1. Respiratory

Question 1

What is the most common infectious agent causing pneumonia in an adult?

Answer 1

Strep pneumonia

Question 2

What are the classes of broad spectrum antibiotics to use in treatment?

Answer 2

Macrolides (Clindamycin)

Beta-lactams (amoxicillin)

Question 3

What is an appropriate resp investigation you may have forgotten about?

Answer 3

Bronchoscopy

Question 4

what is key to do when reading the exam questions?

Answer 4

Actually read the exam questions

Bring highlighter?

Question 5

Describe the appearance of a normal alveoli?

Answer 5

Type I- squamous epithelium
Type II- Surfactant
Elastic fibres
Macropahges

Question 6

What are the four main laws that drive respiration?

Answer 6

Boyles law- the pressure exerted by a gas is inversely proportionate to its volume

Daltons law- total pressure of gas mixture is the sum of the pressures of the individual gases

Charles law- volume of gas is directly related to temperature

Henry’s law- the amount of gas in a liquid is determined by the pressure of gas and its solubility in the liquid

Question 7

What are the broad classes of lung diseases?

Answer 7

Restrictive (pneumothorax- fibrosis)- struggle to get air in

Obstructive (e.g. asthma and COPD) have problems on expiration

Question 8

How do you differntiate between restrictive and obstructive lung diseases?

Answer 8

Spirometry Normal- 70%
Obstructive- below 70%
Restrictive- above 70%

Question 9

What is the difference between alveolar and arterial dead space?

Answer 9

Anatomical dead space- conducting zone unable to participate

Alveolar dead space- ventilated but not perfused

Question 10

Discuss the oxygen-dissociation curve

Answer 10

Oxygen is more likely to be held onto (move to the left) in certain situations:

Low temperature
Alkalotic pH
Low PCO2 (hyperventilation occurs to blow of CO2

Question 11

How does respiration affect blood gas?

Answer 11

Carbon dioxide combines with water to cause a metabolic acidosis

Hyperventilation causing a blow off of hydrogen ions causing respiratory alkalosis

Question 12

What are the different drivers of respiration?

Answer 12

Central chemoreceptors- primary driver found in medulla. Responds to H ions (carbon dioxide)

Peripheral chemoreceptors- carotid and aortic bodies. Primary drivers of respiration in chronic lung disease

Question 13

What are the complications of pneumonia?

Answer 13

Pleurisy- inflammed pleura
Pleural effusion- fluid in the pleural cavity
Empyeme- pus in the pleural cavity

Question 14

What type of lung cancer is caused by smoking?

Answer 14

Adenocarcinoma

Common metastisis points include bone, liver, brain and lung. Also lymph nodes and adrenals

Question 15

What are the two main features that cause C.O.P.D.

Answer 15

Airflow obstruction and hyperinflation

Question 16

What are some symptoms of COPD?

Answer 16

Pursed lip breathing

Shallow breathing

Weight loss

Cardiac disease

Loss of muscle mass

Wheeze

Barrel chest

Question 17

How do you treat COPD?

Answer 17

Pulmonary rehab
Encourage smoking cessation
Inhalers to reduce breathlessness (SABA, SAMA, ICS)
Manage complciations (vaccines)

(AECOPD) CPAP
Nebulised bronchodilators,
corticosteroids,
antibiotics

Question 18

What are the causes of asthma

Answer 18

Genes
Atopy -(moving away from)
Profession
Smoking

Question 19

What is the pathway of inhalers in asthma?

Answer 19

SABA
ICS
LABA
4th agent (LTRA)
(steroid tablet)

Question 20

What level do the lungs bifurcate

Answer 20

T4 (yeah baby)

Question 21

What level of pleura is vulnerable to pain?

Answer 21

parietal

Question 22

What are the three haitus of the diaphragm?

Answer 22

T8- VENA CAVA
T10- OESOPHAGUS
T12- Abdomin Aorta

Question 23

How do you treat pulmonary hypertension?

Answer 23

Treat underlying condition
Oxyegn
Anticoagulation
Diuretics
CCB (amlodopine)
Prostacyclins

Question 24

What are the top 3 interstitial lung diseases?

Answer 24

Sarcoidosis
Idiopathic pulmonary fibrosis
Hyeprstitium pneumonitits

Question 25

What are the nodal stageings for lung cancer

Answer 25

N0 - no nodes
N1- ipsilateral hilar nodes
N2-Ipsilateral mediastinal nodes
N3- controlateral, suproclavicular

Question 26

How do you investigate lung cancer?

Answer 26

Bronchoscopy
EBUS
Image guided biopsy
FINA
Bone biopsy 
Surgical biopsy

Question 27

Tb treatment?

Answer 27

Rifampicin
Isoniazid
Ethambutol
Pyrzine

All four for two months
Two for further 4 months (isoniazid and rifampicin)

Question 28

Tb treatment side effects?

Answer 28

Rifampicin (orange pee)
Isoniazid (hepatitis)
Ethambutol (optic damage)
Pyrzine (gout)