respiratory 1

Question 1

What Lung volume decreased in pregnancy and obesity?

Answer 1

FRC

Question 2

What lung volume reduces in pregnancy but increases in obesity?

Answer 2

RV

Question 3

Can pleural fluid analysis rule out malignancy?

Answer 3

No, only 60% sensitive

High specificity though

Question 4

Role of TPA and DNase in intrapleural infection?

Answer 4

TPA lyse pleural fibrins and septations
DNase reduce viscosity of pus
- improve fluid drainage and reduce hospitalization stay

Question 5

Median survival years of cystic fibrosis?

Answer 5

41 years

Question 6

Reason women have cystic fibrosis exacerbations during follicular phase of menstruation?

Answer 6

Increased estrogen = increased viscosity

Question 7

Ivacaftor can be given in what cystic fibrosis mutation?

Answer 7

G551D

Question 8

Burkholderia cepacia in cystic fibrosis mortality rate?

Answer 8

High 60% in 1 year - not lung transplant, very poor prognosis

Question 9

Recurrent chest infections, cough + infertile - what disorder likely?
-Normal immunoglobulins/ normal sweat chloride test

Answer 9

Primary ciliary dyskinesia

Question 10

Melioidosis - what presentation and clinical important things?

Answer 10

Similar presentation like TB - CXR - mimics milliary TB infiltrate picture
A/w Diabetes

Question 11

Melioidosis cause and treatment?

Answer 11

Burkholderia pseudomallei

Meropenem/Ceftazidime - then oral Bactrim + Doxycyline

Question 12

Burkholderia cepacia cause what type of pneumonia?

Answer 12

Necrotising cavitating pneumonia

Question 13

What type of pulmonary fibrosis associated with neutrophils pattern on BAL?

Answer 13

Idiopathic pulmonary fibrosis

Question 14

Most common cause of clubbing?

Answer 14

Respiratory disorders

Question 15

Bleomycin cleared by what organ?

Answer 15

Kidney

-if kidney dysfunction - pulmonary toxicity

Question 16

How Bleomycin works?

Answer 16

glycopeptide abx = Combine with O2/ Ferric FE + inducing dsDNA breakage

Question 17

Interstitial lung disease pattern due to connective tissue disease?

Answer 17

UIP - basal predominance + honeycombing

Question 18

Lung nodules associated with what type of pulmonary fibrosis?

Answer 18

Hypersensitivity pneumonitis

Question 19

Most important predictor of mortality in IPF?

Answer 19

Reduction in FVC - 10% drop in 6 months

Question 20

Most common side effect of Pirfenidone?

Answer 20

Nausea

• reduces FVC
• skin rash

Question 21

Pirfenidone used for Pulmonary fibrosis. What it doesn’t improve?

Answer 21

Dyspnea score

Question 22

Hypercalciuria or Hypercalcemia - which is more common in sarcoid?

Answer 22

Hypercalciuria

Question 23

Mantoux test cut-off point as positive for immunosuppressed/ old TB/ recent exposure with TB?

Answer 23

> 5 mm

Question 24

Mantoux test cut-off test for NH resident/ healthcare workers/ born in TB endemic areas?

Answer 24

> 10 mm

Question 25

What Biologic agents associated with TB reactivation and diagnosis?

Answer 25

Adalimumab and Certolizumab

Question 26

What age group highest to succumb to TB after exposure?

Answer 26

Infants

Question 27

Bedaquiline in MDR TB - increases sputum conversion rate but at what cost?

Answer 27

Increase mortality

Question 28

what enzyme in liver clears Isoniazid?

Answer 28

N-acetyltransferase - slow acetylators have higher rates of hepatotoxicity

Question 29

Which leg is most affected in pregnancy for DVT and why?

Answer 29

Left leg - compression of left iliac vein by right iliac artery

Question 30

Highest risk factor of VTE in pregnancy?

Answer 30

Previous VTE in pregnancy