Conditions Flashcards

1
Q
which goes to the chest
Preceded by common cold
Clinical features
Productive cough
Fever – minority of cases
Normal chest examination
Normal chest X-ray
May have a transient wheeze
A

Acute bronchitis

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2
Q

Chicken pox pneumonia in which group of people?

A

Adult smokers!

These patients can die from this type of pneumonia

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3
Q

Complications of mycoplasma pneumoniae are common, list some of these?

A

haemolytic anaemia, erythema multiformes, hepatitis, meningoencephalitis

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4
Q

Complications of influenza?

Difference between primary and secondary pneumonia?

A
Death 0.37%
Primary viral pneumonia
Dry cough, bloody sputum and respiratory failure within 24 hours of onset of initial fever
Secondary bacterial pneumonia
A new fever on day 7
Myositis (Skeletal and cardiac)
Encephalitis
Depression
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5
Q

Who do you give pneumococcal and influenza vaccines to?

A
Influenza and pneumococcal vaccines
Over 65
Chronic chest or cardiac disease
Diabetes
Immunocompromised
e.g. splenectomy
Influenza vaccine
Health care workers
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6
Q

Hospital acquired
Need extended gram negative cover
Aspiration pneumonia
Need anaerobic cover

A

Gram negative: gentamicin

Anaerobic: metronidazole

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7
Q

CURB65

A
C  	New onset of confusion
U  	Urea >7
R  	Respiratory rate >30/min
B  	Blood pressure
Systolic < 35 or  > 40
Cyanosis PaO2 < 8 kPa
WBC < 4 or > 30
Multi-lobar involvement
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8
Q

Acute exacerbation of chronic bronchitis management?

A
Management in primary care
Antibiotic. e.g. doxycycline or amoxicillin
Bronchodilator inhalers
Short course of steroids in some cases
Refer to hospital if
Evidence of respiratory failure
Not coping at home

Management in hospital – same as before AND
Measure arterial blood gases
CXR to look for other diseases
Give oxygen if has respiratory failure

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9
Q

Sarcoidosis hypersensitivity?

A

Type 4

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10
Q

Calcium levels in sarcoidosis?

A

Hypercalcemia

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11
Q

Skin condition associated with sarcoidosis?

A

Erythema nodosum

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12
Q

Activity level marker in sarcoidosis?

A

ACE

you also have raised calcium and raised inflammatory markers

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13
Q

Treatment for Sarcoidosis

A

Treatment
Acute: self-limiting condition - usually no treatment
Steroids if vital organ affected (eg impaired lung function, heart, eyes, brain, kidneys)

Chronic: oral steroids usually needed
Immunosuppression (eg azathioprine, methotrexate)

monitor chest X-ray and pulmonary function for several years
often relapses

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14
Q

Extrinsic allergic alveolitis hypersensitivity?

A

Type III

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15
Q

Gold, bleomycin and sulfasalazine could cause which ILD?

A

EAA

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16
Q

EAA presentation

A

Cough, breathlessness, fever, myalgia

17
Q

Signs of EAA?

A

Crackles

clubbing is unusual!

18
Q

Pulmonary fibrosis in EAA?

A

Upper zones

19
Q

FEV1 & FVC and TLCO in EAA?

A

low FEV1 & FVC, high or normal ratio, low gas transfer - TLCO

20
Q

Drugs which could cause idiopathic pulmonary fibrosis?

A

Amiodarone, methotrexate

21
Q
Progressive breathlessness (over several years)
Dry cough
A

Idiopathic pulmonary fibrosis

22
Q

Clubbing in idiopathic pulmonary fibrosis?

A

Yes

23
Q

clubbing, bilateral fine inspiratory crackles

A

Idiopathic pulmonary fibrosis

24
Q

Fibrotic change worse where in idiopathic pulmonary fibrosis?

A

At the lung bases

25
Q

Caplan’s syndrome?

A

Rheumatoid arthritis and pneumoconiosis

26
Q

Silicosis on x-ray?

A

Egg shell calcification of hilar nodes

27
Q

Presentation of malignant mesothelioma?

A

Pleural effusion and chest pain

28
Q

Acute asbestos pleuritis presentation?

A

Fever, pain, bloody pleural effusion