resp

Question 1

Normal FEv1

Answer 1

> 80%

Question 2

risk factors for endometrial cancer

Answer 2

excess oestrogen eg nulliparity
PCOS
Tamoxifen
obesity
diabetes
HNPCC

Question 3

what cancer are psammoma bodies seen in and what are they

Answer 3

collections of calclium
seen in serous cystadenocarcinoma

Question 4

what conditions would cause a decrease in TLCO

Answer 4

pneumonia
pulmonary fibrosis
PE
Pulmonary oedema
emphysema
Anaemia

Question 5

prognostic indicator is melanoma

Answer 5

breslow thickness

Question 6

what O2 sats in asthma warrant an ABG

Answer 6

<92%

Question 7

what level of FEV1 would show bronchodilator reversibiltiy

Answer 7

12%

Question 8

treatment of hyponatraemia based on fluid status

Answer 8

hypovol - norm saline
euvol - fluid restrict
hypervol - fluid restrict 500-1L daily

Question 9

an FEv1/FVC ratio of what indicates obstructive lung disease

Answer 9

<0.7

Question 10

what antibiotics are given prophylactically in COPD and what tests need to be done ?

Answer 10

Azithromycin, LFT due to heaptic cholestatisi and U+E due to long QT

Question 11

What non pharmalogical management is offered to COPD patients

Answer 11

pulmonary rehab
smoking cessation
Annual flu
one of pneumococcal vaccine

Question 12

what is second line treatment for COPD

Answer 12

steroid if asthmatic features
SABA+ LABA+ICS
IF NOT
SABA+ LABA + LAMA

Question 13

what features suggest steroid responsiveness in COPD

Answer 13

prev diagnosis of asthma or atopy
eosionophilia
FEV1 variation >400ml
20% diurnial variation in peak flow

Question 14

first line antibiotics for infective exacerbation of COPD

Answer 14

Amox, clarithromycin or doxycyclin

Question 15

what does capnography monitor

Answer 15

end tidal co2

Question 16

what anaestheic agent doesnt casue a drop in Bp so good in trauma

Answer 16

Ketamine

Question 17

mangement of acute heart failure and hypotension

Answer 17

inotropic agents- dobutamin
noreadrenaline - if inotropes not work
mechanical assisstance - intra-aortic balloon

STOP BB

Question 18

what could cause an transudative thoracentesis

Answer 18

HF, , hypoalbineumia, atelectasis, hypo thyroid, meigs peritoneal dialysis

Question 19

what could cause an exudative thoracentesisi

Answer 19

malignancy, Infection, Infarct adn asbestos
pancreatitis, PE, connective tissue

Question 20

if lymphocytes are seen on cytology of pleural effusion what should be suspected

Answer 20

TB or malignancy

Question 21

first line treatment of acute bronchitis if requiring antibiotics

Answer 21

oral doxycyclin

Question 22

in a secondary pneumothorax <1cm how should it be mananged

Answer 22

admit and O2

Question 23

is alpha 1 antiprypsin obstructive or restrictive

Answer 23

obstructive

Question 24

Does ACEI cause hypo or hyperkalaemia
and how

Answer 24

hyper
block aldosterone - aldosterone casues reabsorptions of Na and water adn secretion of K

Question 25

in non smokers what type of lung cancer is most likely seen

Answer 25

adencarcinoma

Question 26

what antibiotics are used fro atypical pneumonias

Answer 26

macrolides and tetracycline eg doxy

Question 27

pleural effusion with low glucose is characteristic of

Answer 27

rheumatoid or Tb

Question 28

when is lights criteria used and what is it

Answer 28

used in Pleural Effusion to distinguish between exudate and transudate 1. pleural fluid protein divided by serum protein >0.5 2. pleural fluid LDH divided by serum LDH >0.6 3. pleural fluid LDH more than two-thirds the upper limits of normal serum LDH

Question 29

what is meigs syndrome and what type of pleural effusion woud it cause

Answer 29

transudative ovarian tumour causes ascites and pleural effusion

Question 30

what pH of pleural effusion would warrant chest tube

Answer 30

<7.2

Question 31

most common casue od exudative pleural effusion

Answer 31

pneumonia

Question 32

the pill: what cancer does it casue what cancer does it protect against

Answer 32

increased risk of breast and cervical cancer protective against ovarian and endometrial cance

Question 33

most common septci arthritis organism in young adults

Answer 33

neuserria gonorrhoea

Question 34

treatment of a 0-2 CURB65 score CAP

Answer 34

Amoxicillin 1g tds IV/PO (5 days)

Question 35

treatment of a 3-5 CURB65 score CAP

Answer 35

Co-amoxiclav IV 1.2g tds + Doxycycline PO 100mg bd

Question 36

up to what age can asthma be diagnosed without FeNO

Answer 36

up to 5 yrs then must get FeNO test

Question 37

diagnosis of asthma in 5-16 years

Answer 37

BDR test FeNO if norm spirometry or obstructive spiromtry with no BDR

Question 38

positive FeNO test results in children and adutls

Answer 38

adult - 40 parts per billion children 35 parts per billion

Question 39

what is used to measure COPD severity and what are the levels

Answer 39

FEV1 >80% = mild should have symps >50% = mod >30% - severe <30% - v severe

Question 40

if a COPD patient has severe COPD and >2 exacerbations in the last year and alreasy on triple therapy what shoudl be added

Answer 40

PDE-4 inhib roflumilast

Question 41

factors that improve survivial in COPS

Answer 41

smoking cessation long term o2 therapy lung redution surgery

Question 42

when is chest xray repeated in pneumonia

Answer 42

6 weeks

Question 43

paraneoplastic syndrome of small cell

Answer 43

ADH ACTH lambert eaton

Question 44

what blood abnormality may be seen in lung cancer

Answer 44

thrombocytosis (high platelets)

Question 45

features of legionella pneumonia and mycoplasma pneumoni

Answer 45

legionella - hyponatraemia and lymphopenia mycoplasma - dry cough AIHA+ erythema multiforme

Question 46

hypoxia and SOB post surgery diagnosis and treatment

Answer 46

atelectasis - sit upright and breathing exercises

Question 47

mangement of HAP and aspiration pneumonia compare to CAP

Answer 47

HAP = amox+gent for gram -ve cover Asp - amoz+met for anaerobe cover

Question 48

investigations for Goodpasteurs

Answer 48

renal biopsy - linear IgG Increase TCLO due to po haemorrhages

Question 49

mangement of goodpasteurs

Answer 49

plamaphoresis steroids cyclophosphamide

Question 50

type og collagen inolevd in anti-GMB

Answer 50

type 4

Question 51

investigation of PE in individual with renal impairement

Answer 51

V/Q scan

Question 52

what is dabigatran

Answer 52

direct thrombin inhibitor

Question 53

treatment of PE: - normally -severe renal impaire <15 - anti- phospholipid

Answer 53

norma - DOAC eg apixaban REnal -LMWH anti- LMWH followed by warfarin

Question 54

PE with hypotension treatment

Answer 54

thrombolyse

Question 55

treatent of antiphospholipid sydnrome

Answer 55

primary thromboprophylacis - aspirin secondary thromboprophylaxis - warfarin

Question 56

treatment for viraly induced episodic wheeze in kids

Answer 56

salbutamol first ntermittent leukotriene receptor antagonist(montelukast ) 2nd line