Respiratory Medicine — Flashcards

Flashcard 181: Patients who have a pulmonary embolism, despite taking anticoagulation, should be considered for _____

Answer: a inferior vena cava filter

Flashcard 182: Extra-pulmonary tuberculosis can cause _____ of the cervical lymph nodes

Answer: scrofuloderma

Flashcard 183: What are the initial investigations for tuberculosis? _____, x3 sputum smears

Answer: CXR

Flashcard 184: What is the first-line anticoagulation for pulmonary embolism? _____

Answer: DOACs (Rivaroxaban or Apixaban)

Flashcard 185: Tuberculosis risk factor includes _____ in areas with high TB prevalence (e.g. South-East Asia, Africa, Western Pacific)

Answer: living

Flashcard 186: What is the management of active tuberculosis? _____

Answer: Initial 2 month phase: Rifampicin, Isoniazid (taken with pyridoxine), Pyranzinamide, Ethambutol Continuation 4 month phase: Rifampicin, Isoniazid (taken with pyridoxine)

Flashcard 187: Patients who are _____ are at risk of tuberculosis

Answer: immunocompromised

Flashcard 188: In a patient with suspected pulmonary embolism and **renal impairment**, the investigation of choice is a _____.

Answer: V/Q scan

Extra: CT Pulmonary Angiogram (CTPA) is usually the gold standard but is avoided in renal impairment due to the risk of contrast-induced nephropathy. V/Q scanning is the preferred alternative if the chest X-ray is normal. A Wells score > 4 (PE likely) warrants immediate imaging.

Flashcard 189: What is the management of latent tuberculosis? _____

Answer: 3 months of isoniazid (taken with pyridoxine) + rifampicin OR 6 months of isoniazid (taken with pyridoxine)

Flashcard 190: The screening test(s) for latent tuberculosis include the _____ and IGRA.

Answer: Mantoux test

Extra: The Mantoux test (Tuberculin Skin Test - TST) and IGRA are both used for screening latent TB. Active TB is diagnosed via sputum microscopy, culture, or NAAT (CBNAAT).