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Flashcards in Respiratory Medicine Deck (16):
1

What are the PERC criteria?

Pulmonary Embolus Rule-out Criteria
If patient has none of the between then low risk of PE

B - Blood in sputum
R - Room air sats 50
T - Thrombus (previous or DVT suspected ie leg swelling/pain)
H - HR >100
S - Surgery in last 4 weeks

2

What are the three commonest causes of cough with normal CXR?

Asthma (50%)
GORD (20%)
Sinusitis/Rhinitis with post-nasal drip (25%)

3

What are the normal values for ABGs?

PaO2 - 11-15kPa
PaCO2 - 4.5-6kPa
pH - 7.35-7.45
HCO3 - 22-30mmol/L

4

What are the causes of metabolic acidosis?

DKA
Renal failure
Lactic acidosis
- Type A = Lactic acidosis + tissue hypoxia
- Type B = Lactic acidosis - tissue hypoxia (toxicity)

5

What are the sputum and BAL findings in asthma?

Curschmann's spirals - Corkscrew mucus
Creola bodies - Surface epithelial cells
Charcot-Leyden crystals - Eosinophil cells and granule membrane
Eosinophils and mast cells

6

What is Goodpastures Syndrome?

Goodpasture disease is a term used to describe glomerulonephritis, with or without pulmonary hemorrhage, and the presence of circulating anti–glomerular basement membrane (anti-GBM) antibodies.

7

What is Light's criteria?

Pleural fluid is an exudate if one or more of the following criteria are met:
- Pleural fluid protein divided by serum protein >0.5
- Pleural fluid lactate dehydrogenase divided by serum LDH is >0.6
- Pleural fluid LDH >2/3 upper limits of lab normal values for serum LDH

8

What are the causes of transudative pleural effusion?

Common:
- Left ventricular failure
- Liver cirrhosis

Less common: Hypoalbuminaemia, peritoneal dialysis, hypothyroidism, nephrotic syndrome, mitral stenosis

Rare: Constrictive pericarditis, urinothorax, Meig's syndrome

9

What is Meig's syndrome?

Triad of benign ovarian tumours (usually a fibroma) with ascites and transudative pleural effusion, that resolves once the tumour is removed

10

What are the causes of exudative pleural effusions?

Common:
- Malignancy
- Parapneumonic effusions
- Tuberculosis
- Viral disease

Less common: PE, RA, benign asbestos effusion, pancreatitis, post-MI, post CABG

Rare: Yellow nail syndrome, drugs, fungal infections

11

What is Light's criteria?

Pleural fluid is an exudate if one or more of the following criteria are met:
- Pleural fluid protein divided by serum protein >0.5
- Pleural fluid lactate dehydrogenase divided by serum LDH is >0.6
- Pleural fluid LDH >2/3 upper limits of lab normal values for serum LDH

12

What are the causes of transudative pleural effusion?

Common:
- Left ventricular failure
- Liver cirrhosis

Less common: Hypoalbuminaemia, peritoneal dialysis, hypothyroidism, nephrotic syndrome, mitral stenosis

Rare: Constrictive pericarditis, urinothorax, Meig's syndrome

13

What is Meig's syndrome?

Triad of benign ovarian tumours (usually a fibroma) with ascites and transudative pleural effusion, that resolves once the tumour is removed

14

What are the causes of exudative pleural effusions?

Common:
- Malignancy
- Parapneumonic effusions
- Tuberculosis
- Viral disease

Less common: PE, RA, benign asbestos effusion, pancreatitis, post-MI, post CABG

Rare: Yellow nail syndrome, drugs, fungal infections

15

Which bacteria normally produce a lobar pneumonia?

Strep pneumonia

16

Which kind of bacteria normally result in a bronchopneumonia?

Staph A and pseudomonas A