RESP

Question 1

Abx for non-severe bronchiectasis exacerbation - known to be colonised with pseudomonas.

Answer 1

Amoxicillin 1g Q8H

Doxycycline 100mg Q12H

Question 2

Abx for severe bronchiectasis exacerbation - known pseudomonas colonisation

Answer 2

Ceftazidime 2g Q8H
Piptaz 4.5 Q6H
PLUS
Gentamicin/Tobramycin
OR
Ciprofloxacin

Question 3

What are other names for hypersensitivity pneumonitis?

Answer 3

Extrinsic allergic alveolitis

• caused by immunological reaction to an inhaled agent
• presents with fevers, chills, malaise, cough and SOB
• need to consider in context of occupational exposure

Farmer’s lung
Bird/fancier’s lung

Question 4

Interstitial lung disease

Answer 4

• symptoms: progressive SOB, exercise tolerance and dry cough
  sighs: fine creps, evidence of pulmonary hypertension and RHF
• oxygen desaturation may occur with exertion
• IX: CXR, HRCT, connective tissue serology (ANA, ENA, RF, myositis Abx, ANCA)

Question 5

Classification of ILD

Answer 5

ILD of known association: CT disease, drugs, occupational
Granulomatous ILD: sarcoidosis, hypersensitive pneumonitis
Idiopathic (IIP): IPF, non specific IPF, crytogenic organising pneumonia (BOOP), acute interstitial pneumonia
Miscellaneous ILD: LAM and histocytosis X

Question 6

Idiopathic pulmonary fibrosis`

Answer 6

• often seen > 60, male and assoc with smoking
• may seen finger clubbing
• poor prognosis with 2-3 median survival from diagnosis

Question 7

Cryptogenic organising pneumonia

Answer 7

• may present similarly to CAP
• associated with malaise, fevers and cough
• good prognosis with rx of corticosteroids

Question 8

Management of interstitial lung disease

Answer 8

• smoking cessations
• antifibrotic agents: nintedanid and pirfenidone
• lung transplant

Question 9

Empirical therapy for CAP

Answer 9

Mild - amoxicillin 1g Q8H, doxy 100mg BD if suspect atypical
Mod - benzypenicillin 1.2g Q6H + doxycycline 100mg BD
Severe - ceftriaxone 2g and azithromycin 500mg

Question 10

Pertussis Abx

Answer 10

Azithromycin 500mg on the first day followed by 250mg for a further four days