Resp 3

Question 1

What are the 5 main conditions that present with cough?

Answer 1

Pneumonia

TB

Bronchiestasis

Lung Cancer

Mesothelioma

Question 2

What are the causes of an Acute Dry Cough?

Answer 2

Asthma

Drugs (ACE Inhibitor)

Heart Failure

URTI

Question 3

What are the causes of an Acute Productive Cough?

Answer 3

Pneumonia

TB

Question 4

What are the causes of a Chronic Dry Cough?

Answer 4

Asthma

Lung Cancer

GORD

Mesothelioma

Question 5

What are the causes of a Chronic Productive Cough?

Answer 5

COPD

Bronchiestasis

Lung Cancer

Cystic Fibrosis

Question 6

What are the main causative organisms of Community-Acquired Pneumonia?

Answer 6

Streptococcus pneumoniae

Haemophilus influenzae B

Moraxella catarrhalis

Question 7

What are the main causative organisms of Atypical Pneumonia?

Answer 7

Mycoplasma pneumonia (Transverse myelitis)

Legionella pneumophilia (Air Conditioning)

Chlamydia psittaci (Pet birds)

Chlamydia pneumoniae

Question 8

What are the main causative organisms of Hospital Acquired Pneumonia?

Answer 8

Staph aureus (cavitating lesions)

Pseudomonas aeruginosa

Klebsiella (cavitating lesions)

Question 9

How does typical pneumonia present?

Answer 9

Fever

SOB

Cough

Chest Pain (Pleuritic)

Confusion

Question 10

How does Atypical Pneumonia present?

Answer 10

Dry Cough

Headache

Diarrhoea

Mylalgia

Hepatitis

Question 11

What might you observe on Auscultation of a patient with Pneumonia?

Answer 11

Coarse Bibasal Crackles

Bronchial Breathing

Increased Vocal Resonance

Question 12

How would you investigate a possible case of Pneumonia?

Answer 12

FBC, CRP, ABG, Blood Cultures

Sputum MCS

Pleural Fluid MCS (Thoracentesis)

CXR

Question 13

How might you investigate Atypical Pneumonia?

Answer 13

Serology

Urinary Antigens (Legionella, Strep)

Blood Film (Mycoplasma)

LFTs (Legionella)

Question 14

How do Lobar/Bronchopneumonia differ on CXR?

Answer 14

Lobar - Single patch of consolidation

Broncho - Patchy consolidation

Question 15

How would you assess the severity of Pneumonia?

Answer 15

CURB-65

Question 16

How would you manage someone with Pneumonia?

Answer 16

Oxygen

IV Fluids

CPAP

Surgical Drainage

Antibiotics when stabilised

Question 17

Which antibiotics would you use to treat the CAP?

Answer 17

Amoxicillin (+co-amoxiclav if severe)

Question 18

How do you treat Atypical Pneumonia?

Answer 18

Clarithromycin

Question 19

How would you treat Staph-caused HAP?

Answer 19

Flucloxacillin + Gentamycin

Question 20

How would you treat MRSA?

Answer 20

Vancomycin

Question 21

What is Aspiration Pneumonia and how do you treat it?

Answer 21

Pneumonia caused by Anaerobes from Gut Flora

Metronidazole

Question 22

What are the main complications associated with Pneumonia?

Answer 22

Pleural Effusion

Pneumothorax

Lung Abscesses

Empyema

Sepsis

Question 23

What symptoms are classically associated with Lung Abscesses?

Answer 23

Swinging Fevers

Persistent Pneumonia

Foul-Smelling Sputum

Question 24

How does TB typically present?

Answer 24

Hx of Travel to TB-Region

FLAWS

Cough w/ green sputum

Haemoptysis

Lymphadenopathy

Question 25

What is Miliary TB?

Answer 25

Lymphohaematogenous Dissemination of TB

Question 26

What complications can TB cause?

Answer 26

Meningitis Pleural Effusion Pott's Disease (TB of the Spinal Cord) Epididymo-orchitis Addison's Disease Erythema Nodosum

Question 27

How would you investigate a possible case of TB?

Answer 27

Sputum MCS - Ziehl-Neelsen Stain for acid-fast bacilli CXR Lymph Node Biopsy Mantoux Test (Cannot distinguish between latent and active TB)

Question 28

What is Bronchiectasis?

Answer 28

Chronic Dilation of the airways alongside increased mucous production

Question 29

What are the causes of Bronchiectasis?

Answer 29

Cystic Fibrosis Primary Ciliary Dyskinesia (Kartagener's) Young's Syndrome

Question 30

What is the Triad of Young's Syndrome?

Answer 30

Bronchiectasis Sinusitis Infertility

Question 31

What is the classical triad of Kartagener's Syndrome?

Answer 31

Primary Ciliary Dyskinesia Sinusitis Situs Inversus

Question 32

How does bronchiecstasis present?

Answer 32

Chronic Cough Haemoptysis SOB Chest Pain Fever Weight Loss

Question 33

What are the signs of Bronchectasis?

Answer 33

Clubbing Bibasal Crackles

Question 34

What are the main causes of Bibasal Crackles?

Answer 34

Pulmonary Oedema Pneumonia Bronchiectasis Interstitial Pulmonary Fibrosis

Question 35

How would you diagnose Bronchectasis?

Answer 35

Recurrent Chest Infections HR-CT (Signet Ring Sign)

Question 36

How do you manage Bronchiectasis?

Answer 36

**_Conservative:_** Exercise, Good Diet, Good Hydration **_Drugs:_** Salbutamol, ABx (Prophylactic), Vaccinations

Question 37

What is the relative frequency of the different types of Lung Cancers?

Answer 37

Small Cell (15%) Non-Small cell (85%): - Adeno - Squamous Cell - Large Cell

Question 38

What are the typical presenting symptoms of Lung Cancer?

Answer 38

Cough FLAWS Horner's Syndrome (Apical Tumour) SVC Obstruction Remember SIADH

Question 39

Where does Lung Cancer typically metastasise?

Answer 39

Bone Brain Liver Lymphadenopathy

Question 40

How would you investigate Lung Cancer?

Answer 40

CXR Sputum Cytology Bronchoscopy & Biopsy Ca, ALP, LFT - Check for Mets CT, PET, MRI (Staging)

Question 41

What would you observe on the CXR of someone with primary Lung Cancer?

Answer 41

Consolidation Bi-Hilar Lymphadenopathy Upper Lobe Scarring Cavitating Lesions Pleural Effusions

Question 42

What is Mesothelioma?

Answer 42

Malignant neoplasm of mesothelial cells of the pleura. Exposure to Asbestos

Question 43

How does Mesothelioma typically present?

Answer 43

Dry Cough SOB FLAWS Pleural Friction Rub

Question 44

How would you investigate a suspected Mesothelioma?

Answer 44

CXR CT Chest Pleural Fluid Cytology