respiratory 2

Question 1

Anticoagulation regimen in pregnant woman if VTE diagnosed?

Answer 1

LMWH from diagnosis till 6 weeks post-partum and switch to warfarin

• withhold LMWH 24 hours prior to neuroaxial anesthesia
• withhold LMWH 4 hours prior to epidural catheter to minimize epidural hematoma

Question 2

Leukotriene modifiers use in?

Answer 2

Aspirin sensitivity asthma
Eosinophilic asthma

-blocks Th2 response

Question 3

Mepolizumab use for?

Answer 3

Eosinophilic asthma

-doesn’t modify FEV1

Question 4

Lebrikiizumab used for?

Answer 4

Th2 asthma

Question 5

Dupilumab (IL4) used for ?

Answer 5

Steroid dependent asthma

Question 6

ABPA is what type of hypersensitivity?

Answer 6

Type 4 - Th2 mediated

Question 7

Omalizumab used for?

Answer 7

IgE mediated asthma/ Refractory AGBA

Question 8

Most effective drug for nicotine dependence?

Answer 8

Varenicline (Champix)

-Nicotine partial agonist/competitive antagonist ( blocks pleasurable sensation)

Question 9

Bupropion side effects?

Answer 9

Weight gain
Lower seizure threshold
Increase suicide ideation

Question 10

Lung volume reduction surgery indications?

Answer 10

FEV1 > 20%
DLCO > 20%
Large upper lobe bullae

Question 11

Lung transplant indications?

Answer 11

FEV1 < 20 - 25%
PCO2 > 55 mmhg + pO2 < 55 mmHg

Bilateral lungs - Age < 60
Lungs + heart - Age < 55

Question 12

Theophylline mechanism of action?

Answer 12

Inhibit phosphodiesterase - activate cAMP = bronchodilatation

Question 13

Desquamative interstitial pneumonitis (DIP) - what changes?

Answer 13

Langerhans histiocytosis = thin walled cysts in upper lobe

Question 14

Drug induced pulmonary fibrosis
Commonest drug?
MTX clues?
Nitrofurantoin clues?

Answer 14

Commonest drug = Amiodarone
MTX =Eosinophilia and diffuse ground glass changes
Nitrofurantoin = HF

Question 15

Radiation pneumonitis clues?

Answer 15

~6 weeks after treatment = hazy opacities and ground glass changes

Question 16

Silicosis strongly a/w what?

Changes on imaging?

Answer 16

TB

‘Egg shell’ appearance = mediastinal + hilar LN

Question 17

Lofgren syndrome?

Answer 17

Lofgren has painful joints and bull-eye skin

Arthralgia
Erythema nodosum
Hilar lymphadenopathy

Question 18

Heerfordt syndrome?

Answer 18

Heerfordt is Hot Red Eyes Frog

Fever
Enlarge parotids
Uveitis

Question 19

Treatment of bronchiectasis?

Answer 19

Prophylactic = Azithromycin 
MR-pseudomonas = B-lactam + Aminoglycoside
Immunodeficiency = IVIG
Haemoptysis = Bronchial artery embolization

Question 20

CFTR function?

CFTR is found on what chromosome?

Answer 20

traffics Chloride out of cell

Chromosome 7

Question 21

Cystic fibrosis
pathogens caused in adults?
pathogens caused in elderly?

Answer 21

Adults = Non-TB MAC + Burkholderia
Elderly = Pseudomonas

ABPA affects any age

Question 22

Cystic fibrosis - monitor what component of lung function test?

Answer 22

FEV1

Question 23

Bronchiolitis obliterans a/w condition?

Answer 23

Inhalation injury

Drugs - gold

Question 24

Nasal brushings to exclude what?

Answer 24

Hemophilia

Diffuse lung alveolar hemorrhage

Question 25

why azithromycin/macrolide effective in pseudomonas?

Answer 25

inhibit quorum sensing signals

pseudomonas use sensing signals to attract more pseudomonas = build biofilm

Question 26

Homozygous D508 use what?

Heterozygous D508 use what?

Answer 26

Homozygous = Ivacaftor + Lumacaftor

Heterozygous = Iva + Teza + Elexa

Question 27

Apnea/Hyponea index calculation?

Answer 27

Apnea episodes/ Hours of sleep

Question 28

Gold standard test for narcolepsy?

Answer 28

Mean sleep latency test

Narcolepsy = MSLT = 0 - 5 minutes test + repeated rapid REM onset

Question 29

Medications for narcolepsy;
Narcolepsy alone?
Cataplexy?

Answer 29

narcolepsy = modafinil

Cataplexy = SSRI

Question 30

Group 1 pHTN pathophysiology?

Answer 30

Increase endothelin, decrease NO + prostacyclin

Question 31

Surrogate marker for PCWP for left heart disease?

Answer 31

LV end diastolic pressure