Respiratory

Question 2

What are the inhalers used for COPD beyond SABA/SAMA if asthmatic features are present or absent?

Answer 2

asthmatic feature present = LABA + LAMA combination inhalers

asthmatic feature present = LABA + ICS combination inhalers eg Fostair

Question 3

What are the criteria for consideration for LTOT?

Answer 3

1. FEV1 <30%
2. features of cor pulmonale
3. SpO2 < 92 on RA
4. polycythaemia

Question 4

What is the threshold for starting LTOT?

Answer 4

1. pH < 7.3
2. pH 7.3-8 WITH polycythaemia/pulmonary oedema/PAH

on at least 2 ABGs 3/52 apart on optimum Rx

Question 5

two radiolgical findings on HRCT?

Answer 5

1. signet ring sign (airway lumen larger than PA)
2. tram track sign (airway dilatation, visible within 1cm of pleural surface)

Question 6

4 causes of exduative pleural effusion?

Answer 6

pneumonia, malignancy, autoimmune eg RA/SLE, TB

Question 7

4 causes of transudative pleural effusion?

Answer 7

CCF, hypoalbuminaemia, hypothyroidism, Meig syndrome (benign ovarian tumour, effusion, ascites)

Question 8

key investigation in pleural effusion and what tests would you send for?

Answer 8

pleural fluid aspiration - send for protein, LDH, MC&S, cytology

Question 9

The 3 items in Light’s criteria?

Answer 9

exudate if:
1. fluid/serum protein > 0.5
2. fluid/serum LDH > 0.6
3. fluid LDH > 2/3 upper limit of serum LDH