RESP

Question 1

Ix of pneumonia

Answer 1

a-e assessment 
obs 
sputum MCS
urinary antigens
FBC- WCC
U&E
CRP
ESR
LFTS
ABG 
BLOOD culture 
image- CXR
pleural fluid MCS

Question 2

ix for mycoplasma pneumonia

Answer 2

PCR

Question 3

legionella ix?

Answer 3

urinary antigens

Question 4

blood film ix for pneumonia ?

Answer 4

blood film - cold agglutyins

Question 5

crub65 score of 3?

Answer 5

icu admission

Question 6

curb65 score of 2

Answer 6

admit to hospital

Question 7

pneumonia Mx

Answer 7

amoxicillin
clarithromycin - atypical cover
doxycycyline - if allergic to penicillin

Question 8

if curb65 3

mx?

Answer 8

IV co amoxiclav

clarithromycin

Question 9

pneumonia and pregnant
CAP
mx?

Answer 9

erythromycin

Question 10

HAP- staph aureus confirmed

Answer 10

flucloxacillin

Question 11

PCP confirmed pneumonia mx?

Answer 11

co-trimoxazole

Question 12

anerobes from gut flora pneumonia

Answer 12

amoxicillin and metronidazole

Question 13

1st line HAP

mx?

Answer 13

co amoxiclav

Question 14

MRSA pneumonia mx?

Answer 14

IV vancomycin

Question 15

pseudomonas mx?

Answer 15

iv tazocin and gent

Question 16

bronchiectasis IX

Answer 16

sputum MCS- haemophilus
\FBC
ue
crp
LFTs
ABG
culture 
xray 
HRCT

Question 17

What is gold standard Ix for bronchiectasis

Answer 17

High resolution

CT

Question 18

xray finding of bronchiectasis

Answer 18

tram tracking

Question 19

bronchiectasis HRCT

Answer 19

signet ring sign

Question 20

bronchiectasis Mx

gold standard conservative

Answer 20

airway clearance - chest physio

Question 21

bronchiectasis vaccines?

Answer 21

one of pneumococcal seasonal influenza

Question 22

bronchiectasis oral abx for pseudomonas exarcebation

Answer 22

ciprofloxacin

Question 23

Tb bedside investigation

Answer 23

sputum MCS x3 early morning
acid fast bacilli stain - zieiel neelson -
takes 6-8 weeks to culture

Question 24

TB imaging

Answer 24

CXR- bilateral bi hilar lympahdenopthy

caseating granulomas on lymph node biopsy

Question 25

non caseating granuloma on CXR

Answer 25

sarcoidosis | crohns

Question 26

latent tb test?

Answer 26

mantoux / tuberculin skin interferon gamma relase assay if + > cxr

Question 27

lung cancer Ix

Answer 27

``` sputum cytology fbc ca2 alp - bone mets lfts - liver mets ``` cxr ct chest abdo pelvis pet

Question 28

cavitaing lesion on CXR? | malignancy cause

Answer 28

SqCC

Question 29

secondary lung cancer on CXR?

Answer 29

canon ball mets

Question 30

SIADH ix results?

Answer 30

hyponatraemia - euvolemic from SCLC | urine osmolality high

Question 31

mesothelioma | ausculatation?

Answer 31

malignant neoplasm of mesothelial cells - asbestos | pleural friction rub

Question 32

xray mesothelioma

Answer 32

pleural thickening plaques pleural effusion

Question 33

gold standard for asthma investigation?

Answer 33

spirometry | FENO >40

Question 34

peak flow is useful investigation for what?

Answer 34

asthma

Question 35

ECG sign of PE

Answer 35

tachycardia RBBB s1q3t3

Question 36

cxr on PE

Answer 36

westermark sign

Question 37

gold standard for PE | and pregnant?

Answer 37

CTPA | V/Q perfusion screen

Question 38

Mx of a PE

Answer 38

respiratory support thrombolysis anticoagulate DOAC 3/6 months

Question 39

haemodynamically unstable PE

Answer 39

thrombolysis - alteplase, rtPA | thrombectomy

Question 40

primary pneumothorax sob and 0.8cm in size?

Answer 40

needle aspirate and give oxygen admit

Question 41

no sob | Pneumothorax 3cm in size

Answer 41

needle aspirate and admit

Question 42

1cm pneumothorax no sob

Answer 42

discharge | OPD review

Question 43

tension pneumothorax | mx

Answer 43

large bore cannula - 2nd ICS MCL | orange or grey cannula

Question 44

ARDS mx?

Answer 44

``` ICU referral ventilator support 12-24 hours trial aprv >6 dueresis if volume overload drainage of effusion ``` proning

Question 45

gold standard for pulmonary htn?

Answer 45

Right heart catheterisation

Question 46

pulmonary fibrosis Ix gold standard?

Answer 46

HRCT | spirometry

Question 47

cystic fibrosis Mx | when pancreatic insufficency has occured

Answer 47

creon

Question 48

mesothelioma management

Answer 48

Extrapleural pneumonectomy / Pleurectomy | Cisplatin / Pemetrexed

Question 49

acute management of asthma

Answer 49

1. Oxygen – target 94-98% 2. Salbutamol (SABA) Nebulised 3. Ipratropium Bromide 4. Hydrocortisone IV / Oral Prednisolone 5. Magnesium Sulfate IV 6. Aminophylline / IV Salbutamol (SABA)

Question 50

when can you be discharged from an acute asthma attack in hospital stay?

Answer 50

Can discharge if: a. Stable on discharge meds for 12-24hrs b. Inhaler technique checked and documented c. PEF >75% of best/predicted

Question 51

is bronchiectasis an obsturctive or restrictiive picture

Answer 51

obstructive

Question 52

mx of bronchiectasis

Answer 52

carbocysteine nebulsied isotonic/ hypertonic saline azithromycin >3 exarcebations

Question 53

Antifibrotic agents: | when indicated

Answer 53

pirfenidone or nintedanib – indicated if | FVC is 50% - 80%