Chronic SOB

Question 1

What % FEV1 is diagnostic for asthma?

Answer 1

<70% of expected

Question 2

Give an example of an inhaled low-dose corticosteroid that might be given in asthma treatment

Answer 2

Beclomethasone

Question 3

Give an example of a LABA that might be given in asthma treatment

Answer 3

Salmeterol

Question 4

Recall the steps of management for chronic asthma

Answer 4

SABA
SABA + inhaled steroid
LABA + inhaled steroid
\+ LKT agonists 
Oral steroid

Question 5

Recall the PEF indicative of each different severity of asthma

Answer 5

50-75% = moderate
33-50% = acute-severe
<33% = life-threatening

Question 6

Recall the management of acute asthma

Answer 6

Oxygen
Nebulised salbutamol and ipratopium bromide
Oral prednisolone
IV hydrocortisone
-->
IV MgSO4
-->
IV Aminophylline
--> ITU and intubation

Question 7

Which 2 diseases are encompassed by COPD?

Answer 7

Emphysema

Chronic bronchitis

Question 8

What would be heard on auscultation in COPD?

Answer 8

Coarse crackles

Question 9

Recall 3 features seen on general inspection in COPD

Answer 9

Tar-staining
Cyanosis
Barrel chest

Question 10

What would be the percussion finding in COPD?

Answer 10

Hyperresonance

Question 11

Recall the respiratory causes of clubbing

Answer 11

Malignancy
Empyema lung abscess
Interstitial lung disease
CF
Nb. NOT COPD

Question 12

Recall 4 CVS causes of clubbing

Answer 12

Tetralogy of Fallot
Malignancy
Atrial myxoma
Infective endocarditis

Question 13

Recall 4 GI causes of clubbing

Answer 13

Malignancy
IBD
Coeliac
Cirrhosis

Question 14

Which genetic disorder can cause COPD?

Answer 14

Alpha-1 anti-trypsin

Question 15

Recall the steps of management of COPD (not an acute exacerbation)

Answer 15

1. SABA/SAMA
2. Add LABA/LAMA
3. LABA + LAMA OR LABA + inhaled corticosteroid
4. LABA + LAMA + inhaled corticosteroid

Question 16

Give an example of a SAMA and a LAMA

Answer 16

SAMA: ipratropium bromide
LAMA: tiotropium

Question 17

What is symbicort?

Answer 17

Combination of LABA and inhaled corticosteroid

Question 18

What are COPD patients routinely vaccinated against?

Answer 18

Pneumococcus

Influenza

Question 19

How does management of an acute exacerbation of COPD and asthma differ?

Answer 19

• Initial IV hydrocortisone dose is 200mg in COPD and 100mg in asthma
• Step 2 in asthma is IV MgSO4, but in COPD = IV amoxicillin
• Step 4 in asthma = ITU and intubation, in COPD = BiPAP non-invasive ventilation

Question 20

What has extrinsic allergic alveolitis recently been renamed as?

Answer 20

Hypersensitivity pneumonitis

Question 21

Recall 2 drugs associated with ILD

Answer 21

Methotrexate

Amiodarone

Question 22

What would be seen on general inspection in ILD?

Answer 22

Clubbing

Question 23

What would be heard on auscultation of the lungs in ILD?

Answer 23

Bi-basal, fine inspiratory crepitations

Question 24

In what sort of lung disease might ground-glass opacification be seen on CT?

Answer 24

ILD

Question 25

What would lung function tests reveal in ILD?

Answer 25

An obstructive pattern to results

Question 26

To which group of diseases does asbestosis belong?

Answer 26

Pneumoconiasis

Question 27

What respiratory disease do people who keep pigeons tend to get?

Answer 27

Hypersensitivity pneumonitis

Question 28

What is the definition of apnoea?

Answer 28

Cessation of airflow for >10s