respiratory

Question 1

stony dull to percuss

Answer 1

pleural effusion

Question 2

right sided pleuritic chest pain

Answer 2

most likely pneumonia

Question 3

alveolar bat’s wings, kerley B lines, cardiomegaly, dilated prominent upper lobe vessels pleural effusion

Answer 3

pleural oedema

Question 4

ground glass appearance on X-ray

Answer 4

pulmonary fibrosis and respiratory distress syndrome of the newborn

Question 5

Ziehl-Neelsen stain positive for acid fast bacilli

Answer 5

TB

Question 6

caseous necrosis

Answer 6

TB

Question 7

miliary tuberculous

Answer 7

spread of organism into bloodstream. if organism spread via pulmonary artery, miliary dissemination into the lung occurs. if organism spread via pulmonary vein, there is systemic dissemination to the liver, spleen and kidneys

Question 8

positive anti-glomerular basement membrane

Answer 8

Goodpasture’s syndrome

Question 9

chest infection with a parrot/pigeon as pet

Answer 9

caused by chlamydophila psittaci

Question 10

dry cough and diarrhoea after holiday abroad, some indicated of water spread

Answer 10

legionella pneumophila

Question 11

tall, thin young man who indulges in marijuana

Answer 11

probably pneumothorax(Marfan’s)

Question 12

bilateral hilar lymphadenopathy, erythema nodosum, granulomas, fatigue, uveitis and weight loss

Answer 12

sarcoidosis

Question 13

bronchiole wider than neighbouring arteriole(on CT) (signet ring sign)

Answer 13

bronchiectasis

Question 14

D sign on X ray

Answer 14

empyema

Question 15

‘steeple’ sign on X ray

Answer 15

laryngotracheobronchitis/croup

Question 16

child with barking cough

Answer 16

croup

Question 17

pneumocystis pneumonia

Answer 17

HIV( treat with co-trimoxazole)

Question 18

asthma + nasal polyps + salicylate sensitivity

Answer 18

Samter’s triad

Question 19

alcoholic(danger of aspiration pneumonia)

Answer 19

klebsiella pneumoniae

Question 20

red jelly sputum

Answer 20

klebsiella pneumoniae

Question 21

mucoid sputum

Answer 21

chlamydia psittaci

Question 22

rusty sputum

Answer 22

pneumococcal pneumonia

Question 23

cannonball metastases (also weight loss and haematuria)

Answer 23

classically from primary renal cell carcinoma

Question 24

morning headache

Answer 24

hypercapnia or side effects of organic nitrates or ICP

Question 25

ACTH secreting lung tumour

Answer 25

small cell carcinoma of the lung

Question 26

PTHrP secreting lung tumour

Answer 26

squamous cell carcinoma of lung

Question 27

increased serum ACE and CA2+

Answer 27

sarcoid

Question 28

eggshell calcification at hilar region

Answer 28

silicosis left

Question 29

'heart failure cells' seen in alveolar spaces

Answer 29

macrophages that have absorbed haemosiderin- found in chronic pulmonary oedema, and associated left ventricular heart failure. also seen in long standing pulmonary hypertension

Question 30

Ghon focus

Answer 30

an area of infection and caseous necrosis at the periphery of the lung, beneath the pleura- found in TB infection

Question 31

Assmann focus

Answer 31

apical lesion of secondary tuberculous infection

Question 32

Horner's syndrome

Answer 32

can occur when there is a local spread of cancer to the intrathoracic nodes or a pancoast's tumour

Question 33

acute management of asthma

Answer 33

OSHIT MAN

Question 34

thumbprint sign on head x ray

Answer 34

epiglottitis

Question 35

inspiratory whoop/barking cough

Answer 35

pertussis(whooping cough) caused by bordatella pertussis

Question 36

snow storm appearance on x ray

Answer 36

baritosis, silicosis

Question 37

management of infective exacerbation of COPD

Answer 37

ISOAP ipratropium, salbutamol, oxygen, amoxicillin, prednisolone

Question 38

non smoker + lung cancer

Answer 38

peripheral adenocarcinoma

Question 39

squamous + small cell lung cancers

Answer 39

CENTRAL

Question 40

high d-dimers

Answer 40

suspect pulmonary embolism

Question 41

low d-dimers

Answer 41

exclude pulmonary embolism

Question 42

large PE

Answer 42

thrombolysis

Question 43

small PE

Answer 43

low molecular weight heparin( or NOAC e.g. rivaroxaban)

Question 44

honeycomb lung

Answer 44

fibrosing alveolitis

Question 45

asthma spirometry readings

Answer 45

FVC normal FEV1 reduced FEV!/FVC ratio reduced

Question 46

COPD spirometry readings

Answer 46

FVC reduced FEV1 reduced FEV1/FVC ratio normal

Question 47

what sits in the costal groove?

Answer 47

intercostal vein, artery and nerve

Question 48

where is the sternal angle?

Answer 48

level of 2nd rib

Question 49

where is xiphoid process

Answer 49

at leavel T10

Question 50

what do type 1 pneumocytes do?

Answer 50

epithelium of alveoli

Question 51

inspiratory capacity?

Answer 51

amount you can breath in on maximal inspiration

Question 52

inspiratory reserve?

Answer 52

the gap between normal inspiration and maximal inspiration

Question 53

atopic asthma

Answer 53

Th2 response to an antigen

Question 54

what does smoke cause?

Answer 54

macrophage activation which then activates neutrophils and then proteases. this causes alveolar wall damage and mucous hypersecretion cough, increased infections, loss of elastic recoil

Question 55

definitive diagnosis of bronchiectasis?

Answer 55

HRCT

Question 56

where is the larynx found?

Answer 56

in the anterior neck at the level C3-C6

Question 57

bronchiectasis-most common organism?

Answer 57

haemophilus influenzae

Question 58

what does hypercapnia do to dissociation curve?

Answer 58

shifts the oxygen dissociation curve to the right

Question 59

functional residual capacity=

Answer 59

expiratory reserve volume + residual volume

Question 60

what does pulmonary fibrosis result in?

Answer 60

decreased lung compliance