resp

Question 1

Ongoing dyspnoea post needle aspiration in context of pneumothorax?

Answer 1

Chest drain

Question 2

PIMS or PIZZ for genotype associated with AATD?

Answer 2

PIZZ

Question 3

Chronic sinusitis + nephritic syndrome?

Answer 3

Granulomatosis with polyangiitis

Question 4

Management of high altitude cerebral edema (HACE)?

Answer 4

Descent and dexamethasone

Question 5

Male subfertility, sinusitis, dextrocardia, bronchiectasis?

Answer 5

Kartagener’s syndrome

Question 6

Indications for corticosteroids in sarcoidosis?

Answer 6

Hypercalcaemia, uveitis, cardiac or neuro involvement, parenchymal lung disease

Question 7

Mechanism of Bupropion?

Answer 7

Norepinephrine-dopamine reuptake inhibitor and nicotinic antagonist

Question 8

Most useful marker for monitoring the progression of patients with chronic obstructive pulmonary disease (COPD)?

Answer 8

Forced expiratory volume in one second (FEV1)

Question 9

Good prognostic factors in sarcoidosis?

Answer 9

HLA B8 and Lofgren’s syndrome (bilateral hilar lymphadenopathy, erythema nodosum, polyarthritis and fever)

Question 10

First line investigation for asthma?

Answer 10

FBC

Question 11

Bronchiectasis - most common organism?

Answer 11

H Influenzae

Question 12

Benefit of steroids in COPD?

Answer 12

Reduces exacerbations

Question 13

Bilateral pulmonary infiltrates, raised eosinophils, asthmatic?

Answer 13

Allergic bronchopulmonary aspergillosis - Oral glucocorticoids

Question 14

Upper airway compression investigation?

Answer 14

Flow volume loop

Question 15

Varenicline mechanism?

Answer 15

Nicotinic receptor partial agonist

Question 16

Large right-sided pneumothorax measuring 4.4 cm? Patient is asymptomatic.

Answer 16

Minimally symptomatic pneumothorax, regardless of size, can be treated with conservative treatment / regular follow-up

Question 17

Coal, asbestos, arsenic, radon - which one is not a risk for developing lung ca?

Answer 17

Coal

Question 18

Cannot complete sentences in asthma - severe or life threatening?
Peak flow <30% best or predicted - severe or life threatening?

Answer 18

Severe and life threatening

Question 19

More wheezy and breathless than usual having stopped montelukast therapy 3 months ago?

Answer 19

Churg-Strauss syndrome

Question 20

Management of high altitude pulmonary oedema (HAPE)?

Answer 20

Descent and nifedipine

Question 21

Serial peak flow measurements at work and at home for which dx?

Answer 21

Occupational asthma

Question 22

Normal function of the cystic fibrosis transmembrane regulator? Which type of channel does this act on?

Answer 22

Chloride

Question 23

Risk of developing lung ca with asbestos and smoking exposure?

Answer 23

50 times - 10 (smoking) 5 (asbestos)

Question 24

Which one of the following is the main criteria for determining whether a patient with chronic obstructive pulmonary disease (COPD) should be offered long-term oxygen therapy?

Answer 24

LTOT if 2 measurements of pO2 < 7.3 kPa

Question 25

Settings on bi-level pressure support in COPD?

Answer 25

IPAP - 10 EPAP - 5

Question 26

Most common cause of occupational asthma?

Answer 26

Isocyanates

Question 27

Acute severe asthma attack first and second line?

Answer 27

IV MgSO4, aminophylline

Question 28

Presentation of dyspnoea and hypoxaemia 72 hours post operatively?

Answer 28

Basal atelectasis

Question 29

Patient presented with shortness of breath, cough, chest pain, and brown sputum on a background of recently brittle asthma? Raised IgE and eosinophils?

Answer 29

Allergic bronchopulmonary aspergillosis

Question 30

Cherry red lesion seen on bronchoscopy?

Answer 30

Lung carcinoid

Question 31

Before starting azithromycin what tests to be done and why?

Answer 31

ECG + baseline LFTs - rule out prolonged QT

Question 32

Sarcoidosis grading on CXR?

Answer 32

Sarcoidosis CXR 1 = BHL 2 = BHL + infiltrates 3 = infiltrates 4 = fibrosis

Question 33

Normal CO2 in asthma attack grading?

Answer 33

Life threatening

Question 34

Bronchiolitis obliterans associated with which chronic condition?

Answer 34

RA

Question 35

Light's criteria (25-35)

Answer 35

pleural fluid protein divided by serum protein >0.5 pleural fluid LDH divided by serum LDH >0.6 pleural fluid LDH more than two-thirds the upper limits of normal serum LDH

Question 36

Contraindications to lung ca surgery?

Answer 36

Malignant effusion, FEV < 1.5, SVC obstruction, vocal cord paralysis

Question 37

Vital capacity in males and females?

Answer 37

4,500ml in males, 3,500 mls in females

Question 38

ARDS criteria?

Answer 38

Berlin criteria: acute onset of hypoxaemia (pO2/FiO2 ratio less than 300 mmHg), bilateral infiltrates on chest X-ray (CXR), and non-cardiogenic origin of pulmonary oedema

Question 39

Cavitating lung lesion - infection?

Answer 39

Staph aureus, Klebsiella and Pseudomonas

Question 40

Pneumonia commonest in alcohol xs?

Answer 40

Klebsiella pneumonia

Question 41

COPD - still breathless despite using SABA/SAMA and no asthma/steroid responsive features?

Answer 41

LABA LAMA

Question 42

Reticular changes on CT imaging - worse at bases?

Answer 42

IPF

Question 43

Parotid swelling, fever and anterior uveitis?

Answer 43

Heerfordt syndrome

Question 44

Polycythaemia increases risk of?

Answer 44

Stroke

Question 45

Caution for Varenicline and Bupropion?

Answer 45

Self harm, epilepsy

Question 46

Eosinophils and fractional exhaled nitric oxide testing come back as normal? Next step in testing for asthma?

Answer 46

Measure peak expiratory flow (PEF) twice daily for 2 weeks/spirometry

Question 47

Asthma diagnosis?

Answer 47

FeNO > 40

Question 48

Presentation of chronic sinusitis unresponsive to antibiotics, nasal congestion, epistaxis, and a swollen nasal bridge, which strongly suggests involvement of the upper respiratory tract?

Answer 48

Gran with polyangiitis

Question 49

PFTs in obesity?

Answer 49

Reduced FEV1 and FVC with a normal FEV1/FVC ratio, and reduced expiratory reserve volume