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Respiratory JC > Week 3 > Flashcards

Week 3 Flashcards

1
Q

A 50 year old lifelong smoker presents with a persistent cough for 3 weeks with haemoptysis, and has noticed some weight loss. Diagnosis?

A

Lung cancer

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2
Q

Female 40 smoker presents with hoarse voice and stridor, and tiredness. Diagnosis?

A

Tumour in trachea compressing laryngeal nerve

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3
Q

What are some of the clinical findings of someone with lung cancer?

A 
Finger clubbing
Enlarged lymph glands
Dull percussion
Stridor
Dysponea
Thrombophlebitis (rare and red vein)
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4
Q

What is a pancoast tumour? Where does it effect?

A

Tumour of the pulmonary apex usually non-small cell cancers.

Can cause weakness and lack of control of the arm due to compression of brachial plexus

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5
Q

What are the common metastatic sites of lung cancer?

A

Liver, brain, bone, adrenal, skin

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6
Q

What are the four classifications of lung tumours?

A

Adenocarcinoma (glandular cancer)

Squamous carcinoma (keratin deposition)

Small cell carcinoma (worse type)

Large cell carcinoma (large cells no differntiation)

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7
Q

At what stage in development are the lungs made? What are they made from?

A

Week 5

Budded from oesophagus

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8
Q

When are the lung lobes and alveoli made during embryological development?

A

Week 6 for lobes

Week 8 for alveoli

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9
Q

What is the function of the conchae?

A

To cause turbulence of air allowing heating and moistening

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10
Q

What are the function of club cells in the bronchioles?

A

That detoxify and modulate immune and surfactant production

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11
Q

What is the function of type 2 alveolar cells? What is their cell description

A

To produce surfactant, they are polygonal shape with lamellar bodies that secrete surfactant

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12
Q

Women who is a non-smoker who presents with lung cancer. What is the most likely type she has?

A

Adenocarcinoma

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13
Q

During lung formation, what structure are they budded from? At what week?

A

Oesophagus week 5

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14
Q

At what week does the lung bud to make lobes and branches?

A

Week 6

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15
Q

What occurs in week 8 of embryological of lung development?

A

Alveoli

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16
Q

What is the treatment for small cell cancer?

A

Chemotherapy

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17
Q

What is the cell type in the oesophagus?

A

Squamous cell

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18
Q

What is the cell type in the stomach

A

Cuboidal

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19
Q

What is the difference between epidemic and pandemic?

A

Epidemic is due to antigenic drift (where the surface proteins slightly change) occuring in a set area

Pandemic is prevalent in a whole country or the world, occurring due to the complete changing of surface antigens

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20
Q

What is the treatment for small cell lung cancer?

A

Chemotherapy

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21
Q

What are the treatment options for non-small cell lung cancer?

A

Surgery, radiotherapy, chemo

22
Q

What are some of the side effects to cytotoxic chemotherapy?

A

Opportunistic infection, hair loss

23
Q

Women is suffering from stridor due to incurable lung cancer. What palliative care could you provide for this?

A

Stent to stop stridor

24
Q

What is a transudate?

A

If proteins within a pleural effusion are less than 30

Transudate Tiny

25
Q

What is an exudate?

A

When there are more than 30 proteins in a pleural effusion

26
Q

Man presents with breathlessness, fever, weight loss, and a cough. He used to work on a shipyard. Diagnosis?

A

Exposure to asbestos

So mesothelioma

27
Q

What are the treatment options for mesothelioma?

A

Radiotherapy
Chemotherapy
Surgery

28
Q

What score is used to determine survival rates in those with malignant pleural effusions?

A

LENT score

29
Q

Young man presents having fallen in the park, he has quiet breath sounds on auscultation, reduced chest expansion unilaterally, and has pain in the right side of his chest. Diagnosis?

A

Pneumothorax

30
Q

How would treat an emergency pneumothorax?

A

Insert a large bore cannulae in 2nd intercostal space of mid-clavicular line

31
Q

Where would you insert a chest drain for complete management of a pneumothorax?

A

4th intercostal space mid-axillary line

32
Q

What is the orientation of the intercostal muscles?

A

External; hands in pockets
Internal; hands on chest
Innermost; horizontal

33
Q

What is the function of the pectoralis major muscle for deep inspiration?

A

When arms in a fixed position it allows the elevation of the clavicle and expansion of the chest

34
Q

What nerve stimulates contraction forming guarding on the abdominal muscles?

A

Thoracoabdominal

35
Q

What are some of the causative organisms for community acquired pneumonia?

A

Pneumococcus
Haemophilus influenzae
Coliforms ( klebsiella, ecoli, enterobacter)

36
Q

Women presents with mild community acquired pneumonia. Traetment?

A

Amoxicillin for 5 days

37
Q

Women presents with severe community acquired pneumonia. Treatment?

A

Co-amoxiclav IV

Doxycycline

38
Q

What are some of the causative organisms for hospital acquired pneumonia?

A

Pneumococccus, haemophilus influenzae

More likely coliforms (ecoli, klebsiella, proteus, enterobacter)

39
Q

What do you use to treat non-severe hospital acquired pneumonia

A

Amoxicillin

Metronidazole

40
Q

What do youuse to treat severe hospital acquired pneumonia

A

Amoxicillin
Metronidazole
Gentamicin

All IV

41
Q

The stage of lung maturation that takes place between 6-16 weeks’ gestation. It involves the development of multiple branches of the bronchial tree down to the level of the terminal bronchioles.

A

Pseudoglandular

42
Q

The stage of lung maturation that takes place between 26 days’ and 6 weeks’ gestation. It involves the first stages of lung development, and sees the formation of the lungs’ lobes and segments.

A

Embryonic

43
Q

The germ layer that forms the cartilage and smooth muscle in the thorax.

A

Visceral mesoderm

44
Q

What does the vagus nerve innervate?

A

The soft palate and intrinsic laryngeal muscles

45
Q

What does stimulation of the glossopharyngeal and vagus nerve cause?

A

A cough reflex response

46
Q
  1. The stage of lung maturation that takes place between 16-28 weeks’ gestation. It sees the branching of terminal bronchioles into respiratory bronchioles and finally alveolar ducts.
A

Canalicular

47
Q

What germ layer forms the lining of the trachea and bronchial tree?

A

The endoderm

48
Q

What is the first respiratory structure to develop

A

Respiratory diverticulum

49
Q

What occurs during the pseudoglandular phase of lung developemnt

A

Bronchial branches are formed, occuring 6-16 weeks gestation

50
Q

What stage of lung development is surfactant beginning to be produced

A

Saccular stage 28-36 weeks

51
Q

What tumour produces keratin pearls and may produce thyroid transcription factor?

A

Squamous carcinoma

Respiratory JC (11 decks)

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