markers of SLE
IgG and postitive ANA
how to test for CF in newborn
immuno-reactive trypsin raised
normal position of ET tube
2cm above the carina
when is ground glass opacity seen
EAA
daltons law of partial pressure
at constant volume and temperature, the total pressure exerted by a mixture of gases is equal to the sum of the partial pressures of the component gases
boyles law
as volume increases, pressure decreases
henrys law
the solubility of a gas in a liquid is directly proportional to the partial pressure of that gas on the surface of the liquid
where are asbestosis inhaled fibred deposited
in the bifurcaitons of alveolar ducts
what happens when asbestos is deposited?
causes alveolar macrophage alveolitis which causes a process of fibrosis
why does asbestosis have pleural plaques?
asbestos drains via lymphatic drainage and pleural cavities - this forms pleural plaques
they are benign and asymptomatic but may lead to pleural effusion
which is the most carcinogenic asbestos fibre?
crocidolite
are straight or curved asbestos fibres more dangerous
straight
when is ARDS most serious?
secondary to sepsis
what is the O2 goal for ARDS?
88-95%
what drugs can be risk factors for OSA?
benzodiazepides. opiates and alcohol
what is OSA a big risk factor for
pulmonary hypertension
what is the CTFR gene?
an anion channel found on the apical membrane of epithelial cells
what are some complictions of CF
bronchiectaiss, pancreatic insuficiency, meconium ileus, male infertility, portal hypertension
how do CF affect exocrine cells of the pancreas?
they become blocked due to HCO3 not being produced by duct cells - this causes early activation of pancreatic enzymes - autodestruction of pancrease = malabsoption - treat with creon and ADEK supplements
how does CF affect enocrine cells of the pacnreas?
destrutcion of islets of langerhan - they are replaced by fatty tissue and so patients require insulin
what pattern of inheritance is CF?
autosomal recessive
why do you see signet rings in bronchiectasis on CT?
the bronchiole walls have thickened and widened
when is keratinisation lost?
as you go deeper into the epithelium
where are club cells found?
terminal bronchioles
what is the diff between terniaml and resp bronchioles?
resp bronchioles can gas exchnage
what do type 1 pneumocytes do?
gas exchnage
what are conchae?
fleshy bits in the nose which increase SA
where are seromucous glands and venous sinuses found?
lamina propria
what is the trachea made of?
fibrocartilage
what changes occur going into the bronchioles?
loss of cartilage
columnar to cuboidal
what type of hypersensitivity is beryllosis?
type 4
what is the caplan syndrome triad?
pneumoconiosis, RA and pulmonary rheumatoid nodules
what is caplans syndrome?
multiple lung nodules in coal workers with rheumatoid arthiritis cause by an inflammatory reaction to an external allergen
bilateral peripheral nodules
what is the pathogenesis of latent TB?
- macrophage engulfs MB in the alveoli
- MB replicates and kills macrophage - becoming released
- this stimulates an immune response of TH1 cells and macrophages - creaating a granulomata with a caseous necrotic core surrounded by macrophages and lymphocytes
what is the treatment for latent TB?
RI = 3 months
or I = 6 months
what does primary TB look like?
gohn focus in mid periphery zone and large hilar nodes
what does secondary TB look like?
fibrosing and containing apical lesions
what are some paraneoplastic symptoms of lung cancer?
finger clubbing, hypertrophic pulmonary osteoarthopathy, thrombophlebitis, hypercalcaemia, SIADH, eaton-lambert syndrome
are paraneoplastic symptoms from the primary tumour or the met?
primary tumour
what is the most common type of lung cancer?
bronchial carcinoma
what do adenocarcinomas secrete?
TTF
how to diagnose bronchilitis?
PCR on throat or perinasal swab
what is churg strauss syndrom?
eosinophilic infiltration causing vasculitis in small areas and veins - ANCA+
what is seen on XRAY for coal workers pneumoniosis?
upper lobe robe opicates
what can cause cor pulmonale?
acute - PE
chronic - COPD
when to suspect empyema?
resolving pneumonia + feveer
how to treat empyema?
amox + metro
which bacteria causes epiglottiisi?
h influenza
how to treat epiglottiis?
ceftiaxone
bloody pleural fluid?
mesothelioma
microorganisms causing pertussis?
bordatella pertussis
first line treatment for pertussis?
erythromycin
GS investigation for PE
severe- CTPA
pregnant - V/Q
low risk - duplex then CTPA
what would be seen on a chest XRAY for a lung abcess
walled cavity often with a fluid level
where do you aspirate for a tension pneumothroax?
second ICS anteriorly, mid clavicular line
is sarcoidosis T cell mediated?
yes
what is kostmann syndrome?
sevre neutropenia, autosomal recessive
what is a feature of leukocyte adhesion deficiency
high leukocyte number during infection
which gene is affected in leukocyte adhesion deficiency?
CD18
which marker is increased in SLE?
ANA
how do you measure airway hyper-reactivity?
methacholine, histamine or mannitol challenge testing
how can spirometry differentiate between COPD and asthma?
copd - decreases FVC and FEV
asthma - decreased FEV but normal FVC
things that shift the oxyhaemaglbobin curve left
reduced 2,3 DPG, hypothermia, hypocapnia, alkalosis, carbon monoxide
things that shift the oxyhaemaglobin curve right
hyperthermia, hypercapnia, acidosis, sickle cell
decreased pulmonary compliance and examples
greater change in pressure require to produce a change in lung volume because lungs are stiffer
SOB, pulmonary fibrosis, oedema, collapse
restrictive pattern
increased pulmonary compliacnce and examples
have to work harder to get air out of the lungs
hyperinflation of lungs
eg emphysema and COPD
TTF-1
adenocarcinoma and small cell
non small cell markers
kras and EFGR
pg63
squamous cell
PTH
Squamous
ACTH
small cell