Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

MBBS - Year 2 > Respiratory - Lung Infections > Flashcards

Respiratory - Lung Infections Flashcards

(224 cards)

Start Studying
1
Q

Specifics for resp hx

A 
Age 
Gender 
Occupation 
Smoking hx 
Asbestos exposure 
Pets/ birds at home
Hx of childhood resp illness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Classification of resp diseases

A 
Airways diseases 
Lung parenchymal diseases 
Pleural diseases 
Pulmonary vascular diseases 
Lung infections 
Lung cancer 
Thoracic oncology
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Examples of airway diseases

A

Asthma

Allergic rhinitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Examples of lung parenchymal diseases

A

Emphysema

ILD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What’s included in the conducting airways

A

Trachea
Bronchi
Bronchioles
Terminal bronchioles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What included in the acinar airways

A

Transitional bronchioles
Alveolar ducts
Alveolar sacs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does the control of respiration involve

A

Higher brain centres, chemoreceptors and other reflexes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Common symptoms to look out for

A

Breathlessness
Cough
Chest pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

General inspection for resp

A 
Pallor 
Jaundice 
Clubbing 
Cyanosis 
Oedema 
Lymphadenopathy 
Pulse and RR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Common resp ix

A 
Pulse oximetry 
Lung physiology - LFTs/ PFTs 
Gas exchange analysis - ABG 
Radiological modalities - CXR, CT 
Bronchoscopy 
Pleural procedures 
Blood test, sputum test
Urine antigens
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Lung defence mechanisms

A

Muco-cillairy apparatus
Alveolar macrophages
Cytotoxic T cells and NK cells: intracellular pathogens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Epidemiology of CF

A

Most common inherited lethal disease

1 in 2500 babies born have CF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Inheritance of CF

A

Autosomal recessive inheritance on long arm of chromosome 7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What genes is affected in CF

A

CFTR gene contains code to create CFTR chloride channel
LOF mutation causes increased Na and Cl in sweat and increased reabsorption of water from resp system –> viscous mucus and dehydration of epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Clinical features of CF

A 
C/c sinusitis 
Abnormal sweat [Na] and [Cl]
Bronchiectasis 
Liver disease 
Constipation 
Male infertility - loss of vas deferens
Finger clubbing 
Pancreatic insufficiency, pancreatitis, DM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

The Sweat test

A

Pads soaked in pilocarpine are placed on skin to stimulate sweat
Sweat is collected then amount of chloride is measure - should be high to get a +ve result

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Dx and ix for CF

A 
Clinical assessment and examination 
Oxygen saturations
Resp secretions samples 
LFT - FEV1, FVC, FEF
Infant screening test - trypsinogen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Aims of CF treatment

A

Prevent or delay serious lung problems

Maintain lung function and clinical stability for long periods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Symptoms associasted w. exacerbation of pulmonary infection

A

Increased frequency and duration of cough
Increased sputum production
Increased SOB
Decreased exercise tolerance
Decreased appetite
Feeling of increased congestion in the chest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Signs associated w/ exacerbation of pulmonary infection

A 
Increased RR 
Use of accessory muscles for breathing 
Fever and leukocytosis
Wt loss 
New infiltrate on CXR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Prophylactic abx given for Staph A

A

Fluclox

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Treatment of Staph A infections

A

Fluclox

Co-amoxiclav

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Mx of Psuedomonas A

A

Needs combo of nebuliser and systemic abx
Nebulised - 3/12 of nebuliser Colistin OR 1/12 of individual abx
PLUS
Systemic: 3/52 of po Ciprofloxacin (or 3/52 of iV ceftazidime/ Tobramycin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Treating a/c infections of Aspergillus

