MSRA > Resp > Flashcards

Resp Flashcards

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1
Q

Mcc organism causing infective exacerbations in copd

A

Hemo influenza first
Strep pneumo
Moraxella catarrhalis

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2
Q

First line antibiotics for copd exacerbations

A

Amox or clari or doxy

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3
Q

Mcc virus in copd exacerbations

A

Rhinovirus

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4
Q

Mask in copd

A

28% venturi
88-92 unless normal pco2

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5
Q

Non invasive ventilation in copd settings

A

Bipap
Epap 4-5cmh2o ipap 10or12-15 cmh2o

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6
Q

CURB

A

Confusion urea>7 rr>30 sbp<90 or dbp<60

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7
Q

Crb65

A

0
1 or 2
3 or 4
Primary care
In CURB 0or1 low risk

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8
Q

Crp in pmeumonia

A

20 20-100 100
For antibiotics

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9
Q

Low severity cap mx

A

Amox
If allergic macrolide or tetracycline
5days

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10
Q

Mid or high severity cap mx

A

Amox + macrolide
7-10 days

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11
Q

Rr discharge criteria

A

If >24 + any ither factor, do not discharge

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12
Q

Rpt chest xray in pneumonia

A

6weeks

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13
Q

Treatment of oral candidiasis

A

Nystatin miconazole

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14
Q

Step 1 asthma mx

A

AIR (low dose ics/formeterol combo) symptom relief
Highly symptomatic low dose MART ( ics/formeterol) daily maintenance and reliever

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15
Q

Step 2 asthma

A

Low dose mart

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16
Q

Step 3 asthma

A

Moderate mart

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17
Q

Step 4 asthma

A

Check feno and blood esinophil count , if raised refer
If normal, trial of LTRA or LAMA
If no improvement, stop ltra or lama and start alternative

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18
Q

Saba as required only

A

AIR as needed

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19
Q

Saba as required + mod dose ics + ….

