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Phase 2a Medicine > Respiratory > Flashcards

Respiratory Flashcards

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1
Q

What are the surface antigens for influenza A?

A
  1. Haemagglutinin

2. Neuraminidase

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2
Q

What is the function of haemagglutinin?

A

Virus binding and entry to cells

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3
Q

What is the function of neuraminidase?

A

Cuts newly formed virus loose from infected cells and prevents it clumping together

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4
Q

What causes seasonal epidemics?

A

Antigenic drift

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5
Q

What causes pandemics?

A

Antigenic shift

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6
Q

How do new virus strains form?

A

Genetic reassortment

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7
Q

What are the symptoms of influenza?

A
  1. URT symptoms
  2. LRT symptoms
  3. Fever
  4. Headache
  5. Myalgia
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8
Q

What are the risk factors for influenza mortality?

A
  1. Chronic cardiac and pulmonary diseases
  2. Old age
  3. Chronic metabolic disease
  4. Chronic renal disease
  5. Immunosuppressed
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9
Q

What is the Rx of influenza?

A
  1. Oxygen
  2. Hydration/nutrition
  3. Tamiflu
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10
Q

What makes pandemics worse?

A
  1. More travel
  2. Bigger population
  3. Intensive farming
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11
Q

What will make coping with a pandemic better?

A
  1. Better nutrition
  2. Better supportive care
  3. Vaccination
  4. Antivirals
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12
Q

How was avian flu controlled?

A
  1. Cull affected birds
  2. Disinfect farms
  3. Control poultry movement
  4. Vaccinate workers
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13
Q

What is the Rx for swine flu?

A
  1. Oseltamivir

2. Zanamivir

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14
Q

What happens in containment phase?

A
  1. Identify cases
  2. Treat cases
  3. Contact tracing
  4. Large scale prophylaxis
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15
Q

What happens in treatment phase?

A
  1. Treat cases only

2. National flu pandemic service

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16
Q

What happens in type 1 respiratory failure?

A

Low PaO2, normal or low PaCO2

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17
Q

What happens in type 2 respiratory failure?

A

Low PaO2 and raised PaCO2

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18
Q

What can cause raised A-a gradient?

A
  1. Diffusion limitation

2. Shunt (right to left)

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19
Q

What is the pathophysiology of high altitude pulmonary oedema?

A

Exaggerated hypoxic pulmonary vasoconstriction

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20
Q

What is the Rx for high altitude pulmonary oedema?

A
  1. Descent
  2. Oxygen
  3. Pulmonary vasodilators e.g. nifedipine
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21
Q

What factors determine transfer factor?

A
  1. Alveolar volume
  2. Diffusing capacity of membrane
  3. Pulmonary capillary blood volume
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22
Q

What does low TLCO indicate?

A
  1. Thickening of alveolar-capillary membrane

2. Reduced lung volume

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23
Q

What does high TLCO indicate?

A
  1. Increased capillary blood volume

2. Pulmonary haemorrhage

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24
Q

What inhibits O2 transfer in ILD?

