resp

Question 1

most common pneumonia in alcoholics?

Answer 1

klebsiella pneumoniae

Question 2

previous influenza predisposes you to which organism of pneumonia?

Answer 2

staph aureus

Question 3

CAP causative organisms:

Answer 3

1. Streptococcus pneumoniae (accounts for around 80% of cases)
2. Haemophilus influenzae
3. Staphylococcus aureus: commonly after influenza infection
4. atypical pneumonias (e.g. Due to Mycoplasma pneumoniae)
5. viruses

Question 4

COPD management

Answer 4

Question 5

COPD mgt if asthma features:

Answer 5

1. SABA/ SAMA
2. add ICS +LABA
3. PRN SABA
   + regular LABA+ LAMA+ ICS

Question 6

COPD MGT if no asthmatic features

Answer 6

1. SABA/ SAMA
2. PRN SABA
   regular LABA+ LAMA
3. regular LABA + LAMA +ICS

Question 7

silicosis features on CXR

Answer 7

• upper zone fibrosis
• “egg shell calcification” of hilar lymph nodes

Question 8

occupations at risk of silicosis (4)

Answer 8

mining
slate workers
foundries (metal casting/ moulding)
potteries

Question 9

sarcoidosis skin signs (3)

Answer 9

painful shin rash (pretibial nodules)
erythema nodosum
lupus pernio

Question 10

sarcoidosis eye sx:

Answer 10

uveitis

Question 11

sarcoidosis electrolyte derangement:

Answer 11

hypercalcaemia

macrophages inside the granulomas cause an increased conversion of vitamin D to its active form (1,25-dihydroxycholecalciferol)

Question 12

sarcoidosis presentation
i. acute (4)

Answer 12

erythema nodosum
bilateral hilar lymphadenopathy
swinging fever
polyarthralgia

Question 13

sarcoidosis presentation
ii. insidious (4)

Answer 13

dyspnoea
non-productive cough
malaise
weight loss

Question 14

obstructive lung disease spirometry findings:

Answer 14

FEV1 - reduced
FVC - reduced or normal

FEV1/ FVC - reduced

Question 15

obstructive lung diseases (5)

Answer 15

asthma
COPD
bronchiectasis
bronchiolitis obliterans
alpha-1 antitripsin deficiency (emphysema)

Question 16

restrictive lung disease spirometry findings:

Answer 16

FEV1 - reduced
FVC - significantly reduced

FEV1/FVC - normal/ increased

Question 17

restrictive lung diseases (7)

Answer 17

Pulmonary fibrosis
Asbestosis
Sarcoidosis
Acute respiratory distress syndrome
Infant respiratory distress syndrome
Kyphoscoliosis e.g. ankylosing spondylitis
Neuromuscular disorders
Severe obesity

Question 18

features of klebsiella pneumonia (3)

Answer 18

• hx aspiration
• “red currant jelly” sputum
• often affects upper lobes

Question 19

which patient groups are at higher risk of klebsiella pneumonia (2)

Answer 19

diabetics
alcoholics

Question 20

antibiotic of choice for prevention of IECOPD

Answer 20

azithromycin

Question 21

CURB 65

Answer 21

Confusion
Urea >7
RR >30
BP <90/60
age >65

Question 22

bupropion

i. what is it used for?
ii. which patient group should it be avoided in?

Answer 22

i. smoking cessation
ii. epileptics (reduced seizure threshold

Question 23

CXR findings in heart failure:

Answer 23

A alveolar oedema
B Kerley B lines
C cardiomegaly
D dilated prominent upper lobe vessels
E pleural effusions

Question 24

asthma mgt in adults

Answer 24

1. SABA
2. SABA + ICS
3. SABA + ICS + LTRA
4. SABA + ICS + LABA (+/- LTRA

Question 25

SABA examples

Answer 25

salbutamol terbutaline albuterol lavabuterol

Question 26

ICS examples

Answer 26

budesonide beclometasone fluticasone

Question 27

LTRA example

Answer 27

montelukast

Question 28

LABA examples

Answer 28

formoterol mometasone salmeterol

Question 29

LAMA examples

Answer 29

Incruse (umeclidinium) Seebri (glycopyrrolate) Spiriva (tiotropium) Tudorza (aclidinium)

Question 30

SAMA examples

Answer 30

ipratropium

Question 31

causes of upper lobe fibrosis

Answer 31

CHARTS Coal miners' pneumocionosis Histocytosis Ankylosing spondylitis Radiation TB Sarcoid/ silicosis

Question 32

causes of lower zone fibrosis (2)

Answer 32

asbestos idiopathic