Respiratory

Question 1

symptoms of pneumonia

Answer 1

fever
cough
dyspnoea
chest pain

Question 2

Community acquired pneumonia score

Answer 2

CURB65

Confusion
Urea >7mmol/l
Resp rate >30/min
Blood pressure; systolic <90 or diastolic ≤60
Age >65

Question 3

Investigations for pneumonia

Answer 3

CXR
FBC
electrolytes
urea
blood glucose
ABG
blood culture
sputum culture

Question 4

Treatment for Comm Acquired pneumonia

Answer 4

macrolide/tetracycline

fluoroquinolone or combination therapy if drug resistant

Question 5

Treatment for hospital acquired pneumonia

Answer 5

empirical AB therapy
if gram +ve; vancomycin, linezolid, naficillin
if gram -ve; gentamicin, levofloxacin, ciprofloxacen

Question 6

Describe treatment for aspiration pneumonia

Answer 6

positional drainage
oropharyngeal suctioning
levofloxacin/ceftriaxone

Question 7

symptoms of tuberculosis

Answer 7

cough
fever
anorexia
night sweats
pleuritic chest pain
haemoptysis

Question 8

Investigations for tuberculosis

Answer 8

CXR
Sputum culture
FBC

Question 9

treatment for tuberculosis

Answer 9

Rifampicin
Isoniazid
Pyrazinamide
Ethambutol

4 for 2 months, 2 for 4 months

Question 10

Side effects of rifampicin

Answer 10

orange urine
orange tears
reduced effectiveness of oral contraceptive
thrombocytopaenia

Question 11

Side effects of izoniazid

Answer 11

peripheral neuropathy

reduced oral contraceptive effectiveness

Question 12

Asthma symptoms

Answer 12

wheezing
dry cough
exertional dyspnoea

Question 13

Investigations for asthma

Answer 13

spirometry
CXR
PEFR

Question 14

Treatment for asthma

Answer 14

SABA
ICA
LABA
Raise ICS
LTRA
high dose steroid

may add theophylline at steps 3 or 4

Question 15

symptoms of COPD

Answer 15

cough
dyspnoea
barrel chest
hyperresonance on percussion

Question 16

Investigations for COPD

Answer 16

spirometry
pulse oximetry
ABG
CXR
sputum culture

Question 17

Treatment for COPD

Answer 17

short acting bronchodilator (salbutamol)

depending on severity + long acting

Question 18

symptoms of pulmonary embolism

Answer 18

chest pain
dyspnoea
tachypnoea
cough
tachycardia
fever

Question 19

Investigations for pulm emb

Answer 19

Wells/Geneva score
CT pulm angiography
V/Q scan
coagulation studies
CXR
ECG

Question 20

Treatment for pulm emb

Answer 20

Resp support; O2 therapy
IV fluids
Vasoactive agents; norAd
Anticoag; hep and warf
thrombolysis may be given
vit k antagonists

Question 21

symptoms of pneumothorax

Answer 21

chest pain
dyspnoea
hyperexpanded ipsilateral hemithorax

Question 22

Investigations for pneumothorax

Answer 22

CT chest

CXR

Question 23

Treatment of tension pneumothorax

Answer 23

needle decompression
oxygen therapy
tube thoracotomy

Question 24

Treatment of primary spontaneous pneumothorax

Answer 24

O2 therapy

if breathless; percutaneous aspiration

Question 25

Describe non-small cell lung cancer

Answer 25

> 80% of lung cancers

• adenocarcinoma
• SCC
• large cell carcinoma

Question 26

Symptoms of lung cancer

Answer 26

cough
dyspnoea
haemoptysis

Question 27

Investigations for lung cancer

Answer 27

CXR
CT w/contrast
sputum cytology
bronchoscopy
biopsy

Question 28

Treatment of lung cancer

Answer 28

Small cell

• chemo
• radio
• prophylactic cranial irradiation

Non-small cell

• surgery
• if unsuitable; radiotherapy

Question 29

Cancer grading system

Answer 29

Grade 1 - cells look normal and grow slowly
Grade 2 - slightly abnormal and grow faster than other cells
Grade 3 - abnormal cells, grow or spread quickly