A

Thickening of alveolar layer

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25
What is seen on CT chest in ILD?
Honeycombing
26
How can ILD be physiologically measured?
1. Restricted FVC 2. Reduced TLCO 3. Hypoxia on exertion 4. Reduction in exercise capacity
27
What is the histology of idiopathic pulmonary fibrosis (IPF)?
1. Fibroblastic foci | 2. Honeycombing and thickening of alveoli
28
What is the pathophysiology of IPF?
1. Fibroblasts resistant to apoptosis 2. Myofibroblasts proliferate and for fibroblastic foci 3. Lower GE efficiency in lungs
29
What is the imaging for IPF?
High resolution CT - honeycombing, traction bronchi
30
What is the Rx for IPD?
1. Pirfenidone | 2. Nintedanib
31
What is the mechanism of action for pirfenidone?
1. Inhibits TGF-B | 2. Reduces apoptosis of myofibroblasts
32
What are the SE of pirfenidone?
1. Photosensitivity | 2. GI upset
33
What are the SE of nintedanib?
1. GI upset | 2. Diarrhoea
34
What type of reaction is hypersensitivity pneumonitis (HP)?
Type III hypersensitivity
35
Give 3 causes of HP
1. Pets 2. Mould 3. Bird handler
36
What is the Dx for HP?
1. Clinical Hx 2. Precipitin IgG level 3. Bronchoalveoalr lavage
37
What is the Rx for HP?
1. Avoidance allergen | 2. Steroids
38
What are the symptoms of systemic sclerosis?
1. Tightness around mouth 2. Calcinosis 3. Loss of distal digits
39
What are the symptoms of cutaneous syndrome of CREST?
1. Calcinosis 2. Raynaud's phenomenon 3. Oesophageal dysmotility 4. Sclerodactyly 5. Telangiectasia
40
What is seen on scans for sarcoidosis?
Honeycombing at base and periphery of lung
41
What is the Rx for sarcoidosis?
1. Immunosuppressants | 2. Nintedanib
42
What is the palliative Rx for ILD?
1. Opioids 2. Benzodiazepine 3. Supplementary O2
43
What are the symptoms of asthma?
1. Cough 2. SOB 3. Wheezing 4. Chest tightness 5. Secretions
44
What is atopy?
Tendency to develop IgE mediated reactions to common aeroallergens
45
What are the types of asthma?
1. Eosinophilic | 2. Non-eosinophilic
46
Why does asthma have diurnal variation?
Natural dip in adrenaline levels
47
What are the provoking factors for asthma?
1. Allergens 2. Infections 3. Menstrual cycle 4. Exercise 5. Cold air
48
How are asthma exacerbations assessed?
1. A&E attendance 2. GP 3. Admissions 4. ITU
49
What problems are associated with asthma?
1. Eczema 2. Hayfever 3. Nasal disease 4. Other allergies 5. Reflux disease
50
What are the tests for asthma?
1. Eosinophils, SPT, IgE 2. CXR 3. Skin prick tests 4. LFTs
51
What is present on LFTs in asthma?
1. Reduced FEV1 2. Reduced FEV1/FVC ratio 3. PEFR reductions 4. Increased responsiveness to challenge
52
What is a marker of eosinophilic inflammation?
Exhaled nitric oxide
53
Who is at risk of asthma death?
1. >3 classes of Rx 2. Recent admission 3. Previous near fatal 4. Brittle disease 5. Psychosocial factors
54
What is the DDx for asthma?
1. COPD 2. Bronchiectasis 3. Bronchial obstruction 4. Aspiration
55
What drugs are available for asthma?
1. Bronchodilators e.g. beta agonists 2. Steroids 3. Omalizumab 4. Mepolizumab
56
What are some SE of oral steroids?
1. Hoarse voice 2. Oral candida 3. Skin thinning 4. Osteoporosis 5. Adrenal suppression
57
What is the ladder of asthma Rx?
1. Low dose steroids 2. Long acting beta agonist 3. Lacertine receptor antagonist 4. Regular long term oral steroids
58
What is the Rx for non-eosinophilic asthma?
1. Steroids 2. Bronchodilator 3. Bronchial thermoplasty
59
What is the initial management for acute asthma?
1. High flow O2 2. Emergency beta agonists 3. Brief Hx
60
What classifies severe asthma?
1. PEFR 33-50% 2. RR >25 3. HR >110 4. Inability to complete sentences
61
What defines a life threatening asthma attack?
Normal CO2 in acute asthma
62
What is the Rx for severe asthma?
1. O2 2. Salbutamol nebuliser 3. Prednisolone 4. ABGs
63
What makes up lung immune defence?
