Airway disease

Question 1

Symptoms of COPD

Answer 1

Productive cough, SoB

Question 2

Signs of COPD

Answer 2

Wheeze, Tachypnoea, Use of accessory muscles, Hyperinflation, Decreased cricosternal distance, Decreased chest expansion, Hyper-resonance

Question 3

Investigations for COPD

Answer 3

Bloods: FBC

ABG, CXR, Spirometry

Question 4

CXR findings in COPD

Answer 4

Hyperinflation

Question 5

Conservative management of COPD

Answer 5

Smoking cessation, Pulmonary rehab, Improved diet

Question 6

Classification and management of mild COPD

Answer 6

FEV1 50-80%
PRN antimuscarinic (ipratropium bromide)

Question 7

Classification and management of moderate COPD

Answer 7

FEV1 30-50%
Regular antimuscarinc (ipratropium bromide) OR Inhaled LABA and steroid (salmeterol and beclomethasone)

Question 8

Classification and management of severe COPD

Answer 8

FEV1

Question 9

Indications for long term oxygen therapy in COPD

Answer 9

Hypoxic on air, Cor pulmonale

Question 10

Symptoms of COPD exacerbation

Answer 10

Increasing cough, Increasing SoB

Question 11

Investigations for COPD exacerbation

Answer 11

Bloods: FBC, U+Es, CRP, Culture

PEFR, ABG, ECG, Sputum culture

Question 12

Management of COPD exacerbation

Answer 12

Medical: Salbutamol nebs, Ipratropium bromide nebs, Oral prednisolone, Aminophyline IV
Surgical: Non-invasive ventilation

Question 13

Symptoms of asthma

Answer 13

SoB (brought on by exercise), Productive cough (worse at nice)

Question 14

Signs of asthma

Answer 14

Wheeze

Question 15

Investigations for asthma

Answer 15

PEFR, Spirometry

Question 16

Spirometry findings in asthma

Answer 16

Obstructive deficit with a 15% improvement after bronchodilators

Question 17

Step 1 of BTS asthma management

Answer 17

SABA PRN

Question 18

Step 2 of BTS asthma management

Answer 18

SABA PRN, Regular inhaled steroids

Question 19

Step 3 of BTS asthma management

Answer 19

SABA PRN, Regular inhaled LABA and steroid

Question 20

Step 4 of BTS asthma management

Answer 20

Increased steroid dose, add Leukotreine receptor antagonist OR Theophylline

Question 21

Step 5 of BTS asthma management

Answer 21

Add oral prednisolone

Question 22

Risk factors for an asthma exacerbation

Answer 22

Exercise, Infection, Smoke, NSAIDs, Beta-blockers, Cold air

Question 23

Signs of an asthma exacerbation

Answer 23

Tachypnoea, Hyperinflation, Hyperresonance, Accessory muscle use, Tachycardia, Hypotension

Question 24

Investigations for asthma exacerbation

Answer 24

Bloods: FBC, U+Es, CRP, Culture

PEFR, Sputum culture, ABG, CXR

Question 25

Classification of an asthma exacerbation with PEFR of >75%

Answer 25

Mild

Question 26

Classification of an asthma exacerbation with PEFR of 50-75%

Answer 26

Moderate

Question 27

Classification of an asthma exacerbation with PEFR of PEFR 33-50%

Answer 27

Severe

Question 28

Classification of an asthma exacerbation with PEFR of

Answer 28

Life threatening

Question 29

Features of severe asthma exacerbation

Answer 29

Resp rate > 25, Heart rate > 110, PEFR 33-50%

Question 30

Features of life threatening asthma

Answer 30

Cyanosis, Bradycardia, Hypotension, O2 sats

Question 31

Feature of near fatal asthma

Answer 31

Hypercapnia

Question 32

Management of a moderate asthma exacerbation

Answer 32

Back to back salbutamol nebs, Oral prednisolone

Question 33

Management of a severe asthma exacerbation

Answer 33

Salbutamol nebs and ipatropium bromide nebs, Hydrocortisone IV

Question 34

Management of a life threatening asthma exacerbation

Answer 34

IV salbutamol, IV aminophylline, ITU referral

Question 35

Discharge criteria post asthma exacerbation

Answer 35

Off regular nebs for 24hrs, PEFR >75%

Question 36

Discharge management for a patient post asthma exacerbation

Answer 36

Asthma nurse review inhaler technique, GP follow up in 2 weeks, 5 day course of oral steroids

Question 37

Causes of bronchiectasis

Answer 37

Cystic fibrosis, Pneumonia, Measles, Pertussis, TB, HIV, Foreign body, Tumours, Idiopathic

Question 38

Symptoms of bronchiestasis

Answer 38

Productive cough, Hallitosis, Haemoptysis

Question 39

Signs of bronchiectasis

Answer 39

Wheeze, Clubbing, Inspiratory crepitations

Question 40

Investigations for bronchiectasis

Answer 40

Sputum culture, CXR, CT thorax, Bronchoscopy, Spirometry, CF sweat test

Question 41

CXR findings in bronchiectasis

Answer 41

Fibrotic changes, Thickened bronchial outline

Question 42

CT finding in bronchiectasis

Answer 42

Signet ring sign

Question 43

Long term management of bronciectasis

Answer 43

Conservative: Physiotherapy Medical: Bronchodilators, Steroids, Antibiotic prophylaxis Surgical: Lobectomy

Question 44

Management of an acute exacerbation of bronchiectasis

Answer 44

Conservative: Oxygen Medical: Bronchodilators, Steroids Surgical: BiPAP

Question 45

Factors lowering the threshold for anaphylaxis

Answer 45

NSAIDs, Alcohol, Cocaine, Beta-blockers, Tricyclic antidepressants, MAO inhibitors

Question 46

Symptoms of anaphylaxis

Answer 46

SoB, Abdominal pain, Diarrhoea, Vomiting, Itching, Angioedema

Question 47

Signs of anaphylaxis

Answer 47

Erythema, Inspiratory wheeze, Tachycardia, Hypotension, Cyanosis

Question 48

Management of anaphylaxis

Answer 48

Conservative: Lie flat, Remove trigger, IV fluids Medical: Oxygen, Salbutamol and adrenaline nebs, IM adrenaline, IV hydrocortisone, IV chloropheninamine