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Flashcards in Respiratory Medicine Deck (59):
1

Name some respiratory procedures that need endocarditis prophylaxis

Rigid bronchoscopy Mucosal surgeries Tonsillectomy Adenoidectomy

2

How does silica predispose to TB

Silica is toxic to the macrophages

3

The most important finding to confirm the diagnosis of asthma is

Demonstration of airway reversibility

4

Which drug abolishes the symptoms of exercise induced asthma

Leukotrience receptor antagonist

5

A patient with Rheumatoid arthritis presents with a relentless and progressive fall in FeV1. What is the most likely cause

Bronchiolitis Obliterans 

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6

List five lung manifestations in Rheumatoid Arthritis

1. Organising pneumonia

 

2. Fibrosis

 

3. COPD

 

4. Bronchiolitis obliterns 

 

5. Caplans Syndrome

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7

Which patient has the highest risk of developing lymphoma of the lung

Primary Sjögren's syndrome 

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8

What is the genotype of the alpha 1 antitrypsin deficiency which has the worst prognosis

PiZZ

9

List four important causes of eosinophilia

1. Infections

 

2. Drugs

 

3. Atopy

 

4. ABPA

 

5. Church Strauss

10

Name the four important infections that cause significant eosinophilia

1. Microfilaria...Tropical pulmonary eosinophilia

 

2. Ascaris lumbricoides....Loefflers syndrome

 

3. Toxocara canis...visceral lava migrans

 

4. Schistosomiasis species

11

Mounier Kuhn disease

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Tracheo bronchiomegally. Inherited structural abnormality of trachea presenting in adult life as COPD. Trachea dilated from the larynx to 2 to 3 generation airway

12

Yellow nail Syndrome 

1. Yellow non growing curved nails

 

2. Pherepheral edema

 

3. Pleural effusion and bronchiectasis

 

4. Chronic sinusitis

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13

What are the GI complications of Cystic Fibrosis

1. Cirrhosis 

 

2. Pancreatic insufficiency.

 

3. GI malignancies 

 

4. Meconium ileus equivalent

14

A patient being treated for community acquired pneumonia develops a fall in hemoglobin with MCV 102 fl. what is the likely cause

mycoplasma pneumonia

15

List four causes for haemolytic secondary to cold agglutinins

1. Mycoplasma

 

2. Infectious mononucleosis.

 

3. Large cell lymphoma.

 

4. Waldenstorms macroglobulinemia

16

Frequent epistaxis and chronic sinusitis is commonly seen in

Wageners  granulomatosis

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17

What history should usually be there to diagnose Churgh Strauss syndrome 

Asthma

18

Name two large vessel vasculitis

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1. Giant cell arteritis

 

2. Takayasus arteritis

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19

Name two medium vessel vasculitis

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1. Polyarteritis Nodosa

 

2. Kawasakis

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20

Name four vasculitis that affect the lung

1. Takayasus

 

2. Wageners

 

3. Churg Strauss

 

4. Microscopic polyangiitis

21

22

Cause of life threathening hemoptysis in HIV patients

Kaposis Sarcoma

23

What is the role of steroids in PCP pneumonia

Steroids decrease the risk of respiratory failure by 50 % and death by 30 %

24

A non smoker being investigated for acromegally.

Normal Brain MRI

CXR shows a centrally based mass

 

the likely lung tumour is

Carcinoid

25

Paraneoplastic syndrome in lung carcinomas

1. Cerebellum syndromes

 

2. Easton Lambert syndrome

 

3. Hypertrophic pulmonary osteoarthropathy.

 

4. Hypercalcemia.

 

5. Hyponatremia (SIADH)

26

Hypertrophic pulmonary osteoarthropathy is not seen in which lung cancer

Small cell lung carcinoma

27

Alpha one antitrypsin deficiency causes emphysema in which part of the lung

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Lower zone

28

29

What is emphysema

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Permanent enlargement of the airways distal to the terminal bronchiole

30

Name a few types of emphysema 

1.Centriacinar

 

2. Paraseptal

 

3. Panacinar

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31

What is a bulla

Large emphysematous space more than 1 cm in diameter

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32

What is One Smoking Pack Year

20 cigarettes per day for one year

33

Causes of COPD other than smoking

Alpha one anti trypsin deficiency 

occupational

 

environmental

genetic polymorphism

34

Name the genotype that has very low levels of alpha antitrypsin 

PiZZ

35

What is alpha one anti trypsin deficiency 

protease inhibitor

36

At what age do patients with alpha one antitrypsin deficiency present

3 to 4 decade

37

How is COPD confirmed

FEV1 < 80% after dronchodilatation

FEV1/FVC < 75%

38

What criteria is used to grade COPD severity

GOLD

global initiative for obstructive lung disease

39

What is LTOT in COPD

Long term oxygen therapy

40

How is oxygen administered in LTOT

2 to 4 litres for at least 15 hours

41

Two indications for LTOT

1. Po2 < 55 mmHg on room air

 

2. FeV1 < 1.5 L

42

LIGHTS criteria

1. Pleural LDH/serum LDH > .6

 

2. Pleural protein/seem prote> 0.5

 

3. Pearl fluid LDH  > 2/3 of upper of normal

43

What is the firsts in interpreting a PFT

Fev1/FVC ratio

44

How will you interpret a FEV1/FVC ratio

FeV1/FVC ratio < 80...... obstructive

> 80%......restrictive

45

If there is a restrictive lung disease on the FEV1/FVC ratio what is the next step

Look athe diffusion in capacity DLCO

46

In a restrictivlung disease if the diffusion capacity is reduced what  are the possibilities 

Interstitial lung disease

47

In a restrictive lung disease if the diffusion capacity is normal what are the differentials

Extrinsic causes

 

Obesity

 

Chest wall deformit

 

diaphragmatic weakness

48

Name one disease one should suspect in a massive pleural effusion

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Histoplasmosis 

49

Name two drugs that can cause eosinophilic pneumonia 

Nitrofurantoin 

Sulphonamides

50

Which segment of the lung is more prone for aspiration pneumonia

Superior segment of the right lower lobe

Posterior segment of right upper lobe

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51

Which organism in the lung can cause a necrotising process

Anaerobic organisms

52

Can pneumococci cause cavitation in the lung

Can but is unusual 

53

What are the pleural fluid markers for tuberculosis 

Adenosine deaminase

PCR for TB

54

Rheumatoid effusions are best characterised by

Very low glucose levels

55

In COPD contionous low flow oxygen becomes beneficial when

When the PaO2 falls below

55 mmHg

56

What is the role of oral corticosteroids in COPD

Failed inhaled bronchodilator therapy

57

when the diagnosis of primary pulmonary hypertension is done 

 

What is the next step

Acute drug testing with PULMONARY VASODILATORS

  • Inhaled NO
  • IV adenosine
  • IV prostacyclins

58

In Primary Pulmonary HTN who respond to short acting vasodilators 

what is the next step

use long acting calcium channel blockers

59

Hypercapnoea out of propotion to lung disease.

Suspect ?

OSA