A

Antifungals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Treatment of ABPA
Steroids and antifungals
26
ABPA
Allergic Bronchopulmonary Aspergillosis
27
When would we give mucolytics and hydrators
Impaired muco-cilairy clearance Decreased airway surface liquid volume Secretions that are difficult to expectorate
28
Mucus degrading agent used in CF
Dornase alfa | Long-term maintenance therapy is required
29
Practical issues of dornase alfa
Given via nebuliser Expensive - hosp prescription Given at least 30 mins - 1hr before PT
30
What does hypertonic saline do
Expectorant Increases thickness of ASL Promotes coughing
31
ASL
Airway Surface Layer
32
Order of inhaled medicines
Bronchodilator Mucolytics Airways clearance Inhaled abx
33
How is pancreatic insufficiency assessed in CF pts
Clinically | By stool elastase
34
Dietary mx of CF pts
Start on lifelong PERT Regular growth monitoring Fat soluble Vit supplementation - A, D, E, K Higher caloric needs
35
Ionising ix of lung
CXR CT Nuclear med Conventional angiography
36
Non-ionising ix of lung
MRI | Ultrasound
37
VQ scan
Ventilation/ perfusion scan Inhaling radioactive material to examine airflow and blood flow in lungs Usually looking for PE
38
When are pts most likely to have a PET scan
When they are candidates for surgery - to complete staging
39
Use of MRI in resp med
Charcterising mediastinal masses Paravertebral masses (neurogenic tumours) Monitoring of thoracic aneurysms
40
Use of ultrasound in resp med
Detects pleural abnormalities | Probe can be placed in IC space
41
What types of imaging are used in image-guided biopsy or drainage
Ultrasound | CT
42
Collapse (atelectasis)
Reduction of volume in various parts of lung | Obstruction or compression
43
AP vs PA CXRs
Cannot see scapula in PA view | Postero-anterior is preferred over antero-posterior
44
Silhouettes of CXR
Image margins or areas of contrast where structures that are bordering have a clear delineation
45
Is loss of silhouette shadowing on CXR normal
No
46
Normal silhouette on CXR
Lung, heart and hemipericardium border
47
Silhouette sign on CXR
Increased shadowing of interface of lung and heart border
48
What does the silhouette sign on a CXR indicate
Abnormalily - loss of normal silhouette
49
Clinical definitions of consolidation
Dull to percussion Reduced breath sounds Bronchial breathing
50
Histopathological definition of consolidation
Filling of the alveolar spaces w/ pus, water, blood, tumour or protein
51
Air space opacity on CXR
Abnormal density in areas that should normally be aerated in X-ray contrast
52
Air bronchogram
Part of lung is consolidated - alveoli filled w/ fluid but larger airways are patent
53
Radiological definition of consolidation
Presence of air bronchogram
54
Types of loss of lung volume
Lung Lobar Segmental Subsegmental
55
Diagnosing loss of volume of X-ray
``` Mediastinal shift - main factor Tracheal deviation Elevation of diaphragm Displaced hilum Rib crowding ```
56
Hilar point on CXR
Angle between lower lobe & pulmonary artery and upper lobe & pulmonary vein
57
Other patterns of consolidation
``` Diffuse Multifocal Perihilar - Bat's wing Bibasal Peripheral ```
58
Contusion
An injury to the lung parenchyma (bruised) leading to haemorrhage and oedema
59
What is pneumonia caused by
Invasion and overgrowth of pathogens in lung parenchyma
60
Symptoms of pneumonia
``` Dyspnoea - harsh breathing sounds Fever Rigours Shaking chills Dry/ productive cough Chest pain Malaise ```
61
Pathophysiology of pneumonia
Infection to the lung initiates an infl response Causing alveolar oedema + exudate formation Alveoli & resp bronchioles fill w/ serous exudate, blood cells, fibrin bacteria Consolidation of lung tissues
62
Pathogen factors affecting infection
Virulence factors
63
Host factors affecting infection
Innate immunity - physical-mechanical, complement Phagocytes - macrophages, neutrophils Cellular immunity - B cells, T cells Cytokine, chemokine
