Respiratory

Question 1

What is first-line for newly diagnosed COPD?

Answer 1

SABA/SAMA

Question 2

What is the second step in COPD management if SABA/SAMA not controlling COPD?

Answer 2

Add LABA + ICS (asthmatic features) OR

Add LABA + LAMA if no asthmatic features

Question 3

What is the most common type of lung cancer in non-smokers?

Answer 3

Adenocarcinoma

Question 4

What is the most important piece of advice for reducing the risk of recurrent pneumothorax?

Answer 4

Stop smoking

Question 5

What follow-up is recommended for patients with pneumonia?

Answer 5

CXR 6 weeks post-resolution

Question 6

Anion-gap metabolic acidosis occurs due to…

Answer 6

Impaired H+ excretion

Question 7

Metabolic acidosis without anion gap occurs due to…

Answer 7

Loss of HCO3 eg. vomiting

Question 8

Give examples of LABA’s.

Answer 8

Salmeterol or Formoterol

Question 9

Give an example of a SAMA.

Answer 9

Ipratropium

Question 10

Give an example of a LAMA.

Answer 10

Tiotropium

Question 11

Give features of a moderate asthma attack.

Answer 11

PEFR > 50% expected/best
Dyspnoea limiting activity
SpO2 > 92%
HR < 110

Question 12

Give features of a severe asthma attack,

Answer 12

PEF 33-50%
Dyspnoea at rest
Talks in words
RR > 30
HR > 110

Question 13

Give features of a life-threatening asthma exacerbation

Answer 13

PEF < 33%
SpO2 < 92%
Silent chest
Cyanosis
Arrythmia
Exhaustion

Question 14

What is the management of an acute asthma attack?

Answer 14

OSHITMAN
Oxygen
Salbutamol
Hydrocortisone
Ipratropium
Theophylline
Magnesium Sulphate
ANaesthetist

Question 15

What is the asthma treatment ladder in adults?

Answer 15

SABA
SABA + ICS
SABA + ICS + LABA
Consider increasing ICS dose or LTRA
Specialist

Question 16

What is the asthma treatment ladder in children?

Answer 16

SABA
SABA + Very low-dose ICS
SABA + Very low-dose ICS + LTRA if < 5 or LABA if > 5
Increasing ICS or LABA/LTRA
Specialist

Question 17

Which ABG finding suggests near-fatal asthma?

Answer 17

Normal PCO2 (suggests exhaustion)

Question 18

What is bronchiectasis?

Answer 18

Condition in which there is permanent dilation of the bronchi

Question 19

What are the main treatment options for bronchiectasis?

Answer 19

Airway clearance techniques
Treating exacerbations
Pneumococcal vaccine

Question 19

What are the main treatment options for bronchiectasis?

Answer 19

Airway clearance techniques
Treating exacerbations
Pneumococcal vaccine

Question 20

What is the investigation of choice for bronchiectasis?

Answer 20

High-resolution CT

Question 21

Give causes of apical pulmonary fibrosis.

Answer 21

Silicosis
Sarcoidosis
TB
Ank Spon

Question 22

Give causes of basal pulmonary fibrosis.

Answer 22

Idiopathic pulmonary fibrosis
Autoimmune-related
Medication-related

Question 23

What is the treatment for pulmonary fibrosis?

Answer 23

Anti-fibrotic medications like nintedanib and pirfenidone

Question 24

What is the management for pneumothorax < 2cm?

Answer 24

Discharge and advise

Question 25

What is the treatment for pneumothorax > 2cm?

Answer 25

Chest drain

Question 26

What is the treatment of choice for allergic bronchopulmonary aspergillosis?

Answer 26

Oral steroids

Question 27

What is the treatment of choice for allergic bronchopulmonary aspergillosis?

Answer 27

Oral steroids

Question 28

The severity of COPD is based on...

Answer 28

FEV1

Question 29

What follow-up should be given to all patients with pneumonia?

Answer 29

CXR 6 weeks after resolution

Question 30

What does CURB65 stand for?

Answer 30

``` Confusion Urea > 7 RR > 30 BP < 90/60 Age > 65 ```

Question 31

What CURB65 score suggests mild-mod CAP?

Answer 31

0-2

Question 32

What CURB65 score suggests severe CAP?

Answer 32

3-5

Question 33

What is the treatment for mild-mod CAP?

Answer 33

1. Amoxicillin 5/7 | 2. Doxycycline 5/7

Question 34

What is the treatment for severe CAP?

Answer 34

IV Co-amoxiclav and PO Doxycyline

Question 35

What is the treatment for HAP?

Answer 35

Non-severe - PO Amoxicillin 5/7 | Severe - IV Amoxicillin & Gentamicin 7/7

Question 36

What is the treatment for aspiration pneumonia?

Answer 36

Non-severe - PO Amoxicillin and Metronidazole | Severe - IV Amox, Met & Gent

Question 37

Aspiration pneumonia is most likely to occur in which lobe?

Answer 37

R lower lobe

Question 38

What is the treatment for mycoplasma pneumonia?

Answer 38

Erythromycin

Question 39

What is the gold-standard test for COPD?

Answer 39

Spirometry

Question 40

Which prophylactic antibiotic may be given in some patients with recurrent IE of COPD?

Answer 40

Azithromycin

Question 41

Whiteout with trachea deviated away suggests..

Answer 41

Pneumothorax/Pleural effusion

Question 42

Whiteout with trachea deviating towards it suggests...

Answer 42

Collapse

Question 43

What is the most common organism in pneumonia in alcoholics?

Answer 43

Klebsiella

Question 44

TLCO is a measure of...

Answer 44

Gas transfer

Question 45

Pneumonia + lymphopaenia + hyponatraemia suggests...

Answer 45

Legionella

Question 46

What is the management for TB?

Answer 46

2RIPE4RI 2 months rifampicin, izoniazid, pyrazinamide and ethambutol Then 4 months rifampicin & isoniazid

Question 47

Which anti-tuberculous agent is associated with red/orange urine?

Answer 47

Rifampicin

Question 48

Which anti-tuberculous agent is associated with peripheral neuropathy?

Answer 48

Isoniazid

Question 49

Which anti-tuberculous agent is associated with joint pains?

Answer 49

Pyrazinamide

Question 50

Which anti-tuberculous agent is associated with visual loss?

Answer 50

Ethambutol

Question 51

Which type of pneumonia is associated with desaturation on exercise?

Answer 51

Pneumocystis jirovecci