Buzz Words

Question 1

Stony dull to percuss

Answer 1

Pleural effusion

Question 2

Right sided pleuritic chest pain

Answer 2

Most likely pneumonia

Question 3

Alveolar bat wings, Kerley B lines, cardiomegaly, dilated prominent upper lobe vessels, pleural effusion

Answer 3

Pulmonary oedema

Question 4

ground glass appearance on CXR

Answer 4

pulmonary fibrosis and resp distress syndrome of the newborn

Question 5

Ziehl-Neelsen stain positive for acid fast bacilli

Answer 5

TB

Question 6

Caseous necrosis

Answer 6

TB

Question 7

Miliary tuberculous

Answer 7

spread of organism into bloodstream. If organism spread via pulmonary artery, miliary dissemination into lung occurs. If organism spread via pulmonary vein, there is systemic dissemination to the liver, spleen, kidneys

Question 8

Positive anti-glomerular basement membrane antibodies

Answer 8

Good pasture’s syndrome

Question 9

chest infection with a parrot/pigeon as a pet

Answer 9

Caused by chlamydophila psittaci

Question 10

dry cough and diarrhoea after holiday abroad, some indication of water spread

Answer 10

Legionella pneumophila (test urine for antigens)

Question 11

tall, thin young man who indulges in marijuanna

Answer 11

probably pneumothorax (marfan’s)

Question 12

Bilateral hilar lymphadenopathy, erythema nodosum, granulomas, fatigue, uveitis and weight loss

Answer 12

sarcoidosis

Question 13

Bronchiole wider than neighbouring arteriole (on CT) (signet ring sign)

Answer 13

bronchiectasis

Question 14

D sign on X ray

Answer 14

empyema

Question 15

“steeple” sign on X ray

Answer 15

laryngotracheobronchitis/croup

Question 16

child with barking cough

Answer 16

croup

Question 17

Pneumocystis pneumonia

Answer 17

HIV (treat with co-trimoxazole [± prednisolone if severe])

Question 18

asthma + nasal polyps + silcyclate sensitivity

Answer 18

samter’s triad

Question 19

alcoholic (danger or aspiration pneumonia)

Answer 19

Klebsiella pneumoniae

Question 20

red jelly sputum

Answer 20

Klebsiella pneumonia

Question 21

mucoid sputum

Answer 21

chlamydia psittaci

Question 22

rusty sputum

Answer 22

pneumococcal pneumonia

Question 23

cannonball metastases (also weight loss and haematuria)

Answer 23

classically from primary renal cell carcinoma

Question 24

morning headache

Answer 24

hypercapnia or side effects of organic nitrates

Question 25

ACTH secreting lung tumour

Answer 25

small cell carcinoma of the lung

Question 26

PTH secreting lung tumour

Answer 26

squamous cell ca. of the lung

Question 27

small cell carcinoma

Answer 27

neuroendocrine, highly malignant, and may be associated with ectopic endocrine syndromes

Question 28

increased serum ACE and Ca2+

Answer 28

sarcoid

Question 29

eggshell calcification at hilar region

Answer 29

silicosis

Question 30

'heart failure cells' seen in alveolar spaces

Answer 30

macrophages that have absorbed haemosiderin, found in chronic pulmonary oedema and associated (severe) LV HF. also seen in long standing pulmonary hypertension

Question 31

Ghon focus

Answer 31

area of infection and caseous necrosis at the periphery of the lung, beneath the pleura- found in TB.

Question 32

Assmann focus

Answer 32

apical lesion of secondary TB infection

Question 33

"coin lesion" found on chest radiographs- common lesions are...

Answer 33

Primary bronchial or lung carcinoma, metastatic tumour (esp kidney), bronchial hamartoma, carcinoid tumour, granulomatous inflammation, lung abscess

Question 34

Horner's syndrome

Answer 34

can occur when there is a local spread of cancer to the intrathoracic nodes or a pancoast's tumour. Signs include: ptosis (drooping of the eyelid), enophthalmos (sunken eye), miosis (small pupil) and the lack of sweating on the ipsilateral side of the face. - due to the cervical sympathetic chain.

Question 35

acute management of asthma

Answer 35

a. Oxygen 100% through a non-rebreather mask b.  Salbutamol Nebulised back-to-back. c.  Hydrocortisone IV or Prednisolone PO d.  Ipratropium Bromide Nebulised hourly e. Theophylline IV or aminophylline IV f Magnesium g anaesthetist

Question 36

thumbprint sign on head x ray

Answer 36

epiglottitis

Question 37

inspiratory whoop/barking cough

Answer 37

pertussis

Question 38

snow storm appearance on x ray

Answer 38

baritosis, silicosis

Question 39

management of infective exacerbation of COPD

Answer 39

``` I - ipratropium S- salbulatmol O- oxygen A- amoxicillin P- prednisolone ```

Question 40

non- smoker and lung cancer

Answer 40

(peripheral) adenocarcinoma

Question 41

squamous and small-cell lung cancer

Answer 41

Central

Question 42

high d-dimers

Answer 42

suspect (but not diagnose) PE (send for CTPA or V/Q scan)

Question 43

low d-dimers

Answer 43

exclude PE

Question 44

large PE

Answer 44

thrombolysis

Question 45

Small PE

Answer 45

LMWH

Question 46

honeycomb lung

Answer 46

fibrosing alveolitis