64
Environmental factors affecting infection
``` Travel, occupation Medical devices (ventilators) ```
65
Pneumonia classification
Community (CAP) Hosp (HAP) Immune compromised
66
Age group affected in CAP
All ages
67
Classic infection seen in CAP
Bacterial or viral
68
When does HAP occur
2-3 days after admission
69
Who gets immuno-compromised pneumonia
HIV pts Transplant pts Cancer pts 1' immunodeficiency pts
70
CAP epidemiology
6th leading cause of death in world Leading cause of death due to infectious diseases Highest incidence <5yrs and >65yrs - incidence increases w/ age and in winter
71
Resp tract bacterial pathogens
Strep pyogenes Strep pneumonia H. influenza
72
Bacterial/ viral pathogens causing CAP
Strep pneumonia and H. influenza cause 85% of cases Moraxella catarrhalis Influenza - Staph A Resp viruses
73
Atypical bacteria causing CAP
``` Chlamydia psittaci Coxiella birmetoo - Q fever Mycoplasma pneumonia Legionnaire's disease Mycobacterium TB ```
74
DDx signs of pneumonia
Sputum Halitosis General appearance Haemoptysis
75
Most common symptoms of bacterial pneumonia
Productive cough
76
How can colour of sputum help suggest pathogen
Rust (S. Pneumoniae) Green (Pseudomonas) Redcurrant (Klebsiella) Bad-smelling (anaerobes)
77
What is a sudden onset on pneumonia symptoms associated with
Bacterial infection
78
What is slow onset of URTI and wheezing associated w/ in pneumonia
Viral infection
79
Who gets pneumococcal pneumonia
V young and v elderly People w/ asplenia or functional asplenia People w/ other cases of impaired immunity and certain c/c condns
80
What is lobular pneumonia likely to progress to in pneumococcal pneumonia
Empyema or pleural effusion if treated insufficiently
81
Empyema
Collection of pus in pleura
82
How many serotypes are there of pneumococcal pneumonia
90
83
Vaccines against pneumococcal pneumonia
13-valent pneumococcal conjugate vaccine - intro childhood immunisation in 2010 23-valent pneumococcal polysaccharide vaccine
84
What months do pneumococcal pneumonia peaks in
Dec and Jan
85
CURB-65
Tool used to determine whether pts w/ pneumonia should be admitted or not ``` Confusion Urea >7mmol/l RR > 30 BP < 90/60 mmHg Age > 65 ```
86
CURB-65 score of 0-1
Low severity <3% mortality Treatment at home if 0 or hosp If 1
87
Ix for CAP
CXR Sputum culture - viral throat swabs Hospitilisation Resp virus PCR and further bloods - CRP/ESR, serology
88
When do abx need to be started for CAP
Within 4 hrs of admission
89
Treatment for moderate/severe CAP
``` Empirical therapy (dual) - penicillin (amoxicillin, tazobactam) and macrolide (clarithromycin) Antivirals --> oseltamovir for 7/7 (but within 3/7 - 5/7 of start of symptoms) ```
90
Smoking and CAP
Associated w/ 2x fold increase
91
Epidemiology of HAP
4th most common HAI | Prevalence 14.1%
92
Risk factors for HAP
``` Abx Surgery C/c lung disease Advanced age Immunosuppression Tracheal intubation Mechanical ventilation ```
93
Types of HAP
Ventilator associated pneumonia Aspiration pneumonia Environmental source Hosital transmission
94
Causative organisms of ventilator associated HAP
``` Pseud aeruginosa Haemophilia Staph A - MRSA E. coli, Kleb pneumoniae, Enterobacter Strep Fungi (Candida spp Aspergillus) ```
95
Causative organism of aspiration HAP
Gram -ve organisms Anaerobes Strep pneumonia
96
Initial stages of aspiration HAP
Pneumonitis then further infection by pathogens ensue | Makes course long and characteristic
97
Examples of humoral immune dysfunction
Complement deficient | Ig deficient
98
Examples of cellular immune dysfunction
Neutropenia (e.g. chemo) | Lymphopenia (e.g. HIV transplant)
99
How does low CD4 T cell count increase chances of catching pneumonia
Reactivation of dormant virus (CMV, HSV, etc) Reactivation of dormant bacteria e.g. TB Susceptible to intracellular bacteria (TB, atypical mycobacteria) Susceptible to fungi
100
How does poor phagocyte function in HIV increase risk of pneumonia
