rash, gout e- vision changes, optic neuritis
90
CAP 0-2 curb65
amoxicillin
91
wilsons disease
excess copper
92
signet ring cells
andeocarcinoma (mucin producing)
93
why is a combo of drugs used in tb
to prevent resistence
94
CAP 0 pen allergic
doxy
95
purpose of balloon on endotracheal tube
secure it in place, to prevent leakage of respiratory gases, and to protect the tracheobronchial tree from receiving undesirable material
96
clara cells
found in terminale bronchioles

YEAR 4 (27 decks)

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