General

Question 0

Most common causes for common cold

Answer 0

Rhinovirus Coronavirus RSV Influenza HMPV …

Question 1

Increased incidence of colds

Answer 1

Mannose binding lectin deficiency

Question 2

False negative sweat chloride

Answer 2

Malnutrition Edema Insufficient sweat Hyponatremia CFTR mutation but normal sweat

Question 3

OSA symptoms

Answer 3

Morning headache FTT Pulmonary HTN Neurocognitive effect Growth Obesity/HTN Fatigue Apnea-hypopnea index=if under 12 > 1.5 per hour, if greater than 12 > 5 per hour

Question 4

Pneumothorax causes

Answer 4

Primary- idiopathic sub pleural bleb, marfan, erlers danlos Secondary-CF, pneumonia, asthma, malignancy Ecstasy

Question 5

Anterior mediastinal mass

Answer 5

5 t s Teratoma Thymoma Terrible lymphoma Thymus Thyroid T cell leukaemia Cystic hygroma Intrathoracic goiter

Question 6

Posterior mediastinum mass

Answer 6

Neurogenic tumours Neurofibroma

Question 8

Penicillin allergic pneumonia treatment

Answer 8

Azithromycin Clarithromycin

Question 9

what is pulsus paradoxus? and when does it occur?

Answer 9

> 10 mmgh - large decrease in systolic blood pressure and pulse wave amplitude during inspiration. Cardiac tamponade, severe dyspnea, obesity, and positive pressure ventilator support, constrictive pericarditis, tension pneumo, large PE

Question 10

what PFT features will be affected in restrictive lung disease

Answer 10

decreased TLC, VC and resting lung volume

Question 11

what PFT features will be affected in OBSTRUCTIVE lung disease

Answer 11

decreased peak exp flow and FEV1

Question 12

what are the bad bugs for CF?

Answer 12

staph aureus H.Flu Pseudomonas aeroginosas Burhoderia cepacia Stenotrophomonas Maltophilia Aspergillus

Question 13

what are the genetics of CF

Answer 13

AR in CFTR gene on long arm of Chrom 7 3 base pair deletion Delta 508 - 70%

Question 14

which CF bugs are associated with worst outcome

Answer 14

Pseudomonas Burkoderia cepacia

Question 15

what autoimmune disorders can present with hemoptysis?

Answer 15

HSP idiopathic pulmonary hemosiderosis Goodpasture’s Wegener’s SLE polyarteritis nodosa

Question 16

causes of cough in first month of life

Answer 16

CRADLE CF Resp infection-viral Aspiration - swallowing issues, GERD, TEF, FB Dyskenisia - ciliary Lung and airway malformation - laryngeal web, malacia, Edema - cardiac

Question 17

what causes exudative pleural effusion

Answer 17

All high! prot, sp gravity… pneumonia TB Malignancy SLE Chylothorax

Question 18

what causes transudate pleural effusions

Answer 18

CHF hypoproteinemia state cirrhosis upper airway obstruction

Question 19

what is Kartagener Syndrome

Answer 19

Version of primary ciliary dyskinesia situs inversus chronic sinusitis bronchiectasis

Question 20

which is more specific - intradermal skin test for allergies or Prick skin test

Answer 20

prick skin test

Question 21

which is more sensitive - in vitro testing for allergies or skin testing?

Answer 21

Skin Testing!

Question 23

Allergic Bronchopulmonary Aspergillosis

What are the clinical features?

Answer 23

hypersensitivity reaction to Aspergillus in CF

leads to inflammation and obstruction

Rx: steroids and antifungal (Voriconazole)

Question 24

What are causes of restrictive lung disease?

Answer 24

they have decreased lung compliance

• neuromuscular weakness
• alveolar filling process: lobar pneumonia, pulm edema
• pleural disease
• thoracic narrowing - scoliosis
• abdo distention

Question 25

what are causes of Chronic Cough

Answer 25

1. asthma 2. post nasal drip 3. post infectious tussive syndrome 4. GERD 5. tracheoesophageal fistula 6. tracheomalacia 7. chronic infection 8. FB 9. psychogenic 10. environmental

Question 26

patients with congenital central alveolar hypoventilation syndrome have a increased risk of..

Answer 26

Hirschsrpung and neural crest tumors defect in PHOX2B

Question 27

what are secondary causes of central hypoventilation

Answer 27

1. narcotics 2. Chiari malformation 3. inc ICP 4. CNS tumour 5. mitochondrial/metabolic disorder 6. dysautonomia

Question 28

what syndrome is associated with choanal atresia

Answer 28

10-20% with Choanal atresia have CHARGE syndrome Coloboma, Heart disease, Atresia choanae, Retarded growth(development, CNS anomalies or Genital anomalies or hypogonadism or both, and Ear anomalies or deafness or both

Question 29

what are causes of vocal cord paralysis?

Answer 29

1. left recurrent laryngeal nerve is more susceptible 2. trauma - thoracic procedure 3. mediastinal lesion 4. Central - chiari malformation, hydrocephalus, intracranial hemorrhage

Question 30

how does vocal cord paralysis present?

Answer 30

biphasic stridor weak cry hoarsness aphonia inc risk of aspiration should improve in 3-6 mo, likely permanent after 1 year

Question 31

what is the most common cause of tracheal compression

Answer 31

anomalous innominate artery-arises more distally than normal from aortic arch

Question 32

when is a cough deemed chronic?

Answer 32

\> 4-8 weeks

Question 33

What are CXR findings suggestive of foreign body aspiration

Answer 33

1. localized emphysema 2. pneumonia 3. atelectasis 4. normal

Question 34

what electrolyte abnormality would you expect with CF

Answer 34

hyponatremic hypochloremic metabolic alkalosis

Question 35

what % of CF can be missed with the newborn screen?

Answer 35

5%

Question 36

what are prognostic factors for CF?

Answer 36

MAles do better FEV1 Burkohderia Cepacia pneumotorax nutrition status DM

Question 37

if a patient comes to you with year round wet cough and nasal congestion, recurrent AOM. What should you think of?

Answer 37

primary ciliary dyskinesia Hx of neonatal resp distress and 47% have laterality defects Dx on electron microscopy

Question 38

if a patient has recurrent aspiration pneumonias, what is in your DDX

Answer 38

1. laryngeal cleft - VACTRL, CHARGE, midline defects 2. H type fistula - gold standard is rigid brnch

Question 39

what are features of psychogenic cough

Answer 39

honking disapears at night no other features worse with stress can last months to years all investigations are normal

Question 40

what are 3 important investigatons to do for chronic wet cough?

Answer 40

CXR PFT and bronchodilator response Sweat test

Question 41

for CF with resp exacerbation. What Abx choice?

Answer 41

cetfatzidine + Tobramycin for pseudomonas + Staf aureus coverage