Resp

Question 1

Most common cause of occupational asthma

Answer 1

isocyanates (spray paint)

Question 2

upper lobe fibrosis

Answer 2

CHARTS
C - Coal worker’s pneumoconiosis
H - Histiocytosis/ hypersensitivity pneumonitis
A - Ankylosing spondylitis
R - Radiation
T - Tuberculosis
S - Silicosis/sarcoidosis

Question 3

causes of exudative pleural effusion

Answer 3

1. Malignany
2. Emphyema (low pleural glucose conc + pleural fluid <7.3)

Question 4

what can cause a false negative manatoux test

Answer 4

sarcoidosis

Question 5

upper zone fibrosis, egg-shell calcification of hilar nodes

Answer 5

silicosis

Question 6

klebsiella symptoms

Answer 6

red current jelly sputum
alcoholics
Lead to pleural emphyema

Question 7

contraindication to lung cancer surgery

Answer 7

superior vena cava obstruction
vocal cord paralysis

Question 8

what drug class is ipatropium bromide

Answer 8

SAMA

Question 9

Example of a LABA

Answer 9

salmetrolol

Question 10

Example of a LAMA

Answer 10

Tiotropium

Question 11

cause of coarse crackers

Answer 11

fluid in lungs

Question 12

idiopathic pulmonary fibrosis what is heard

Answer 12

fine end inspiratory crepitations

Question 13

cavitating lesions what cancer

Answer 13

squamous cell

Question 14

what is used to guide antibiotic treatment in acute bronchitis

Answer 14

CRP >100 immediate
(doxycycline/amoxicillin)

Question 15

pleural fluid protein >30

Answer 15

exudative

Question 16

COPD prophylaxis

Answer 16

azithromycin

Question 17

Diagnosis of mesothelioma

Answer 17

thoracoscopy and histology

Question 18

high risk pneumothorax treatment

Answer 18

straight to chest drain

Question 19

What is meigs syndrome

Answer 19

fibroma
ascites
pleural effusion

Question 20

What is the triangle of safety

Answer 20

base of the axilla, lateral edge pectoralis major, 5th intercostal space and the anterior border of latissimus dorsi

Question 21

When do you have to do abg

Answer 21

oxygen sats <92%

Question 22

what is lupus pernio associated with

Answer 22

sarcoidosis

Question 23

what is sued to prevent recurrence of pneumothorax

Answer 23

Video assisted thoracoscopic surgery (VATS) pleurodesis
61%

Question 24

Over rapid aspiration/drainage of pneumothorax can result in

Answer 24

pulmonary oedema

Question 25

what must be done before starting TNF-inhibitors?

Answer 25

chest x ray to look for TB

Question 26

indication for thrombolysis in PE

Answer 26

massive PE + hypotension

Question 27

most common cause of IE with strep viridians

Answer 27

poor dental hygience

Question 28

why do you get hypercalcaemia in sarcoidosis

Answer 28

increased conversion of vitamin D to its active form

Question 29

treatment of Allergic bronchopulmonary aspergillosis

Answer 29

pred and itraconazole

Question 30

what does A1TP do

Answer 30

protect against neutrophil elastase which causes breakdown of alveoli

Question 31

lights criteria for exudative

Answer 31

pleural fluid protein divided by serum protein >0.5 pleural fluid LDH divided by serum LDH >0.6

Question 32

CAP treatment

Answer 32

amoxicillin TDS 500mg

Question 33

Adult acute asthma management

Answer 33

1. Oxygen 2. Oxygen driven nebulised salbutamol 5mg 3. Steroids: pred 40mg or IV hydrocortisone 20mg 4. Neb ipratropium bromide

Question 34

What immediate investigations would you do in an asthma attack

Answer 34

Current Peak Flow: Expected - *>75% mild, 50-75% moderate, <33% life threatening SpO2 - hypoxia ABG - hypoxia, normo/hyper capnia & uncomplicated acidosis CXR - ?infection

Question 35

Important investigations following pleural tap

Answer 35

1. LDH and Protein in Pleural Fluid/Serum → determine whether effusion is exudate or transudate 2. Effusion Cytology → to investigate possible concerns of malignancy 3. Glucose or pH of Effusion → investigate possible malignancy (both should be low)

Question 36

What is seen on chest x-ray with pleural effusion

Answer 36

Blunting of costophrenic angles Opaque consolidation in right hemithorax & concave meniscus sign

Question 37

In considering the patient for a chest drain insertion, you wish to avoid the costal blood vessels. Where are these located and how can they be avoided?

Answer 37

Location → costal grooves on the inferior surface of the ribs How to Avoid → insert the chest drain directly above the rib (4-6th on mid-axillary line) aiming inferiorly

Question 38

what will CTPA show with PE

Answer 38

occlusion of pulmonary vasculature +/- distally threadlike vessels

Question 39

cause of pneumonia in bird owners

Answer 39

Chlamydia psittaci

Question 40

what eye condition does ethambutol cause

Answer 40

optic neuritis

Question 41

criteria for discharge following asthma attack

Answer 41

been stable on their discharge medication (i.e. no nebulisers or oxygen) for 12-24 hours inhaler technique checked and recorded PEF >75% of best or predicted

Question 42

A 33-year-old man who is known to be HIV positive presents with cough and dyspnoea. Auscultation of his chest is unremarkable but he is noted to desaturate on exertion.

Answer 42

pneumocytosis jiroveci

Question 43

which TB drug causes INR to go up vs down

Answer 43

down: rifampicin (inducers) Up: isoniazid (inhibitors)

Question 44

which pneumonia organism cause positive cold agglutination test → peripheral blood smear may show red blood cell agglutination

Answer 44

mycoplasma

Question 45

common complication of PJP

Answer 45

pneumothorax

Question 46

LTOT requirements

Answer 46

Offer LTOT to patients with a pO2 of < 7.3 kPa or to those with a pO2 of 7.3 - 8 kPa and one of the following: secondary polycythaemia peripheral oedema pulmonary hypertension

Question 47

A small (1-2cm) calcified nodule is visible in the lateral area of the right mid zone

Answer 47

ghon focus - latent TB

Question 48

malignancy associated with asbestos

Answer 48

bronchogenic carcinoma.

Question 49

which side is aspiration pneumonia more common in

Answer 49

right

Question 50

how many lobes does right lung have

Answer 50

3