Respiratory Flashcards
(88 cards)
1
Q
Blood smear for TB
A
Acid fast Ziehl-Nelson staining
2
Q
Best test for latent TB
A
Interferon Gamma release assay
3
Q
S/e Rifampicin
A
Yellow wee
Enzyme inducer
4
Q
S/e Isoniazid
A
Peripheral neuropathy
Hepatitis
5
Q
Pyrazinamide
A
Hepatotoxicity
General arthralgia
6
Q
Ethambutol
A
Colour blindness
Optic neuritis
Check vision before
7
Q
What is a Ghon complex?
A
Ghon Focus + lymph node
8
Q
Common organsims bronchiectasis
A
- H. influenza
- Strep pneumoniae
- Staph. aureus
- Pseudomonas aeruginosa
9
Q
What Abx for pseudomonas?
A
Ciprofloxacin
10
Q
Drug for cerebral oedema
A
IV mannitol
11
Q
Definitive Mx for IPF
A
Lung transplant
12
Q
How can you distinguish mesothelioma from other tumours
A
Calretinin
13
Q
ABx regime for lung abscess
A
2-3weeks IV
4-8wks oral
14
Q
Cause of Mumps
A
Paramyxovirus
15
Q
Main issue with mumps
A
Orchitis
Meningitis risk
16
Q
Dx Mumps
A
IgM/IgA PCR
17
Q
Mx Mumps
A
Supportive
18
Q
Measles virus
A
Morbillivirus –> RNA paramyxovirus
19
Q
Severe complication of measles
A
Sub-acute sclerosing pan-encephalitis - SSPE
Otitis media
Encephalitis
Death
20
Q
Character of Measles rash
A
Maculopapular blanching rash
Starts on head moves to trunk over 3-4 days
21
Q
Koplick spots associated condition
A
Measles
22
Q
Dx Measles
A
Fever for at least 1 day and one of:
- Cough
- Coryza
- Conjunctivitis
23
Q
Ix for Measles
A
Salivary swab - IgM
LFTs - raised transaminase
Blood film - leucopaenia and lymphopaenia
24
Q
When is MMR vaccine?
A
12-18months
25
Rubella rash
Tiny pink macule on face and trunk
Starts behind ears spreads down
Develops 14-17days post-infection
26
Clinical way to differentiate rubella from measles
Lymphadenopathy on the head
27
Cx of Rubella
Thrombocytpenia
Encephalitis - within 6 days after rash
Guillan-Barre
28
How long is Rubella infectious for
7 days before and 6 days after rash disappearing
29
How long is Measles infectious for?
3-5 days before and 4 days after onset of rash
30
Ix for Rubella
Salivary IgM/IgG
PCR
FBC
31
What medication do you avoid in rubella?
Aspirin - Reye's syndrome
32
Main Cx for rubella
Sensorineural deafness
33
How long is chicken pox infective for?
4 days before rash
| Until rash lesions have healed
34
Where does chicken pox usually start?
Back, head and trunk
35
Progression of chicken pox rash
Red macule - papule - vesicle - pustule - crusting
36
Dx of whooping cough
Nasal pharyngeal aspirate
| PCR
37
CURB 0-1 Mx
Amox 500mg TDS
38
CURB 2
Admit
| Amox + Clarithro - consider IV
39
CURB 3+
ITU
| Co-amox, + clarithro/cefuroxime if allergic
40
SIRS criteria
HR >90
Temp >38 or <36
RR >20
WCC <4 or >12
41
Borders for chest drain
- Lateral border latissimus dorsi
- Lat border pec major
- 5th Intercostal space
42
How lo g for flying post pneumothorax
3 months
43
Warfarin Mx for PE
```
Provoked = 3 months + reassess
Unprovoked = 6 months/lifelong
Cancer = at least 6 months
```
44
Blood test to distinguish bacterial vs viral infection
Procalcitonin - raised with bacteria
45
Step 3 asthma
LABA
Increase steroid if poor response
Trial leukotriene receptor antagonists or SR theophylline
46
Step 4 asthma
Increase ICSI
Add Leukotriene receptor antagonist
B2 agonist tablet
47
Step 5
Oral daily steroid tablet
48
Cancers that cause SIADH
SCLC
| Mesothelioma
49
Do not put NEB through oxygen in which condition?
