Resp spot test

Question 1

Name the types of extrinsic allergic alveoli’s

Answer 1

Farmers lung
Pigeon fanciers lung
Malt workers lung
Cheese makers lung

Question 2

What will be seen on CXR in extrinsic allergic alveolitiis

Answer 2

Diffuse micro nodular interstitial shadowing

Question 3

What will be seen on CT in extrinsic allergic alveolitis

Answer 3

Ground glass opacities

Question 4

Outline the presentations over time of extrinsic allergic alveolitis

Answer 4

Acute
- 4-8hrs, flu like illness, fever, chest tightness

Subacute

• fatigue
• cough
• anorexia

Chronic

• Weight loss
• RHF
• Cynaosis and clubbing

Question 5

Outline the pathology seen in histocytosis X

Answer 5

Clonal proliferation of langerhans cells

Question 6

Treatment of legionnaires

Answer 6

Clarithromycin

Fluroquinolone

Question 7

Gold standard treatment for a pulmonary embolism

Answer 7

CT pulmonary angiography

Question 8

Name the ECG changes that can be seen in a PE

Answer 8

Sinus tachy 
Right ventricular strain 
Right axis deviation 
RBBB
S1Q3T3

Question 9

Outline the features seen in a Pancoast tumour

Answer 9

1. Erosion of the 1st rib
2. Ipsilateral Horner’s syndrome
3. Pain the arm radiating to the 4th and 5th metatarsal
4. Wasting of dorsal intros
5. Weakness of abduction of the shoulder

Question 10

Name the gene and chromosome that is defective in CF

Answer 10

DF508

Chromosome 7

Question 11

What is Caplan’s syndrome

Answer 11

Pulmonary Fibrosis in coal workers with rheumatoid arthritis

Question 12

List potential causes of pneumonconioses

Answer 12

Coal
Asbestosis
Silica

Question 13

List the clinical features often seen in pneumoconiosis

Answer 13

Dry cough
Dysponea
Black sputum
SOBOE

Question 14

What are the CXR changes seen in coal workers lung

Answer 14

Large nodular fibrotic mass

Upper lobes

Question 15

CXR findings in asbestosis

Answer 15

Small nodular opacities
Shaggy cardiac silhouette
CT ground glass appearance

Question 16

CXR findings is silicosis

Answer 16

Nodular pattern in the upper lobes

Eggshell calcifications

Question 17

List potential conditions associated with restrictive lung function findings

Answer 17

idiopathic pulmonary fibrosis
sarcoidosis
pneumoconiosis

Question 18

Pathology of mesothelioma

Answer 18

Discrete plaques and nodules that coalesce to produce sheet like neoplasm
@ lower part of the chest
asbestos is the principal carcinogen involved

Question 19

Dx of mesothelioma

Answer 19

Thorascopically guided biopsy

Question 20

Clinical signs associated with a tension pneumothorax

Answer 20

Hyperexpanded 
Hyperreasonant 
Distended neck veins 
Deviated trachea
No breath sounds on the effected sign

Question 21

What cells produce surfactant

Answer 21

Type II pneumocytes

Question 22

CXR finding in lung cancer

Answer 22

Peripheral opacites 
Pleural effusion 
Hilar enlargement 
Consolidation 
Coin lesions

Question 23

CXR findings of sarcoidosis

Answer 23

Hilar and medistinal involvement
Nodal and parenchymal involvement
Pulmonary fibrosis

Question 24

List 5 causes of hypoxaemia

Answer 24

Hypoventilation 
Ventilation perfusion mismatch 
Right to left shunt 
Low inspired oxygen 
Diffusion abnormality

Question 25

According to the BTS guidelines who should be considered for NIV

Answer 25

Persistant resp acidosis > 1hour of standard medical therapy pH 7.25-7.35 pH<7.25 (HDU)

Question 26

List the contraindication for NIV

Answer 26

Impaired consciousness Severe hypoxia Copious resp secretion

Question 27

List the investigations you would perform in pulmonary fibrosis and what they will show

Answer 27

CXR - reticular shadowing of the lung peripheries - shaggy heart border HRCT - Honeycombing, ground glass opacification LuFT - Restrictive Abs - ANA +ve

Question 28

List the causes of pulmonary fibrosis

Answer 28

Connective tissue disorders - RA - SLE - SS Occupational lung disorders - Asbetos - coal - dust - silica Medications - Amiodarone - bleomycin - methotrexate Inhalation of irritants - hypersensitivity pneumonitis Radiation

Question 29

Prophylactic treatment of pneumocystis jirovecci

Answer 29

Co-trimoxazole

Question 30

Features of charge strauss

Answer 30

Asthma Transient pul infiltrates Hypereosinophillia Systematic vasculitis

Question 31

Which patients are most likely to suffer from allergic bronchopulmonary aspergillos

Answer 31

Glucocorticoid-dependent asthmatics Cystic fibrosis patients Type II hypersenstivity reactions Can cause mucus plugging

Question 32

List the extra pulmonary features that can develop with mycoplasma pneumonia

Answer 32

``` Haemolytic anaemia ( cold aggluttins) IgM abs directed towards the I antigen of the erythrocyte Renal failure Hepatitis Myocarditis Meningitis Cerebellar ataxia ```

Question 33

Features of sarcoidosis

Answer 33

``` ACE increase Granuloma Athritis Uveitis Erythema nodusum Lymphadenopathy Lupus pernio Idiotpathic Non caesating Gammaglobin Vitamin D increase ```

Question 34

List the contraindication to radio contrast

Answer 34

Pregnancy Renal failure Contrast allergy

Question 35

Causes of bihilar lymphadenopathy

Answer 35

Sarcoidosis Tuberculosis Lymphoma HIV

Question 36

Features of acute respiratory distress syndrome

Answer 36

``` Dysponea Hypoxaemia Resp failure Non cariogenic pulmonary oedema Acute onset <1week Bilateral opacities on CXR PaO2/FiO2 <300 (PEEP) ```

Question 37

Risk factors for developing ARDS

Answer 37

``` Sepsis Aspiration Pneumonia Blood transfusion Respiratory failur e ```

Question 38

CXR finding in ARDS

Answer 38

Bilaterally infiltrates

Question 39

Management of ARDS

Answer 39

Low tidal volume Supportive care (ITU) Abx and rx cause

Question 40

List the causes of clubbing

Answer 40

RESP - mesothelioma - bronchiectasis - fibrosis - lung carcinoma GI - Lymphoma - IBD - Cirrhosis - Coeliac disease Cardiac - Cyanotic heart disease - Myoxoma - Bacterial endocarditis