Susceptible pneumococcus
101
CXR in HIV pneumonia
Ground glass showing
102
Treatment of HIV pneumonia
Trimethoprim - sulfanethoxazole
103
CXR in CMV pneumonitis
Ground glass shadows
104
Treatment of CMV pneumonitis
Ganciclovir
105
CXR in TB
UL consolidation | Nodular
106
Symptoms of TB
``` Productive cough Fever Night sweats Wt loss Erythema nodusum ```
107
Treatment of TB
Isoniazid/ Rifampicin/ Pyrazinamide/ Ethambutol for 2/12 then I & R for further 4/12 TB drugs are hepatotoxic for measure LFTs
108
Atypical mycobacterium
M avid - intracellular complex
109
Cause of pneumonia in neutropenic pts
``` Chemo Leukaemia Bone marrow transplant Steroids DM ```
110
CXR in invasive aspergillosis
Consolidation
111
Treatment for invasive aspergillosis
Amphotericin B or caspofungin
112
Types of samples
``` Swabs Secretions Invasive samples Blood Urine ```
113
Where do we take a swab sample from
Ear Throat Pemasal
114
Types of secretion samples
NPA | Sputum
115
Types of invasive samples
Aspirates Washings Biopsies
116
Urine sampling for resp pathogens
Antigen detection - Legionella, pneumococcus
117
Sputum collection for TB culture
Sputum specimenn are essential to confirm dx Should be from lung secretions Collect 3 specimen on 3 diff days
118
What type of sputum is best for TB culture
Spontaneous morning sputum vs induced specimens
119
Staining mycobacteria
Ziel-Nielsen stain Auramin stain AFB
120
Serology (blood) for resp pathogens
Antibody titre | Ag detection
121
Primary prevention of infection
Prevent or reduce exposure | Immunisation (pnumococus, influenza)
122
Secondary prevention of TB
Chemoprophylaxis | Contact tracing
123
Tertiary prevention of infection
Minimise disability arising from infection Effective treatment PT
124
What does the URT incl
``` Anterior snares Nasal passages Paranasal sinuses Nasopharynx Oropharynx Portion of larynx ABOVE vocal cords ```
125
What does the LRT incl
``` Portion of larynx beneath viral cords Trachea Bronchi Bronchioli Alveoli ```
126
Lab techniques used to identify bacteria
Microscopy - gram stain, immunofluorescence Bacterial culture or DNA/ PCR sequencing Antigen detection - EIA/ ELISA Antibody deduction
127
Treatment of Strep pneumonia
Penicillin | Macrolides
128
Does Strep pneumonia affect URT or LRT
LRT
129
Bacterial causes of bacterial throat infection
Gp A Strep (also Gp C & G) | C. diphtheria
130
When is Strep pneumonia vaccinated against in children
Pneumococcal vaccine at 2, 4, 12/12
131
Who do bacterial sore throats primarily affect
School-age children
132
Less serious complications of Gp A Strep infections caused by Strep progenies
Quinsy Otitis media/ sinusitis Mastoiditis
133
Systemic complications of Gp A Strep infections caused by Strep pyogenes
Scarlet fever
134
Immune mediated complications of Gp A Strep infections caused by Strep pyogenes
Rheumatic fever Glomerulonephritis Rheumatic heart disease
135
What does Coryne diphtheriae cause
Toxins that destroy epithelium coating resp system
136
Is C diphtheriae Grame -ve or +ve
Gram +ve bacilli
137
Complications of C. diphtheriae
Resp obstruction - fatal Toxic myocardiopathy Toxic neuropathy
138
Treatment of C. diphtheriae
Antitoxin | Erythromycin
139
Prevention of C. diphtheriae infections
Immunisation - DTaP/ IPV/ Hib at 2/3 and 4/12 | Close contacts - 7/7 erythromycin
140
Is H influenzae Gram -ve or +ve
Gram -ve coccobacilli
141
Treatment for H. influenza infections
Amoxi Co-amoxiclav Doxy
142
Pertussis (whooping cough)
Known for uncontrollable, violent coughing which often makes it hard to breathe Results in 'whooping' sound ad can be v serious
143
Bacterium causing pertussis
Bordetella pertussis
144
What does horizontal transmission incl
``` Direct contact Inidrect contact Droplet Airborne Vector borne ```
145
Typical presentation of H. influenza infection
66 M w/ hx of COPD and recurrent LRTIs
146
Typical presentation of pneumocystis jiroveci
47 F w/ known HIV presents w/ fever and B/L infiltrates in lungs
