RESP INVESTIGATIONS Flashcards

1
Q

bronchiolitis

A

PCR on throat

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2
Q

ILD

A

CT scan

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3
Q

fibrosis

A

CT scan

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4
Q

Allergic Alveolitis

A

lung biopsy

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5
Q

Obstructive Sleep apnoea

A

polysomography

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6
Q

Lung cancer

A

bronchoscopy + CT guided biopsy

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7
Q

Pneumothorax

A

CXR

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8
Q

Epiglottitis

A

Blood Culture

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9
Q

Pneumonia

A

CXR

sputum culture + viral PCR

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10
Q

Legionella pneumonia

A

Legionella urinary antigen testing
BAL/tracheal aspirates
serology
PCR test on sputum

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11
Q

Aspergillus

A

BAL (bronchoalveolar lavage) or fungal culture for PCR

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12
Q

Pneumocystis Pneumonia

A

sputum culture + PCR
BAL/tracheal aspirates
direct immunofluorescence

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13
Q

Bronchiectasis

A

HRCT

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14
Q

Idiopathic Pulmonary Fibrosis

A

HRCT - reticulonodular fibrotic shadowing (worse at lung bases), honey combing cystic changes
CXR

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15
Q

mycoplasma tuberculosis

A
\+ve to acid alcohol fast bacilli
sputum/tissue microscopy - ZN stain
IGRT
PCR
culture on selective media (3 months)
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16
Q

sarcoidosis

A

CXR - bilar lymphadenopathy
CT - peripheral nodular infiltrate
Biopsy - non-caseating granuloma

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17
Q

Asthma

A

spirometry - FEV1/FVC ration < 75%
reversibility to salbutamol
Provocation testing

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18
Q

COPD

A

spirometry - FEV1/FVC ratio < 75%

less reversibility to salbutamol

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19
Q

Exac. of COPD

A

sputum culture

CXR

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20
Q

Restrictive lung disease

A
spirometry - FEV1/FVC ratio > 75%
TLCO reduced
decreased O2 on exercise or at rest
CXR
serology
CT
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21
Q

lung cancer - to see cell type and proximity to carina

A

bronchoscopy (if within 2cm then inoperable)

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22
Q

lung cancer - to see size and mets

A

CT

PET (more expensive)

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23
Q

pleural malignancy

A

aspiration of pleural effusion
CT guided tissue biopsy
thoracoscopy

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24
Q

chlamydia / coxiella pneumonia

A

serology

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25
Q

Mycoplasma pneumonia

A

serology/PCR

26
Q

influenza

A

PCR nasopharyngeal swab

27
Q

bronchiolitis

A

PCR

28
Q

Bordatella pertussis (whooping cough)

A

Bacterial culture from nasal swab

PCR

29
Q

pneumocystis

A

BAL (better than sputum culture) for immunofluorescence or PCR

30
Q

Empyema

A

US and frank pus

31
Q

pneumoconiosis

A

CXR

32
Q

what would asbestosis show in a CXR

A

holly leaf from pleural plaques

33
Q

what would silicosis show on a CXR

A

egg shell calcification

34
Q

pulmonary hypertension

A

ECG and CXR

35
Q

Stridor

A

laryngoscope
Bronchoscopy
CXR, CT

36
Q

sleep apnoea

A

snoring and raised Epworth scale

overnight sleep study - oximetry

37
Q

how do you differentiate T1 and T2 respiratory failure

A

ABGs
T1 - O2 low, CO2 normal
T2 - O2 low, CO2 high

38
Q

test for CF done in GP

A

faecal elastase
quick and simple
assesses exocrine pancreatic disfunction

39
Q

2 other tests for CF

A

sweat test - high sodium

genetic testing

40
Q

CXR of CF

A

bronchiectasis and hyperinflation

41
Q

US of CF

A

fatty liver and chronic pancreatitis

42
Q

spirometry of CF

A

obstructive

43
Q

Chronic granulomatous disease

A

NBT test (nitroblue tetrazolium) - change colour in H2O2 sensitive dye - don’t have disease

44
Q

T/B cell deficiency

A

total WBC count differential
serum immunoglobulins + protein electrophoresis
Quantitation of lymphocyte subpopulation

45
Q

allergy

A

skin prick test

RAST test for patients on antihistamine

46
Q

flu

A

PCR using nasopharyngeal/throat swab

antibody detection

47
Q

atypical pneumonia

A

serology or PCR

48
Q

chlamydia trachiomatis

A

PCR on mothers urine

prenasal/throat swab of child

49
Q

pneumocystis jiroveci

A

BAL
induced sputum
direct immunofluorescence (antigen detection)

50
Q

suspected pneumonia

A

blood culture
serology
ABGs, FBC, U+Es, LFTs
CXR

51
Q

RSV

A

PCR on throat/pernasal swab

52
Q

metapneumovirus

A

PCR on throat/nasopharyngeal swab

53
Q

haemophillus influenza

A

X and V test

culture on chocolate agar

54
Q

Lung cancer

A

CXR
+/- CT
+/- PET
+/- Bronchoscopy - if central lesion and patient fit enough
+/- percutaneous FNA biopsy
+/- sputum cytology if not fit enough for bronchoscopy

55
Q

what is used to subtype LC on small biopsy

A

immunohistochemistry

56
Q

what is TTF-1 expressed in

A

small cell carcinomas

adenocarcinoma

57
Q

what is p63 expressed in

A

squamous cell carcinoma

58
Q

atypicals

A

clotted blood cultures

59
Q

viral

A

throat swab

60
Q

bacterial culture

A

sputum