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38 Cards in this Set
- Front
- Back
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the most common heritance pattern for CF is
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autosomal recessive
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the most common hereditary risk factor for thromboembolism is
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factor V leiden
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the two key principles of mechanical ventilation are
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adequate oxygenation and limiting airway pressure
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which lung cancer is most frequently associated with paraneoplastic syndromes
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SCLC
- cushings, SIADH, NB. hypercalcaemia is most often assoc. with SCC. |
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in small cell lung cancer, which patients are treated surgically
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only t1n0m0 or t2n0m0
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which of the lung cancers has the poorest / best prognosis at 5 years
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poor - SCLC = 1%
Best - SCC - 25% |
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What are the NSCLCs
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adenocarcinoma (non-smokers)
SCC (hypercalcaemia) Large cell carcinoma |
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a 60 year old man with a 30 pack yr smoking Hx presents with cough, haemoptysis and dyspnoea. What investigations would you order
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CXR, CT
Spirometry sputum cytology FBC |
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NSCLC with nodes -ve (stage 1)
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surgery _50% survival
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NSCLC with ipsilateral node involvement (stage 2)
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surgery + radiation_ 30% survival
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what is the best way to monitor clexane (LMWH) levels in patients ( if required )
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Anti Xa levels
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venous thrombosis in pregnancy is most commonly seen where?
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Left leg veins
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what criteria is used to assess pneumonia severity?
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CURB 65
Confusion Urea >7 Resp Rate >30 Blood pressure - systolic <90; diastolic <60 age >65 if 0-1 treat as outpatient 2- consider hospitilisation 3-5 - think ICU |
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what is the most sensitive and specific investigation for tuberculosis
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sputum culture for mycobacterium TB
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what should be done first to Dx TB (ie. quickest Dx)
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3 sputum samples stained for acid fast bacilli
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why does COPD potentially lead to cor pulmonale
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chronic hypoxia causes pulmonary vasoconstriction and thus pulmonary hypertension (>40mmHg systolic)
this puts pressure on the Right ventricle causing concentric hypertrophy and eventially cor pulmonale/Right heart failure. |
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If highly suspicious of PE what is the first test you should order?
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CTPA
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does a normal V/Q scan rule out PE?
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yes
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High thrombus risk operations - eg. THA should be given what for VTE prophylaxis
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LMWH + fondaparinux + 4 weeks warfarin.
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what are the most common organisms in acute exacerbation COPD
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H.Influenzae
Streptococcus pneumoniae, and Moraxella catarrhalis |
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what therapies improve outcome inCOPD
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smoking cessation, O therapy
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when are inhaled corticosteroids indicated in COPD
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FEV1 <50%; or 2+ acute exacerbations in a year
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what are patients with COPD given as part of their COPD action plan to take if an exacerbation occurs
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Abx and corticosteroids
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smokers emphysema is normally located in which area of the lung
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Centriacinar - upper lobes and superior segments of lower lobes
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a PCO2 of >45 in someone with asthma or COPD is a sign of what
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impending respiratory failure (FEV1<25%)
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are ICS used in COPD because they slow decline in lung function
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NO - they are used because they reduce the frequency and severity of exacerbations
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what is the leading indication for lung transplant
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COPD
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what is croup and how is it treated
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suglottic laryngitis (barking cough, stridor, worse at night)
75% caused by parainfluenzae Rx= oral dexamethasone |
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what is the leading cause of hospital admission in <1 yo
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Bronchioloitis
PC- cough, wheeze, dyspnoea 50% caused by RSV Rx = maintain SaO2 and hydration |
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what is the most common cause of pneumonia in children <5 (ie. not neonates)
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RSV
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what is the most common organism in neonatal pneumonia
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GBS, E.coli
Rx = ampicillin and gentamicin |
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what are the 4 criteria for 'ruling in' GABS throat
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fever, absence of cough, lymphadenopathy, purulent tonsils.
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causes of transudative pleural effusion
- low protein <.5 - low LDH <.6 |
anything that either increases hydrostatic pressure or decreases plasma oncotic pressure
CHF cirrhosis nephrotic syndrome PE |
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what are the signs of a complicated/ infected pleural effusion
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low pH
low glucose positive gram stain must drain |
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what are the causes of exudative pleural effusion?
- high protein - high LDH low pH and low glucose if bacterial infection (pneumonia, empyema) high lymphocytes in - cancer, TB, lymphoma) |
increased permeability of pleural capillaries due to
- infection - malignancy - inflammation (RA, SLE, PE) - trauma |
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when should CPAP be offered in OSA
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AH index >30, Sx of daytime dysfunction, HTN or CVD.
otherwise - weight loss, stop smoking, drink less |
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when do the benefits of ICS kick in
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night Sx - within days
FEV1 - within weeks no SABA use - months to years airway hyperresponsiveness - years |
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what lobe is most commonly affected in aspirational pneumonia?
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R middle lobe
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