147
Typical px of M tuberculosis
37 M Latvian origin prensts w/ R upper lobe cavity Flu like symptoms Erytheme multiforme
148
Typical presentation of RSV
2 F productive cough and wheeze
149
Typical px of Strep pneumonia
48 M w/ CAP | Most common cause of CAP
150
Typical px of Pseudomonas
27 M w/ CF and productive cough
151
What do tetracyclines target
30S subunit
152
What does penicillin target
Cell wall synthesis
153
What does Rifampicin target
RNA polymerase
154
What does Quinolone (Ciprofloxacin) target
DNA gyrase
155
What does trimethoprim target
Folate synthesis
156
What do macrolide target
50S subunit
157
How can bacteria become resistant to abx
Either intrinsically resistant due to inherent structural characteristics or acquired through horizontal and vertical transmission
158
Why do Gram -ve bacteria have intrinsic resistance
Due to reduced permeability of cell wall
159
Most common URTI
Common cold - self limiting illness
160
Causative viruses of the common cold
``` Rhinoviruses (30-40%) Adenovirus (5-10%) Coronaviruses (10-15%) Influenzavirus (25-30%) Parainfluenzavirus (5%) ```
161
Bronchiectasis
Irreversibly damaged bronchi - dilated and thickens | Usually colonised w/ bacteria --> pus formation and mucus hypersecretion
162
Examples of obstructive airways disease
``` COPD (c/cbronchitis, emphysema) Asthma Bronchiectasis CF Bronchiolitis ```
163
What do obstructive airway diseases affect
Your ability to exhale all the air in the lungs
164
What does mucus consist of
Musins (5%) and water (95%) | This contributes to 10x expansion
165
What does mucus production respond to
Stimuli
166
Approach to mx of bronchiectasis pts
``` Consider it as possible dx Confirm dx - HRCT Think about underlying cause Assessments - sputum microbiology Structure a mx plan - airway clearance and abx? ```
167
When should bronchiectasis be considered in adults
``` Younger pts Long hx of symptoms No smoking hx Large volumes of purulent sputum Haemoptysis ```
168
When should bronchiectasis be considered in children
``` C/c productive cough Asthma not responding to treatment Episode of severe pneumonia or recurrent pneumonia Localised c/c bronchial obstruction Unexplained haemoptysis ```
169
HRCT in bronchiectasis
Signet ring sign - white circle (blood vessel) smaller than black circle (dilated airways) Tram line appearnce
170
Clinical features of bronchiectasis
Regular, daily sputum production over long period that is mucoid or purulent in colour Cough Social embarrassment related to symptoms
171
Symptoms seen in a/c exacerbations of bronchiectasis
Increasing sputum volume Worsening sputum colour Haemoptysis Malaise/ tiredness
172
Examination findings of bronchiectasis
Crackles over affected area
173
Causes of bronchiectasis
``` Resp infections Direct damage - foreign body inhalation, GORD Mucocililary disorders Allergic/ infl Immune effects CTD - rhA, SScl ```
174
Mucocilliary disorders causing bronchiectasis
Cilliary dyskinesia | CF
175
Allergic/ infl cause of bronchiectasis
ABPA
176
Resp infections leading to bronchiectasis
Bacterial pneumonia Mycoplasma pneumonia Mycobacterium Viral
177
Bacterial pneumonia infections causing bronchiectasis
Bordetella pertussis Staph A H influenza Klebsiella
178
Viral infections casing bronchiectasis
Measles Adenoviruses Influenza
179
Ciliary defects as a cause of bronchiectasis
Primary ciliary dyskniesia (1 in 30,000) No real mx Seen in Kartagener's syndrome
180
Kartagener's syndrome
Inherited disorder of ciliary function V rare - 1 in 60,000 Triad of features - bronchiectasis, sinusitis, situs invertus
181
Who is ABPA most likely to occur in
Asthmatics | CF pts
182
What does ABPA cause
Intense bronchial infl | IgE and IgG antibodies to aspergillus
183
Secondary immune defects causing bronchiectasis
Lymphoid malignancy | HIV/ AIDS
184
Primary immune defects causing bronchiectasis
