Resp

Question 1

Asthma management cascade

Answer 1

check notes

Question 2

copd management cascade

Answer 2

check notes

Question 3

acute asthma management

Answer 3

Oxygen
Salbutamol 5mg NEB
Hydrocortisone 100mg Iv/Pred 40mg PO
Ipratropium 500mcg NEB

Magnesium sulphate 2g IV

Question 4

primary pneumothorax = < 2cm and asymptomatic

Answer 4

discharge

Question 5

primary pneumothorax = >2cm and symptomatic

Answer 5

admit for aspiration

if that fails chest drain

Question 6

secondary pneumothorax = 0-1cm and asymptomatic

Answer 6

oxygen and admit for 24 hours

Question 7

secondary pneumothorax = 1-2cm and asymptomatic

Answer 7

aspiration

Question 8

secondary pneumothorax = >2cm OR symptomatic

Answer 8

chest drain

Question 9

mx of tension pneumothorax

Answer 9

STAT Needle decompression, 2nd intercostal space, midclavicular line, then CXR, then chest drain

Question 10

level of carina

Answer 10

4th thoracic vertebra

Question 11

what are the borders of the chest drain site

Answer 11

lateral border of pectorals major

5th intercostal space

base of axilla

Lateral latissimus dorsi

Question 12

what is components of CURB 65

Answer 12

new confusion 
urea > 7
RR > 30
BP systolic < 90 or diastolic < 60
age 65 or over

Question 13

treatment of legionella pneumonia

Answer 13

levofloxacin 500mg bd for 10-14 days

OR

clarithromycin 500mg plus rifampicin 600mg bd for 10-21 days if allergic

Question 14

bacteria seen in immunocompromised and IVDU patients and Ix for it and specific Tx

Answer 14

pneumocystis jivovecii

ix = BAL

tx = co-trimoxazole

Question 15

Ix for legionella

Answer 15

urinary antigen

Question 16

bug that presents as atypical pneumonia and “4 year cycle” with erythema multiform - and Ix and Tx

Answer 16

mycoplasma

Ix = serology

Mx = clarithromycin

Question 17

bug associated with alcoholics, diabetics and “red jelly sputum” and specific tx

Answer 17

klebsiella

tx = cefotaxime

Question 18

bug associated with pneumonia post influenza A

Answer 18

staph aureus

Question 19

4 features of interstital lung disease

Answer 19

dru cough
sob
clubbing
diffuse inspiratory crackles

Question 20

what is seen on CT in ILD

Answer 20

ground glass opacification

Question 21

CXR suggestive of coal workers pneumoconiosis

Answer 21

small round opacities in upper zones

Question 22

what is the most dangerous types of asbestos

Answer 22

blue asbestos

Question 23

what is the long term management for a provoked PE

Answer 23

3 months of rivaroxiban

Question 24

what is the long term management for a unprovoked PE

Answer 24

6 months of rivaroxiban

consider Ix for malignancy

Question 25

suspect PE + hypotension = Mx?

Answer 25

thrombolyse >> alteplase

Question 26

blood gas seen in PE

Answer 26

respiratory alkalosis

Question 27

what is type 1 and type 2 resp failure

Answer 27

1 = hypoxia [with normal or low co2] 2 = hypoxia with hypercapnia

Question 28

treatment for CAP = CURB65 score 0-2

Answer 28

1st line = Amox 1g tds 5 days If pen allergic = Doxy PO 200mg day 1, 100mg od for 5 days If n-b-m = IV clarithromycin 5 days

Question 29

treatment for CAP = CURB65 score 3-5

Answer 29

1st line = IV Co-Amox + PO Doxy bd If pen allergic = IV Levofloxacin 500mg BD Step Down = PO Doxy BD if n-b-m or ICU/HDU = IV Co-Amox + IV clarithromycin Total = 7 days IV/PO

Question 30

treatment for HAP = non-severe

Answer 30

PO Amox if pen allergic = PO Doxy 100mg bd 5 days of Tx

Question 31

treatment for HAP = severe

Answer 31

IV amox + gent If pen allergic = IV Co-Trimox + Gent Step down = PO Co-trimox 7 days of Tx

Question 32

treatment for aspiration pneumonia = non-severe

Answer 32

PO Amox + Metronidazole If pen allergic = PO Doxy + Metronidazole 5 days treatment

Question 33

treatment for aspiration pneumonia = severe

Answer 33

Iv Amox + Met + Gent Step Down = PO Amox + Met If pen allergic = PO Doxy/IV clarithromycin + Met + Gent Step Down = PO Doxy + Met 7 days Tx

Question 34

cascade of Ix for PE

Answer 34

1st = CXR to exclude other pathology 2nd = WELLS Score If WELLS score > 4 = P.E. likely If WELLS score < 4 = P.E. unlikely 3rd = P.E. likely = CTPA if P.e. unlikely = D-Dimer 4th If D-Dimer positive = CTPA

Question 35

what should patients who cannot have a CTPA be scanned with

Answer 35

V/Q scan

Question 36

tx of PE

Answer 36

LMWH or fondaparinux immediately within 24 hours = warfarin [for 3 months]

Question 37

how long should LMWH/fondaparinux be continued in PE treatment

Answer 37

for 5 days or until INR 2 or above

Question 38

cascade of Ix for lung cancer

Answer 38

1st line = CXR 2nd line = CT with contrast 3rd line = Bronchoscopy 4th line = PET scan

Question 39

what lung cancer is most chemosensitive

Answer 39

SCLC

Question 40

mx of NSCLC

Answer 40

Stage I - II = surgery/curative radiotherapy | Stage III - IV = palliative radiotherapy +/- chemotherapy

Question 41

TB treatment plan

Answer 41

Initial phase = 2 months of RIPE Continuation phase = 4months of RI

Question 42

side effects of rifamipicin

Answer 42

hepatitis | orange sweat/tears/urine

Question 43

side effects of isoniazide

Answer 43

hepatitis agranulocytosis peripheral neuropathy

Question 44

side effects of pyrazinamide

Answer 44

gout arthralgia myalgia hepatitis

Question 45

side effects of ethambutol

Answer 45

optic neuritis

Question 46

pneumonia that causes a rusty sputum

Answer 46

pneumococcal pneumonia

Question 47

where is the problem in the lung in workers disease

Answer 47

apex of lung

Question 48

where is the problem in asbestosis

Answer 48

base of the lung

Question 49

causes of resp acidosis

Answer 49

severe asthma pneumonia hypoventilation opioids

Question 50

causes of resp alkalosis

Answer 50

hyperventilation/panic attack PE CNS problems pregnancy

Question 51

causes of metabolic acidosis

Answer 51

DKA lactic acidosis alcohol

Question 52

causes of metabolic alkalosis

Answer 52

severe vomiting