1. Commensal flora 2. Swallowing 3. Lung anatomy 4. Innate and adaptive immunity
64
What is the DDx for pneumonia?
1. HF 2. PE 3. Cancer 4. TB 5. ILD
65
Which groups are at risk of pneumonia?
1. Elderly 2. COPD 3. Immunocompromised 4. Nursing home residents 5. DM
66
What is the pathophysiology of pneumonia?
1. Bacteria translocate to sterile airway 2. Overwhelm resident host defence 3. Develop inflammatory response 4. Neutrophils and inflammatory exudate fill alveolar space
67
What are the symptoms of pneumonia?
1. Fever 2. Cough 3. Sputum 4. SOB 5. Pleuritic chest pain
68
What are the signs of pneumonia?
1. Raised HR 2. Raised RR 3. Lung dull to percussion 4. Decreased air entry 5. Hypoxia
69
What are the Ix for pneumonia?
1. CXR 2. FBC 3. Biochemistry (LFT, urea) 4. CRP 5. Pulse oximetry 6. Microbiological tests
70
What can be seen on CXR in pneumonia?
1. Air bronchogram 2. Interstitial or diffuse shadowing 3. Pleural collections
71
What are the signs of sepsis?
1. Delirium 2. Renal impairment 3. High RR 4. Lactic acid production 5. BP drop
72
How is communist acquired pneumonia assessed?
CURB65
73
What does CURB65 mean?
1. Confusion 2. Urea >7 mmol/L 3. RR > 30 4. BP low 5. 65+
74
What are the main pathogens to cause pneumonia?
1. S. pneumoniae 2. H. influenzae 3. S. aureus 4. Klebsiella pneumoniae
75
What Abx are used to treat S. pneumoniae?
1. Amoxicillin 2. Cefuroxime 3. Cefotaxime
76
What is used to treat pneumonia with abnormal pathogens?
1. Erythromycin 2. Ciprofloxacin 3. Doxycycline
77
What features are seen in mycoplasma pneumoniae?
1. Haemolytic anaemia 2. Raynaud's 3. Bullous myringitis 4. Encephalitis
78
What are the extra-pulmonary features in Legionella pneumonia?
1. Diarrhoea 2. Abnormal LFTs 3. Hyponatraemia 4. Myalgia
79
Who is most at risk of Legionella pneumonia?
1. Travellers 2. Elderly 3. Immunocompromised
80
What is the Ix for pneumonia?
1. Sputum culture 2. Serology 3. Urinary antigen 4. PCR 5. Blood culture
81
What is the prevention for pneumonia?
1. Vaccine against pneumococcal disease, influenza | 2. Smoking cessation
82
What are the signs of empyema?
1. Failure of fever to settle on Abx 2. Pain on deep inspiration 3. Signs of pleural collection
83
What is the Ix for parapneumonic effusion?
Thoracentesis
84
What is the Rx for empyema?
1. Chest drainage | 2. Co-amoxiclav
85
Which groups is lung abscess more common in?
1. Aspiration 2. Alcoholics 3. Poor dentition
86
Who is at risk of hospital acquired pneumonia?
1. Elderly 2. Ventilator assisted 3. Post-operative
87
What is the Dx for hospital acquired pneumonia?
1. New infection 2. Purulent secretions 3. New radiological infiltrates 4. New CRP increase 5. Increased O2 requirements
88
What are the Abx for hospital acquired pneumonia?
1. Piperacillin-tazobactam 2. Linezolid or vancomycin 3. Colistin
89
What causes most bronchiolitis?
Respiratory syncytial virus (RSV)
90
What is the pathophysiology of bronchiolitis?
Inflammation of bronchioles and mucus production cause airway obstruction
91
What are the symptoms of bronchitis?
1. Cough 2. Phlegm 3. Breathlessness 4. Wheeze
92
What is the pathophysiology of bronchitis?
Self-limited inflammation of epithelia of bronchi due to URI
93
What distinguishes chronic bronchitis?
COPD pt. with cough for at least 3 months in each of 2 successive years
94
What are the Ix for bronchitis?
1. CXR normal 2. Throat swabs 3. Serology
95
Give 3 causes of upper respiratory tract infections (URI)
1. Rhinovirus 2. Influenza A virus 3. Coronavirus
96
What are the complications of URIs?
1. Sinusitis 2. Pharyngitis 3. Otitis media
97
What groups are at high risk of flu?
1. Chronic respiratory condition 2. Heart disease 3. DM 4. Renal disease
98
What are the Rx for flu?
1. Oseltamivir | 2. Zanamivir
99
What viruses commonly cause pharyngitis?
1. Rhinovirus | 2. Adenovirus
100
What are the complications of bacterial pharyngitis?
1. GABHS associated disease 2. PSGN 3. Scarlet fever 4. Rheumatic disease
101
What is the result of acute localised obstruction in lungs?
1. Atelectasis 2. Valve effect 3. Pneumonia
102
What are the main forms of chronic obstruction?
1. Chronic bronchitis 2. Asthma 3. Bronchiectasis
103
What are the signs of chronic bronchitis?
1. Productive cough for 3 months over 2 years 2. Mucus hypersecretion 3. Respiratory bronchiolitis
104
Who is most at risk of chronic bronchitis?
Middle aged heavy smokers
105
What are the consequences of chronic bronchitis?
1. Hypercapnia 2. Hypoxaemia 3. Cyanosis 4. Right heart failure
106
What is emphysema?
Enlargement of alveolar airspaces with destruction of elastin in walls
107
What are the causes of emphysema?
1. Smoking 2. Alpha1 antitrypsin deficiency 3. Coal dust 4. Cadmium toxicity
108
What are the clinical features of emphysema?
1. Reduced PaCO2 2. Normal PaO2 3. Weight loss 4. Right HF 5. Overinflated chest
109
What is bronchiectasis?
Permanent dilation of bronchi and bronchioles due to obstruction and severe inflammation
110
What are the symptoms of bronchiectasis?
1. Chronic cough | 2. Foul-smelling sputum flecked with blood
111
What is the pathophysiology of bronchiectasis?
1. Dilation of bronchi and bronchioles 2. Inflammation 3. Fibrosis
112
What are the complications of bronchiectasis?
1. Pneumonia 2. Asthma 3. Metastatic abscesses 4. Amyloid formation
113
What are the causes of adult respiratory distress syndrome (ARDS)?
1. Drugs and toxins 2. Gastric aspiration 3. Radiation pneumonitis 4. Shock 5. Diffuse intrapulmonary haemorrhage
114
What are the signs of ARDS?
1. Acute respiratory distress 2. Tachypnoea 3. Dyspnoea 4. Pulmonary oedema
115
What is the pathogenesis of ARDS?
1. Massive insult to alveoli and capillaries 2. Related O2 toxicity 3. Polymorphs release enzymes and activate complement
116
What is pneumoconiosis?
Lung disease caused by inhaled dust
117
What is the pathophysiology of coal workers' pneumoconiosis (CWP)?
1. Coal dust ingested by macrophages | 2. Aggregate around bronchioles
118
What are the types of CWP?
1. Anthracosis 2. Macular CWP 3. Nodular CWP
119
What happens in progressive massive fibrosis?
Fusion of nodules creates a large zone of dense scarred and black lung
120
What is extrinsic allergic alveolitis?
Type 3 hypersensitivity causing bronchiolitis, chronic inflammation and granulomas
121
What are the common types of extrinsic allergic alveolitis?
1. Bird fancier's lung | 2. Farmer's lung
122
What nodule type is seen on CWP?
Caplan's nodules
123
What is lymphangitis?
Process with diffuse permeation of lung by malignant cells
124
What are the causes of lung cancer?
1. Cigarettes 2. Asbestos 3. Radon 4. Nickel 5. Lung fibrosis
125
What are the symptoms of lung cancer?
1. Cough 2. Recurrent chest infection 3. Haemoptysis 4. Increasing SOB 5. Malaise 6. Weight loss
126
What are the majority of thoracic neoplasia?
Carcinoma
127
What are the commonest primary lung cancers?
1. Squamous cell carcinoma 2. Adenocarcinoma 3. Large cell undifferentiated carcinoma 4. Small cell carcinoma
128
Describe small cell lung carcinoma (SCLC)
High grade epithelial neoplasm with strong cigarette association
129
What is the Rx for SCLC?
Chemotherapy
130
Describe non-small cell lung carcinoma (NSCLC)
Variable grade epithelial neoplasm with cigarette smoking association
131
What is the Rx for NSCLC?
1. Chemotherapy 2. Gene based chemo 3. Surgery 4. Radiotherapy
132
What are the targets for new NSCLC drugs?
1. EGFR 2. ALK1 3. ROS1 4. PDL1
133
What can cause lung nodules appear from cancer?
1. TB 2. Lymph nodes 3. Hamartoma
134
What are the main primary tumours affecting pleura?
1. Pleural fibroma | 2. Malignant mesothelioma
135
What is the main cause of mesothelioma?
Asbestos
136
What are the Rx for mesothelioma?
1. Chemo 2. Surgery 3. Radiotherapy
137
What happens during bronchoconstriction?
1. Tightening airway smooth muscle 2. Lumenal occlusion by mucus and plasma 3. Airway wall thickening
138
What is an example of a short acting beta agonist?
Salbutamol
139
What is an example of a long acting beta agonist?
Formaterol
140
Give examples of inhaled corticosteroids (ICS)
1. Beclomethasone dipropionate 2. Budesinide 3. Ciclesonide
141
How do ICS work?
1. Suppress production of chemotactic mediators 2. Reduce adhesion molecule expression 3. Inhibit inflammatory cell survival
142
What are the SE of ICS?
1. Loss of bone density 2. Adrenal suppression 3. Cataracts 4. Glaucoma
143
What is the Rx of bronchiectasis?
1. Abx 2. Physical therapy 3. Transplantation
144
What is respiratory failure?
Inability of lungs to adequately oxygenate arterial blood supply +/- eliminate CO2 from venous supply
145
What defines type 1 respiratory failure?
PaO2 <8kPa
146
What defines type 2 respiratory failure?
PaCO2 >6kPa
147
What are the causes of respiratory failure?
1. Reduced FiO2 2. VQ mismatch 3. Increased shunt 4. Diffusion impairment 5. Alveolar hypoventilation
148
What are the types of VQ mismatch?
1. Shunt | 2. Dead space
149
What is dead space (increased VQ)?
Ventilation of under perfused alveoli
150
What is shunt (reduced VQ)?
Perfusion of under ventilated alveoli
151
What are the causes of diffusion impairment?
1. Emphysema 2. ILD 3. Pulmonary oedema
152
What are the signs of type 1 respiratory failure?
1. Cyanosis 2. Increased RR 3. Accessory muscle use 4. Tachycardia 5. Confusion
153
What is alveolar hypoventilation?
Alveolus poorly ventilated can't remove CO2, levels rise and pass into arterial blood
154
What are the causes of alveolar hypoventilation?
1. COPD 2. CF 3. Obesity 4. Sleep apnoea 5. Drug OD
155
What is the pathophysiology of obstructive sleep apnoea?
Relaxation of pharynx during sleep
156
What are the signs of hypercapnia?
1. Bounding pulse 2. Flapping tremor 3. Confusion 4. Drowsiness 5. Reduced consciousness
157
What is the Rx of type 1 respiratory failure?
1. Oxygen (94-98%) 2. Treat underlying cause 3. CPAP
158
What is the Rx of type 2 respiratory failure?
1. Oxygen (88-92%) 2. Treat underlying cause 3. Non-invasive ventilaiton
159
What is the special stain for TB mycobacteria?
Ziehl-Neelsen stain for acid fast bacilli
160
What are the risk factors for TB?
1. Born in high prevalence area 2. IVDU 3. Homeless 4. Alcoholic 5. Prisons
161
How is TB spread?
Aerosol
162
What is the pathophysiology of TB?
1. Bacilli and macrophages coalesce to form granuloma (primary focus) 2. Mediastinal lymph nodes enlarge 3. Mediastinal LN and primary focus join to make primary complex 4. Granuloma grows into cavity full of bacilli
163
What is the presentation of TB?
1. Weight loss 2. Night sweats 3. Cough >3/52 4. Chest pain 5. Breathlessness
164
What is the disease progression of TB?
1. Primary infection 2. Acute TB 3. Latent TB 4. Re-activation
165
What are the types of extra pulmonary TB?
1. Lymph node TB 2. Miliary TB 3. Bone TB 4. Abdominal TB
166
What is miliary TB?
Bacteria everywhere in body and cause tiny granulomas widespread
167
How is active TB diagnosed?
1. Prolonged inflammatory response 2. CXR 3. Microbiology 4. Microscopy AFB, PCR, culture 5. Biopsy
168
How is latent TB diagnosed?
Tuberculin skin test Mantoux
169
Which type of TB gives false negative to Mantoux test?
Miliary TB
170
What can be used to test for M. tuberculosis in patients who had BCG vaccine?
Interferon gamma release assays
171
What is the Rx for TB?
1. Rifampicin 2. Isoniazid 3. Pyrazinamide 4. Ethambutol
172
What drugs commonly interact with rifampicin?
OCP
173
What are some side effects for TB drugs?
1. Red urine 2. Hepatitis 3. Neuropathy 4. Rash
174
What are the risk factors for drug resistant TB?
1. Previous Rx 2. High risk area 3. Contact of resistant TB 4. Poor response to therapy
175
What is the prevention for TB?
1. Active case finding 2. Detection and Rx of latent TB 3. Vaccination
176
What re the risk factors for latent TB?
1. Recent infection 2. New entrants 3. HCPs 4. Immunocompromised
177
How is latent TB diagnosed?
Mantoux test or IGRA
178
What is the Rx for latent TB?
1. Isoniazid | 2. Rifampicin + isoniazid
179
What is COPD?
COPD is characterised by airflow obstruction, usually progressive, not fully reversible and doesn't change markedly over several months
180
What are the mechanisms underlying COPD?
1. Airway inflammation 2. Airway fibrosis 3. Increased airway resistance 4. Loss of alveolar attachments 5. Decrease of elastic recoil
181
Why do airways collapse during expiration in COPD?
Increased intrathoracic pressure
182
What are the risk factors for COPD?
1. Smoking 2. Age 3. Male 4. Genetics
183
What are the symptoms of COPD?
1. Cough 2. SOB 3. Phlegm 4. Wheeze
184
What are the signs of COPD?
1. Raised respiratory weight 2. Hyperexpansion 3. Barrel shaped chest 4. Cyanosis 5. Weight loss
185
What does CAT tool assess?
1. Cough 2. Phlegm 3. Chest tightness 4. Breathlessness when using stairs 5. Activity limitation at home 6. Confidence leaving home 7. Sleep 8. Energy
186
What is the DDx for COPD?
1. HF 2. PE 3. Pneumonia 4. Lung cancer 5. Asthma
187
What is the non-pharmacological Rx for COPD?
1. Smoking cessation 2. Exercise training programmes 3. Pulmonary rehab programme 4. Influenza and pneumococcal vaccine
188
What are the pharmacological Rx for COPD?
1. B2 agonist 2. Anticholinergics e.g. tiotropium 3. Theophylline 4. ICS 5. Oxygen therapy 6. Ventilatory support (NIV)
189
What surgeries can be used for COPD?
1. Lung volume reduction surgery | 2. Lung transplant
190
What are the most common causes of COPD exacerbation?
1. URI | 2. Infection of tracheobronchial tree
191
What is the Rx for COPD exacerbation?
1. Short acting B2 agonist 2. Abx 3. Systemic corticosteroids 4. Oxygen
192
How are COPD exacerbations assessed?
1. ABGs 2. CXR 3. ECG 4. Bloods 5. Purulent sputum
193
Which COPD pt. should be given Abx?
1. Increased dyspnoea 2. Increased sputum volume 3. Increased sputum purulence 4. Mechanical ventilation
194
What can cause occupational lung diseases?
1. Dusts 2. Mists 3. Fumes 4. Vapours
195
What does response to a workplace exposure depend on?
1. Physical and chemical nature of agent 2. Duration and dose of exposure 3. Individual susceptibility
196
What conditions have a shorter latency?
1. Occupational asthma | 2. Pneumonitis
197
What can cause occupational asthma?
1. Spray paint 2. Lab rats 3. Metalwork
198
What causes most occupational asthma?
Sensitisation to an agent inhaled at work
199
What causes 10% of occupational asthma?
Massive accidental irritant exposure at work
200
How does occupational asthma present?
1. Latent period 2. Deteriorating symptoms 3. Gradual improvement 4. Depression
201
What causes occupational asthma?
1. Wood 2. Flour 3. Metal working fluids 4. Isocyanate paint
202
What causes extrinsic allergic alveolitis?
1. Moles 2. Metalwork fluids 3. Mushroom pickers 4. Farmers lung
203
What are the symptoms of extrinsic allergic alveolitis?
1. Cough 2. SOB 3. Fever 4. Flu like symptoms
204
What is pneumoconiosis?
Lung disease caused by inhalation of mineral dust
205
What are the types of pneumoconiosis?
1. Asbestosis 2. Coal worker's pneumoconiosis 3. Silicosis
206
What is seen in asbestos related lung disease?
1. Pleural disease 2. Pulmonary fibrosis 3. Cancer
207
Describe pleural plaques
Layers of collagen, often calcified
208
Describe diffuse pleural thickening
1. Follows benign effusion 2. Obliteration of costophrenic angle 3. Lung expansion restricted by thickened pleura
209
What is the presentation of asbestosis?
1. Interstitial lung fibrosis 2. Long latency 3. Hx of heavy exposure 4. Progressive breathlessness
210
What is mesothelioma?
Rapidly progressive and incurable pleural cancer
