phase 2 resp

Question 1

which gene is mutated in CF

Answer 1

Cystic fibrosis transmembrane conductance regulator on chromosome 7

Question 2

What is the mode of action of tiotropium bromide?

Answer 2

Causes bronchodilation by blocking muscarinic acetylcholine receptors

Question 3

where to put needle for pneumothorax

Answer 3

Right 2nd intercostal space, midclavicular line

Question 4

incubation period for influenza?

Answer 4

1-4 days

Question 5

what causes Pigeon fancier’s lung?

Answer 5

Avian proteins

Question 6

where does mesothelioma metastasize

Answer 6

locally - rarely metastasizes to local sites

Question 7

extra pulmonary signs of tb

Answer 7

Persistently swollen glands, Abdominal pain, Dysuria, Haematuria, Pain and loss of movement in an affected bone or joint, Confusion, Persistent headache, Seizures

Question 8

PE first line investigation

Answer 8

CT pulmonary angiogram

Question 9

differential diagnosis for influenz

Answer 9

Common cold
URTI
Pharyngitis
Meningitis
Bacterial / lower RTI
Malaria / dengue fever

Question 10

x ray for tb

Answer 10

Ghon complex / Ghon focus / dense homogenous opacity / hilar lymphadenopathy / pleural
effusion

Question 11

name of the syndrome that is causing his eyelid to be droopy, pupil constricted and lack of sweat
on the left side of his face?

Answer 11

Horner’s syndrome

Question 12

what causes horners syndrome

Answer 12

Pancoast tumour of the apex of the left lung

Question 13

what kind of nerve is involved in horners syndrome

Answer 13

Sympathetic

Question 14

pathophysiology of pancoast tumour

Answer 14

Pancoast tumour invades the apical chest wall, and as it becomes larger, it can affect other nearby
structures, including intercostal nerves, the brachial plexus (causing his shoulder pain and arm
weakness), and the sympathetic chain

Question 15

3 sites which lung cancer is most likely to metastasise from

Answer 15

Breast cancer, colon cancer, prostate cancer, sarcoma, bladder cancer, neuroblastoma, and Wilm’s
tumor.

Question 16

extrapulmonary signs of sarcoidosis

Answer 16

Erythema nodosum, polyarthritis, lupus pernio, uveitis, arrhythmias, granulomatous hepatitis

Question 17

differentials manifesting with bilateral hilar lymphadenopathy on x-ray.

Answer 17

tb, lymphoma, silicosis

Question 18

potential causes of bronchiectasis.

Answer 18

cystic fibrosis
TB
AIDS
airway obstruction

Question 19

signs on examination of that patient for bronchiectasis

Answer 19

Coarse crackles heard in early inspiration and often in the lower zones, large airway rhonchi (lowpitched snore-like sounds), wheeze, clubbing is found infrequently.

Question 20

complications of bronchiectasis

Answer 20

Repeated infection and deteriorating lung function, empyema, lung abscess, pneumothorax from
repeated coughing, life-threatening haemoptysis, respiratory failure.

Question 21

most appropriate antibiotic for h influenzae

Answer 21

Co-amoxiclav, doxycycline

Question 22

differential diagnoses for a COPD exacerbation. (

Answer 22

Pneumonia, pneumothorax, congestive heart failure, pulmonary oedema, pleural effusion

Question 23

pneumothorax symptoms

Answer 23

Two thirds of patients will have both pain and dyspnoea, However, a significant number may be
asymptomatic and therefore a high index of suspicion is needed

Question 24

is D dimer sensitive or specific for PE

Answer 24

High sensitivity, low specificity

Question 25

pleural effusion vs pneumothorax

Answer 25

Pleural effusion – dullness on percussion,
Pneumothorax – hyper-resonant on percussion,

Question 26

what is fev1 in obstructve

Answer 26

FEV1<0.8

Question 27

Most common organism in COPD exacerbation

Answer 27

haemophilus influenzae.

Others = strep pneumoniae, Moraxella catarrhalis

Question 28

what kind of effusion would MI cause

Answer 28

Transudative effusion – bilateral effusions are more likely to be due to cardiac failure.

Question 29

what can develop after pleural effusion is aspirated and ph is low

Answer 29

empyema

Question 30

questioons to ask for asthma histoey

Answer 30

Family history, other atopic diseases, diurnal variation, cough at night, better/worse at home/school/work/in holidays, any allergies, drug history

Question 31

what signs indicate poor asthma control

Answer 31

Nocturnal cough, multiple exacerbations, wheeze, recessions, hyperinflated chest

Question 32

what is FVC in obstructiv

Answer 32

normal

Question 33

asthma patient currently on Salbutamol and a corticosteroid inhaler. What must you do before adding in more pharmacological interventions?

Answer 33

check inhaler techniqye