RESP

Question 1

Stony dull to percuss

Answer 1

Pleural Effusion

Question 2

Right sided pleuritic chest pain

Answer 2

most likely pneumonia

Question 3

Ground-glass appearance on X-ray

Answer 3

Pulmonary fibrosis and Respiratory Distress Syndrome of the newborn

Question 4

Ziehl-Neelsen stain positive for acid fast bacilli

Answer 4

TB

Question 5

Caseous necrosis

Answer 5

TB

Question 6

Positive anti-glomerular basement membrane antibodies

Answer 6

Goodpasture’s syndrome

Question 7

Chest infection with a parrot/pigeon as pet

Answer 7

caused by chlamydophila psittaci

Question 8

Dry cough and diarrhoea after holiday abroad, some indication of water spread

Answer 8

Legionella pneumophila (test urine for antigens) - hyponatraemia

Question 9

“Tall, thin young man who indulges in marijuana”

Answer 9

probably pneumothorax (Marfan’s)

Question 10

Bilateral hilar lymphadenopathy, erythema nodosum, granulomas, fatigue, uveitis and weight loss

Answer 10

Sarcoidosis

Question 11

Bronchiole wider than neighbouring arteriole (on CT) (signet ring sign)

Answer 11

Bronchiectasis

Question 12

“D sign on X ray”

Answer 12

Empyema

Question 13

Child with barking cough

Answer 13

croup

Question 14

Pneumocystis pneumonia

Answer 14

HIV (treat with Co-trimoxazole [± prednisolone if severe])

Question 15

Alcoholic (danger of aspiration pneumonia)

Answer 15

Klebsiella pneumoniae

Question 16

Red Jelly sputum

Answer 16

Klebsiella pneumoniae

Question 17

Rusty sputum

Answer 17

s. Pneumococcal pneumonia

Question 18

ACTH secreting lung tumour

Answer 18

Small cell carcinoma of the lung

Question 19

PTHrP secreting lung tumour

Answer 19

Squamous cell ca. of lung

Question 20

Small-cell carcinoma

Answer 20

neuroendocrine, highly malignant, and may be associated with ectopic endocrine syndromes, worst prognosis

Question 21

Increased serum ACE and Ca2+

Answer 21

sarcoidosis

Question 22

Eggshell calcification at hilar region

Answer 22

Silicosis left

Question 23

Assmann Focus

Answer 23

Apical lesion of secondary tuberculous infection

Question 24

Ghon Focus

Answer 24

An area of infection and caseous necrosis at the periphery of the lung, beneath the pleura - found in tuberculosis infection.

Question 25

Horner’s Syndrome

Answer 25

Can occur when there is a local spread of cancer to the intrathoracic nodes or a Pancoast’s tumour. Signs include: ptosis (drooping of the eyelid), enophthalmos (sunken eye), miosis (small pupil), and lack of sweating on the ipsilateral (same side as invasion) side of the face. This is due to invasion, of the cervical sympathetic chain

Question 26

OSHIT MAN

Answer 26

Acute management of Asthma       **O**xygen 100% througH a non-rebreather mask         **S**albutamol (5mg) Nebulised back-to-back.           **H**ydrocortisone (100mg) IV or Prednisolone(40mg) PO         **I**pratropium Bromide (0.5mg) Nebulised hourly           **T**heophylline IV or aminophylline IV           Magnesium and call an       Anaesthetist

Question 27

iSOAP

Answer 27

4. Management of infective exacerbation of COPD i - ipratropium S - Salbutamol O - Oxygen A - amoxicillin P - prednisolone

Question 28

Honeycomb lung

Answer 28

fibrosing

Question 29

Small PE

Answer 29

DOAC or LMWH WITH Warfrin

Question 30

Large PE:

Answer 30

thrombolysis

Question 31

Low d-dimers

Answer 31

EXCLUDES PE

Question 32

CENTRAL TUMOUR

Answer 32

Squamous + Small-cell Lung cancers

Question 33

PERIPHERAL TUMOUR

Answer 33

Non-smoker + lung cancer

Question 34

High d-dimers

Answer 34

suspect (but not diagnose) Pulmonary Embolism (send for CTPA or V/Q scan)