Hypogammaglobulinaemia (early childhood onset) | Common variable immunodeficiency (late childhood/ adult onset)
185
Humoral immune defects and bronchiectasis
Disorder of antibody production | Low incidence but immune defects important to excl as treatable w/ IV Ig replacements
186
Common presentation of primary humeral defects
Sepsis (lungs and sinuses)
187
Ix for bronchiectasis
``` Bloods Specialist tests Sputum culture - repeated and regular Radiology Lung function ```
188
Blood for bronchiectasis
Ig IgG and Aspergillus-spp IgE/ IgG RhF and ANA
189
Specialist tests for CF
CF sweat tests/ genetics | Immunology tests
190
Imaging for bronchiectasis
CXR | HRCT - tram line, signet sign
191
Testing lung function for bronchiectasis
Spirometry - obstructive pattern
192
What pathogens can amoxicillin treat in bronchiectasis
Strep pneumonia | H. Influenza
193
What pathogens can macrolide treat in bronchiectasis
Strep pneumonia (M. Catarrhalis) (H. influenza)
194
What pathogens can co-amoxiclav treat in bronchiectasis
Strep pneumonia M. Catarrhalis H. Influenza Pseud. aeruginosa
195
What pathogens can ciprofloxacin treat in bronchiectasis
Strep pneumonia M. Catarrhalis H. Influenza Pseud. aeruginosa
196
What pathogens can ceftazidime (IV) treat in bronchiectasis
Pseud. aeruginosa
197
Mx of bronchiectasis
Treat underlying disorders e.g. steroids (ABPA), Ig replacement PT Abx Prophylaxis - po, nebuliser
198
PT's role in treating bronchiectasis
Regular BD airway clearance techniques – active cycle, forced expiratory, postural drainage
199
Treatment of a/c exacerbations of bronchiectasis
Amoxicillin - po Ciprofloxacin - IV 10 - 14 days at home or in hosp
200
Common symptoms seen in lung infections
``` Cough Wheezing Sneezing Facial pain - sinusitis Chest pain Breathless/ SOB Fever Haemoptysis and other red flag symptoms ```
201
Main ddx for chest pain
``` PE Pneumonia Pleurisy PTX MI Aortic dissection ```
202
PTX
Pneumothorax
203
Pleurisy
Infl of pleura (lining of lungs)
204
Main ddx of SOB
HF | Anaemia
205
Ddx of c/c cough
``` Lung cancer CF COPD ACEi GORD Bronchiectasis C/c rhino sinusitis (PND syndrome) ```
206
PND syndorme
Post -nasal drip syndrome
207
Features of Horners syndrome
Ptosis Miosis Enophthalmos
208
Why do we assess for tremors in resp exam
Associated w/ (over)use of beta 2 agonist
209
What causes asterixis (flapping tremor)
CO2 retention in conditions that result in type 2 resp failure e.g. COPD
210
When does Horner's syndrome develop
The sympathetic trunk is damaged by lung cancer affecting apex of lung (Pancoasts tumour)
211
Why do we look for oral candidiasis in resp exam
Associated w/ steroid inhaler use (local immunosuppression)
212
Resp causes of displaced apex beat
RV hypertrophy (pulmonary HTN, COPD, ILD) Large pleural effiusion Tension PTX
213
Causes of symmetrical reduced chest expansion
Pulmonary fibrosis (reduced lung elasticity)
214
Causes of asymmetrical reduced chest expansion
PTX Pneumonia Pleural effusion
215
What does increased vocal resonance suggest
Increased tissue density e.g. consolidation, tumour, lobar collapse
216
What does decreased vocal resonance suggest
Presence of fluid or air outside lung e.g. pleural effusion, PTX
217
Special features of empyema
Failure to recover fully w/ abx | Characteristic 'swinging' fever
218
Risk factors for empyema
Trauma Pneumonia Immunocompromised status
219
Treatment of empyema
Urgent drainage | IV abx
220
Ddx of hameoptysis
``` PE Pneumonia TB Aspergilloma Bronchiectasis Lung cancer Granulomatous w/ polyangitiis ```
221
Sepsis 6
Take lactate, blood cultures, measure urine output | Give fluids, IV abx and oxygen
222
Side effects of isoniazid
``` Peripheral neuropathy (give pyridoxine) Liver toxicity ```
223
Side effects of rifampicin
Liver toxicity | Turns bodily fluids red/ orange colour
224
Side effects of ethambutol
``` Visual disturbances (colour disturbances, loss of acuity) Avoid in CKD ```

MBBS - Year 2 (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions