respiratory buzzword sheet

Question 1

stony, dull to percuss

Answer 1

pleural effusion

Question 2

right sided pleuritic chest pain

Answer 2

most likely pneumonia

Question 3

Alveolar bats wings, kerley B lines, Cardiomegaly, Dilated prominent upper lobe vessels, pleural Effusion

Answer 3

pulmonary oedema

Question 4

Ground- glass appearence X-ray

Answer 4

pulmonary fibrosis, respiratory distress syndrome of the newborn

Question 5

Ziehl- Neelsen stain positive for acid fast bacilli

Answer 5

TB

Question 6

Caseous necrosis

Answer 6

TB

Question 7

Miliary TB

Answer 7

spread of an organism into blood stream. If pulmonary artery- miliary dissemination into lung. If pulmonary vein- systemic dissemination into kidney, liver, spleen

Question 8

positive antiglomerular basement membrane antibodies

Answer 8

Goodpasture’s syndrome

Question 9

Chest infection with parrot/pidgeon as pet

Answer 9

chlamydophila psittaci is cause

Question 10

dry cough and diarrhoea after holiday abroad. Some indication of water spread

Answer 10

legionella pneumophila (test urine for antigens) - hyponatreamia

Question 11

Tall thin induldges in marijuana- snoop dog.

Answer 11

probably pneumothorax (Marfan’s increases chance of pneumothorax)

Question 12

Bilateral hilar lymphphadenopathy, erythema nodosum, granulomas, fatigue, uveitis, weight loss

Answer 12

sarcoidosis

Question 13

bronchiole wider than neighbouring arteriole (on CT) (signet rign sign)

Answer 13

bronchiectasis

Question 14

D sign on X ray

Answer 14

empyema

Question 15

Steeple sign on X-ray

Answer 15

laryngotracheobronchitis/croup

Question 16

child with barking cough

Answer 16

croup

Question 17

pneumocystis pneumonia

Answer 17

HIV (treat with Co-trimoxazole plus prednisolone (if severe) SS

Question 18

Asthma + nasal polyps + salicylate sensitivity

Answer 18

Samter’s triad (aspirin induced asthma)

Question 19

Alcoholic (aspiration pneumonia)

Answer 19

klebsiella pneumonia

Question 20

red jelly sputum

Answer 20

klebsiella pneumonia

Question 21

mucoid sputum

Answer 21

chlamydia psittaci

Question 22

Rusty sputum

Answer 22

pneumococcal pneumonia (strep)

Question 23

cannonball metastases (weight loss and haematuria)

Answer 23

classically from primary renal cell carcinoma

Question 24

Morning headache

Answer 24

Hypercapnia or side effects of organic nitrates

Question 25

ACTH secreting lung tumour

Answer 25

small cell carcinoma of the lung

Question 26

PTH secreting tumour

Answer 26

squamous cell carcinoma of the lung

Question 27

small cell carcinoma

Answer 27

neuroendocrine, highly malignant and may be associated with ectopic endocrine syndromes.

Question 28

Increased serum ACE and Ca2+

Answer 28

sarcoid

Question 29

Eggshell calcification at hilar region

Answer 29

silicosis

Question 30

'Heart failure cells' seen in alveolar spaces

Answer 30

macrophages that have absorbed haemosiderin - found in chronic pulmonary oedema, and associated with severe LV heart failure. Also seen in long-standing pulmonary hypertension

Question 31

Ghon Focus

Answer 31

An area of infection and caseous necrosis at the periphery of the lung. beneath the pleura - found in TB infection. Ghon focus rupture (rare) through visceral pleura into pleural cavity = TB pleurisy

Question 32

Assmann Focus

Answer 32

Apical lesion of secondary TB infection

Question 33

'Coin lesion' found on chest in radiographs

Answer 33

Rounded solitary lesion. The common lesions are: primary bronchial or lung carcinoma, metastatic rumour (esp. Of kidney) bronchial hamartoma, carcinoid tumour, granulomatous inflammation, lung abscess

Question 34

Horner's syndrome

Answer 34

Can occur when there is a local spread of cancer to the infra thoracic nodes or a pancoast's tumour. Signs include Ptoasis (drooping eyelid) enophlhalmos, miosis, and lack of sweating on same side of invasion of face. (Invasion of cervical sympathetic chain.

Question 35

Acute management of asthma

Answer 35

Oxygen 100% non rebreather Salbutamol nebuliser back to back Hydrocortisone IV or prednisolone Ipatropium bromide nebulised hourly Theophylline IV or aminophylline IV Magnesium and call an ANaesthatist

Question 36

Thumbprint sign on head x Ray

Answer 36

Epiglottis

Question 37

Inspiration whoop/barking cough

Answer 37

Pertussis

Question 38

Snow storm appearence on x-Ray

Answer 38

Baritosis, silicosis

Question 39

Management of infective exacerbation of COPD

Answer 39

I SOAP Ipatropium Salbutamol Oxygen Amoxicillin Prednisolone

Question 40

Non smoker and lung cancer

Answer 40

(Peripheral) adenocarcinoma

Question 41

Squamous and small cell lung cancers

Answer 41

CENTRAL

Question 42

High-d dimers

Answer 42

Suspect PE (CTPA or V/Q scan)

Question 43

Low d dimers

Answer 43

Exclude PE

Question 44

Large PE

Answer 44

Thrombolysis

Question 45

Small PE

Answer 45

Low molecular weight heparin

Question 46

Honeycomb lung

Answer 46

Fibrosing alveolitis