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Respiratory Flashcards

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1
Q

How many lobes are there in the right lung?

A

3

Main bronchus wider and more vertical

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2
Q

What is the pattern of lung function tests in normal lungs?

A

FEV1 >80% predicted
FVC >80%
FEV1:FVC 75-80%

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3
Q

What is the pattern of lung function tests in restrictive lung disease?

A

FEV1 <80%
FVC <80%
FEV1:FVC >70%

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4
Q

What is the pattern of lung function tests in obstructive lung disease?

A

FEV1 <80%
FVC normal or low
FEV1:FVC <70%

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5
Q

What are some causes of restrictive lung disease?

A

Fibrosis, sarcoidosis, pneumonia, CTF, effusion, kyphoscoliosis

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6
Q

What are some causes of obstructive lung disease?

A

Asthma, COPD, bronchiectasis, cystic fibrosis

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7
Q

What are the commonest organisms in CAP?

A

Streptococcus pneumoniae

Haemophilius influenzae

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8
Q

What are some causes of aspiration pneumonia?

A

Stroke, myasthenia, bulbar palsies, reduced consciousness, oesophageal disease

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9
Q

What are some examination findings in pneumonia?

A 
Reduced expansion 
Dull percussion 
Increased vocal fremitus 
Bronchial breathing
Pleural rub
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10
Q

What investigations should be done in pneumonia?

A

FBC, U&E, LFT, CRP, ABG
CXR
Sputum culture
Urine - legionella and pneumococcal antigens

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11
Q

What is in the CURB score?

A 
Confusion
Urea >7mmol/L
Resp rate >30 
BP <90 systolic or <60 diastolic
65 years
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12
Q

What are some clinical features of legionella pneumonia and how is it treated?

A

Flu like symptoms then dry cough & dyspnoea
Anorexia, D&V, hepatitis, renal failure, confusion
Fluoroquinolone

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13
Q

What are some clinical features of chlamoydophila pneumonia?

A

Biphasic illness

  1. Pharyngitis, otitis, hoarseness
  2. Pneumonia
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14
Q

What are some complications of pneumonia?

A 
Type 1 respiratory failure
Hypotension
Atrial fibrillation 
Pleural effusion 
Empyema
Lung abscess
Myocarditis and pericarditis
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15
Q

What is the triad of Kartagener syndrome?

A

Primary ciliary dyskinesia
Situs inverts
Frontal sinus abnormalities

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16
Q

What are the symptoms and signs of bronchiectasis?

A

Persistent cough, copious purulent sputum, intermittent haemoptysis
Finger clubbing, coarse inspiratory crepitations

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17
Q

What investigations should be done for bronchiectasis?

A

Sputum culutre
CXR - cystic shadows, thickened bronchial walls, tramline &ring shadows
HRCT
Spirometry

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18
Q

What are some features of small cell lung tumours?

A

Neuroendocrine cells
Central location - smokers
Grow fast
Cause paraneoplastic syndromes

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19
Q

What are some different types of non-small cell lung tumours?

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A

Adenocarcinoma - peripheral
SCC - central, smoking, PTH release
Carcinoid
Large cell

20
Q

What does ACTH release from small cell tumours cause?

Study These Flashcards
A

Increased cortisol

Cushing’s and immunosuppression

21
Q

What does autoantibodies release from lung tumours cause?

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A

Lambert-Eaton myasthenic syndrome
Type 2 hypersensitivity
Gait difficulty, autonomic involvement, hyporeflexia

22
Q

What does PTH-related protein release from lung tumours cause?

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A

Ca released from bones

Weak bones and hypercalcaemia

23
Q

What does ADH release from lung tumours cause?

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A

Water retention
Bloating, oedema, hypertension
Increased urinary sodium

24
Q

What different things can aspergillus cause?

Study These Flashcards
A 
Asthma
Allergic bronchopulmonary aspergillosis 
Aspergilloma 
Invasive aspergillosis 
Extrinsic allergic alveolitis
25
What is the pathophysiology of asthma?
1. Bronchial muscle contraction 2. Mucosal swelling/inflammation 3. Increased mucus production
26
What are some features of severe asthma?
Inability to complete sentences RR >25 PEF 33-50%
27
What are some features of life-threatening asthma?
Silent chest, confusion, exhaustion, cyanosis SpO2 <92% Increased CO2 PEF <33%
28
What are some complications of COPD?
``` Acute exacerbations Polycythaemia Respiratory failure Cor pulmonale Pneumothorax Lung carcinoma ```
29
What are the criteria for long term O2 therapy?
Stable non-smokers PaO2 <7.3 PaO2 7.3-8 + pulmonary HTN/oedema/polycythaemia Terminally ill patients
30
What is acute respiratory distress syndrome?
Lung damage and inflammatory mediators caused by direct lung injury or secondary to severe systemic illness
31
What are some causes of ARDS?
Pneumonia, aspiration, vasculitis | Sepsis, DIC, pancreatitis, ALF
32
What are some diagnostic criteria for ARDS?
Acute onset CXR - bilateral infiltrates PCWP <19mmHg or no heart failure Refractory hypoxaemia
33
What are some causes of type 1 respiratory failure?
Pneumonia, PE, asthma, emphysema, fibrosis, ARDS
34
What are some causes of type 2 respiratory failure?
COPD, obstructive sleep apnoea, CNS tumour/trauma, myasthenia, GBS
35
What are symptoms and signs of a PE?
Acute breathlessness, pleuritic pain, haemoptysis | Tachypnoea, tachycardia, hypotension, raised JVP
36
What is the emergency management of PE?
``` O2 if needed Morphine and anti-emetic IV access and LMWH Fluid bolus if needed Long term anticoagulation ```
37
What are some causes of a pneumothorax?
Spontaneous, asthma, COPD, TB, carcinoma, Marfan's, Ehler's Danlos
38
What is a transudate and what causes it?
Low protein effusion due to increased venous pressure or hypoproteinaemia heart failure, cirrhosis, nephrotic syndrome
39
What is an exudate and what causes it?
Effusion due to leaky pleural capillaries Infection Inflammation - RA, SLE Malignancy
40
What are the lab values for an exudate?
Protein >35g/L Effusion: serum protein >0.5 Effusion: serum LDH >0.6
41
What is sarcoidosis?
A multisystem granulomatous disorder
42
What are the acute signs and symptoms of sarcoidosis?
Fever, erythema nodosum, polyarthalgia, bilateral lymphadenopathy
43
What are the pulmonary manifestations of sarcoidosis?
Dry cough, dyspnoea, reduced exercise tolerance | BHL +/- fibrosis/infiltrates
44
What are the non-pulmonary manifestations of sarcoidosis?
Lymphadenopathy, hepato-splenomegaly Uveitis, conjunctivitis, glaucoma Bell's palsy, neuropathy, SOL Cardiomyopathy, arrhythmias
45
What is the treatment of sarcoidosis?
Acute - bed rest and NSAIDs | May need steroids to induce remission
46
What are some causes of interstitial lung disease?
Asbestosis Amiodarone, sulfasalazine, nitrofurantoin Sarcoidosis, RA, SLE, CTD, Sjogren's Idiopathic
47
What are the symptoms and signs of idiopathic pulmonary fibrosis?
Dry cough, exertion dyspnoea, malaise, cyanosis, finger clubbing, end inspiratory crepitations

FINALS (19 decks)

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