Respiratory 1

Question 1

Causes of raised TLCO?

Answer 1

asthma
pulmonary haemorrhage
L->R cardiac shunts
polycythaemia

Question 2

most common organism of infective exacerbation of COPD?

Answer 2

haemophilus influenza

Question 3

Treatment of ABPA?

Answer 3

oral steroids: high dose pred in acute management followed by low -> medium dosing for maintenance

• tapered off over 3-12 mo.
• pred decreases the risk of bronchiectasis

Question 4

causes of basal pulmonary fibrosis?

Answer 4

• idiopathic
• asbestosis
• connective tissue disorders e.g. SLE
• drug induced: amiodarone, bleomycin, methotrexate

Question 5

causes of apical pulmonary fibrosis?

Answer 5

• EAA
• coal worker’s pneumoconiosis
• silicosis
• sarcoidosis
• ank spond
• histiocytosis
• TB

Question 6

Contraindications to surgery for lung cancer?

Answer 6

• stage IIIb / IV (mets present)
• FEV1 < 1.5L*
• malignant pleural effusion
• tumour near hilum
• vocal cord paralysis
• SVC obstruction

Question 7

uveoparotid fever: parotid enlargement, fever, uveitis secondary to sarcoidosis?

Answer 7

Heerfordt’s syndrome

Question 8

acute form of sarcoidosis characterised by bilateral hilar lymphadenopathy, erythema nodosum, fever, polyarthralgia?

Answer 8

Lofgren’s syndrome

Question 9

Source of bleeding in cases of severe haemoptysis requiring treatment?

Answer 9

1. bronchial arteries - 90%

2. pulmonary arteries - 5%

Question 10

pharmacological prophylaxis of acute mountain sickness

Answer 10

1st line: acetazolamide

carbonic anhydrase inhibitor which acts on the kidneys to generate a primary metabolic acidosis. A compensatory respiratory alkalosis occurs in response, resulting in hyperventilation and improved oxygenation.

Question 11

Management of high altitude cerebral oedema (HACE)?

Answer 11

• descent

- dexamethasone

Question 12

Management of high altitude pulmonary oedema?

Answer 12

• descent
• nifedipine, dexamethasone, acetazolamide, phosphodiesterase type V inhibitors*
• oxygen if available

Question 13

Mepolizumab

Answer 13

Anti-IL5 monoclonal antibody

• down-regulates eosinophil activity
• significantly improve symptoms in resistant asthma

Question 14

Omalizumab

Answer 14

Anti IgE monoclonal antibody

- effective in treating resistant asthma with evidence of raised IgE and allergic symptoms

Question 15

Treatment of extensive small cell lung cancer?

Answer 15

Palliative chemotherapy

Question 16

Treatment of NTM Mycobacterium avium complex (MAC) infection?

Answer 16

Rifampicin, clarithromycin and ethambutol.

Treatment should continue until the patients sputum has remained negative for MAC for 12 months

Question 17

Treatment of NTM Mycobacterium kansasii infection?

Answer 17

Rifampicin, isoniazid and ethambutol.

Treatment should continue until the patient has been sputum culture negative for 12 months.

Question 18

Management of palliative SOB in dying pt with ESRF?

Answer 18

alfentanil - a short acting opiate

Question 19

Theophylline toxicity can cause..?

Answer 19

HypoK, hyperglycaemia

Tachycardia, increased av node conduction, increased myocardial contractility

Question 20

Histology of rapidly progressive glomerulonephritis?

Answer 20

formation of epithelial crescents in the majority of glomeruli.