211
What are the symptoms of mesothelioma?
1. Unexplained pleural effusion 2. Progressive breathlessness 3. Chest pain 4. Weight loss
212
What is the prevention of occupational lung disease?
1. Risk assessment 2. Prevent or minimise exposures to harmful substances 3. Surveillance of workers 4. Identify health problems early
213
What is the pathophysiology of CF?
1. Mucus secretions are stick and thick | 2. Secretions block passageways in lungs and pancreas
214
What gene is mutated in CF?
CFTR
215
What are the symptoms of CF?
1. Persistent cough with thick mucus 2. Wheezing 3. Exercise intolerance 4. Foul-smelling greasy stools 5. Poor weight gain
216
What is the Dx for CF?
1. Newborn screening (IRT level) 2. Sweat test 3. Genetic tests
217
What is the Rx for CF?
1. Trikafta 2. Physiotherapy 3. Dornase alfa
218
What is the pathophysiology of pleural effusion?
Build up of excess fluid between layers of pleura
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What are the symptoms of pleural effusion?
1. Chest pain 2. Dry cough 3. Fever 4. SOB 5. Difficulty breathing when lying down
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What is the Dx of pleural effusion?
1. CXR 2. CT chest 3. USS chest 4. Thoracentesis
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What is the Rx of pleural effusion?
1. Chemo 2. Therapeutic thoracentesis 3. Tube thoracostomy
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What is the pathophysiology of pneumothorax?
Air leaks into space between lung and chest wall causing lung collapse
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What are the symptoms of pneumothorax?
1. SOB 2. Chest pain (unilateral) 3. Sharp pain on inhalation 4. Tachycardia 5. Blue discolouration of lips
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What is the Dx of pneumothorax?
1. CXR 2. CT chest 3. USS
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What is the Rx for pneumothorax?
1. Needle aspiration 2. Chest tube 3. Pleurodesis 4. Surgery
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What are the symptoms of pulmonary HT?
1. SOB 2. Fatigue 3. Syncope 4. Chest pain 5. Peripheral oedema
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How is pulmonary HT diagnosed?
1. Bloods 2. CXR 3. ECG 4. Echocardiogram 5. Right heart catheterisation
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What are the Rx for pulmonary HT?
1. Epoprostenol 2. Riociguat 3. Sildenafil
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What is the pathophysiology of Goodpasture's syndrome?
Autoantibodies to alpha-3 chain of type IV collagen
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What are the symptoms of Goodpasture's syndrome?
1. Reduced urine output 2. Haemoptysis 3. Oedema
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What are the Ix for Goodpasture's syndrome?
1. Renal function test 2. Renal biopsy 3. Anti-GBM antibody titre 4. ANCA
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What is the Rx for Goodpasture's syndrome?
1. Cyclophosphamide 2. Prednisone 3. Plasmapheresis
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What is the pathophysiology of Wegener's granulomatosis?
Inflammation in blood vessels, especially in respiratory tract and kidneys
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What are the symptoms of Wegener's granulomatosis?
1. Pus drainage with crusts from nose 2. Cough with bloody phlegm 3. SOB 4. Fever 5. Fatigue
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What is the Ix for Wegener's granulomatosis?
1. High CRP 2. Anti-neutrophil cytoplasmic antibodies 3. CXR 4. Biopsy
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What is the Rx for Wegener's granulomatosis?
1. Prednisone 2. Cyclophosphamide 3. Rituximab 4. Plasmapheresis

Phase 2a Medicine (15 decks)

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