A

Mod dose MART

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20
Q

High dose ics

A

Refer

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21
Q

Small cell lung ca arises from

A

APUD FEYRTER CELSS

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22
Q

Cytology negative exudative effusions in mesothelioma

A

Local anaesthetic thoracoscopy

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23
Q

Asbestosis + smoking

A

Risk of bronchogenic ca > risk of mesothelioma

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24
Q

Most common malignancy associated with asbestosis

A

Bronchogenic ca

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25
Moet common form of asbestos related lung disease
Pleural plaques Benign
26
Lung function in asbestosis
Restrictive Related to length of exposure
27
Most dangerous form of asbestosis
Crocidolite
28
Inv of choice for ipf
Hrct
29
Serum ace levels
Sarcoidosis
30
Ipf aka
Cryptogenic fibrosing alveolitis
31
Pirfenidone
Antifibrotic agent used for ipf
32
Honeycombing + traction bronchiectasis
Ipf
33
ModerTe asthma attack
Pefr 50-75 Normal speech Rr<25 Pr<110
34
Severe acute asthma
Pefr33-50 Unable to complete sentences Rr>25 Pr>110
35
Life threatening asthma
Pefr<33 O2<92 NORMAL PCO2 SILENT CHEST CYANOSIS BRADY EXHAUSTION ETC
36
Near fatal asthma
Raised pco2 Mv with raised inflation pressures
37
Cxr in acute asthma
If Life threatening Suspected pneumo Failure to respond to treatment
38
Mg or aminophylline first
Mgso4
39
First line for acute sever asthma with life threatening features
Nebulised saba
40
Investigations in copd
POST BRONCHODILATOR spirometry fev1/fvc less than 70 Cxr Fbc Bmi
41
Stages copd
0.7 fev1, 80% 0.7 50-79% 0.7 30-49% 0.7 30%
42
First line for copd
Saba or sama
43
Asthmatic variation of copd
Prev history of atopy or asthma Esinophil 400ml variation in fev1 Diurnal variation 20%
44
No Steroid responsiveness/asthmatic copd
Saba /sama Laba +lama If already taking sama, switch to saba
45
Asthmatic/steroid responsiveness copd
Saba /sama Laba+ics Lama+laba+ics If already taking sama switch to saba
46
Theophylline interaction
Reduce dose if macrolide or fluoroquinolone used
47
Antibiotic prophylaxis for copd pts
Azithromycin
48
Prerequisites for oral prophylactic antibiotics in copd
Smoking cessation optimized treatment still exacerbations Ct thorax sputum culture Lfts ecg
49
Roflumilast
Oral pde4i Reduce risk of exacerbations in severe copd
50
Systolic parasternal heave
Cor pulmonale Loop Diuretics ltot
51
Factors which improve survival in copd
Smoking Ltot Lung vol reduction
52
Peak flow in discharge criteria of asthma
75%
53
Need for chest tube in pleural infection determined by
Purulent/cloudy sample Stain/culture identified organism Ph of pf less than 7.2
54
Pleural aspiration tools
21G needle 50ml syring
55
Lights criteria
apply lights if protein between 25-35 Pf protein/se protein 0.5 Pf ldh/se ldh 0=6 Pf ldh more than 2/3rd of se ldh At least 1
56
Pf low glucose
Ra tb
57
Pf raised amylase
Pancreatitis esophageal perforation
58
Pf low complement c3c4
Sle
59
Pf blood stained
Mesothelioma pe tb
60
Acute exacerbations of copd, critically ill. O2?
High flow nrbn
61
Most common type of lung ca
Adeno
62
Ca often seen in non smokers
Adeno
63
Which ca has cavitating lesions
Sqaumous
64
Which ca not related to smoking
Alveolar cell
65
Leading cause of acute bronchitis
Viral
66
Crp acute bronchitis
20-100 delayed prescription 100 immediate antibiotics ORAL DOXY ALT AMOX
67
A1at deficiency pathology
Lack of protease inhibitor produced by liver A1at protects from neutrophil elastase
68
A1atd genetics
Chromosome 14 AUTOSOMAL RECESSIVE OR CO DOM MSZ PiMM normal PiMM
69
Liver problems in a1atd
Adult - cirrhosis, hcc Children - cholestasis
70
Spirometry in a1atd
Obstructive
71
Lifelong ban on deep sea diving
Pneumothorax Unless b/l surgical pleurectomy , normal lung fn and ct postop
72
Catamenial pneumothorax
Thoracoc endometriosis Develops with menses
73
Non symptomatic pneumothorax
Conservative mx regardless of size
74
High risk pneumothorax
Chest drain
75
Safe chest drain
>=2cm laterally or apically on chest xray
76
Op review for conservative mx of pneumothorax
Every 2-4daya
77
Fitness to fly after pneumo
2 weeks after successful drainage 1 wk post check xrsy(bts
78
Fev1 fvc ratio normal values
80 80-120 75-85
79
Egg shell calcification of hilar node with upper zone fibrosis
Silicosis
80
Occupations at risk of silicosis
Mining slate works foundries potteries
81
Abg triad for co2 retention
Normal ph high pco2 high hco3
82
Klebsiella pneumonia
Cavitating pneumonia in upper lobes Diabetics and alcoholics
83
Ac vents
Legionella
84
When to give amox + clari combo for pneumonia
Curb 2or more
85
Metabolic effects of small cell lung ca
Adh hyponatremia Acth cushings, adrenal hyperplasia,hypokalenic acidosis Lambert eaton syndrome
86
Treatment of smal cell lung ca
Chemo + radio Unless very early stage, no nodal inv
87
Paraneoplastic syndrome ass with sq cell ca
Pthrp
88
Paraneoplastic syndromes involving squamous cell ca
Pthrp hyperca Clubbing Hpoa Hyperthyroidism due to ectopic tsh
89
Paraneoplastic syndromes ass with adenocarcinoma
Gynaecomastia hpoa
90
Most common organism isolated from pts with bronchiectasis
Hemophilus influenza
91
Symptom control in non cf bronchiectasis
Inspiratory muscle training Postural drainage
92
Which mediastinal mass associated with myasthenia
Thymoma
93
Common causes of anterior mediastinum mass
Teratoma terrible lymphadenopathy thymic thyroid
94
Drug mx of ipf
Pirfenidone Nintedanib
95
Azi prophylactic dose for copd
250mg 4 acute exacerbations last year requiring hosp admission
96
Indications for niv
copd with acidosis Type2resp failure sec to chest wall deformity, nmd, osa Pulm edema unresponsive to cpap Weaning from intubation
97
Which syndrome predisposes to osa
Marfans
98
Mslt
Osa eeg Assessment of sleepiness ( not dx)
99
100
Post tetanic potentiation
Lambert eaton
101
Diagnostic testing for lambert eaton
Anti voltage gated ca channel
102
50-60% lems associated with
Small cell
103
2 indications for surgery in bronchiectasis
Uncontrolled hemoptysis Localised disease
104
Painful skin rash + cough
Sarcoidosis
105
Swinging fever polyartgralgia
? sarcoidosis
106
Ocular manifestation of sarcoidosis
Uveitis
107
Lupus pernio
Sarcoidosis Indurated plaques in face Urt involved
108
Syndromes associated with sarcoidosis
Lofgrens Heerffordts (uveoparietal)
109
Criteria for ards
Acute Pulm edema Non cardiogenic Po2/fio2 less than 40
110
Main therapeutic effect of ics in copd
Reduce frequency of exacerbations
111
Dyspneoe + hypoxemia 72 hrs post op
Basal atelectasis
112
Step down treatment of asthma
Reduction of 25-50% dose of ics Every 3months review
113
Most common causes of bilateral hilar lymphadenopathy
Sarcoidosis tb
114
Near fatal asthma
Intubation
115
Salicylate poisoning abg
Resp alkalosis + met acidosis
116
Cbs disorders abg
Resp alkalosis
117
A1at deficiency spirometry
Obstructive
118
Granulomatosis with polyangitis triad
Pulmonary hemorrhage Rapidly progressing glomerulonephritis Saddle nose
119
Hemoptysis+past history of tb
Aspergilloma
120
Good pasture features
Hemoptysis Glomerulonephritis Systemic unwell
MSRA
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