COPD
50
Signs of Legionella
- Foreign travel
| - Dry cough, flu-like Sx
51
Ix for Legionella
- Lymphopenia
- Hyponatraemia
- Derranged LFTs
52
Dx Legionella
Urinary antigen
53
Mx legionella
Erythromycin
54
Sx Mycoplasma pneumoniae
Prolonged gradual onset
Flu-like Sx before dry cough
Erythema multiforme/nodosum
55
Ix Mycoplasma
Bilateral consolidation on CXR
Thrombocytopaniea
Low Hb
56
Mx Mycoplasma
Erythromycin/Clarithromycin
57
Atypical pneumonias
```
Mycoplasma penumoniae
Legionella pneumophila
Chlamydia pneumoniae
Coxiella burnetti
Chlamydia psittaci
```
58
Which condition associated with Q fever?
Coxiella burnetti - farm animals
59
Which type of cancer associated with smoking?
Squamous cell
60
How does Squamous cell lung cancer usually present?
Obstruction of bronchus - infection
61
Adenocarcinoma characteristics
most common in non-smokers
Peripheral tumours
Metastasise to brain and bone
62
What other condition is SCLC associated with?
SIADH
| Cushing's - ACTH
63
Short-term Abx for bronciectasis exacerbation
Cipro/taz
64
Long-term Abx for bronchiectasis
Azithromycin
65
where does sarcoidosis commonly affect?
Skin, Lungs, Eyes
66
Skin condition associated with sarcodosis
Lupus pernio
| Erythema nodosum
67
Mx sarcoidosis
Corticosteroids
Cytotoxics
Lung transplant
68
Drug used to treat IPF
Pirfenidone - monitor LFTs
| Ninterdanim - TK inhibitor
69
What is mycoplasma associated with?
Haemolytic anaemia
70
What Sx is Klebsiella associated with?
Red current jelly sputum
Usually hospital ventilator acquired
Alcoholics
Cavitating pneumonia in the upper lobes,
71
What is the holly leaf sign associated with?
Asbestosis
72
Which drug can cause thrombophlebitis?
Clarithromycin
73
Which criteria do you use to determine ABx prescription in COPD?
Anthonisen criteria. Must have 2 of:
- Increased SoB
- Increased sputum
- Increased sputum purulence
74
Mx for infective exacerbation COPD
Amox TDS
Oral pred 5 days
Increased bronchodilators
75
Organism causing infective COPD exacerbation but no consolidation on CXR
Haemophilus influenza
76
Purpose of pursed lipbreathing
Splint open breathing
77
Range of venturi colours from low to high %
```
Blue - 24
White - 28
Orange - 31
Yellow - 35
Red - 40
Green - 60
```
78
Drugs that can cause pulmonary fibrosis
Amiodarone
Bleomycin
Methotrexate
79
When must insurance claim be made for coal-workers/asbestos lung?
within 2 years of diagnosis
80
Ix for pleural effusion
```
Pleural tap - Thoracocentesis
Amylase
Albumin
MC+S
AAFB culture - alcohol and acid fast bacillus culture
```
81
Lymphocytes in pleural fluid mean what
TB until proven otherwise
82
Bubbling pleural drain
Pneumothorax
83
Swinging pleural drain
Drain is in correct place
84
Following PE, how long do you bridge with LMWH for before starting warfarin?
5 days or until INR >2
85
Pain medication pulmonary oedema
2.5-5mg diamorphine
86
Causes of respiratory alkalosis
```
anxiety leading to hyperventilation
pulmonary embolism
salicylate poisoning*
CNS disorders: stroke, subarachnoid haemorrhage, encephalitis
altitude
pregnancy
```
87
Tests for pleural aspiration
MC+S
LDH
pH
Albumin
88
when is LTOT offered?
```
pO2 of < 7.3 kPa or
pO2 of 7.3 - 8 kPa and one of the following:
- secondary polycythaemia
- peripheral oedema
- pulmonary hypertension
```
