respiratory

Question 1

stony dull percussion

Answer 1

pleural effusion

Question 2

right sided pleuritic chest pain

Answer 2

most likely pneumonia

Question 3

alveolar bat wings

Answer 3

pulmonary oedema

Question 4

ground-glass appearance on x-ray

Answer 4

pulmonary fibrosis and respiratory distress syndrome of the newborn

Question 5

ziehl-neelson stain positive for acid fast bacilli

Answer 5

TB

Question 6

caseous necrosis

Answer 6

TB

Question 7

milliary TB spread

Answer 7

spread of TB through blood. if organism spreads via pulmonary artery miliary dissemination into the lung occurs.
if spreads via pulmonary vein, systemic dissemination to the liver, spleen, and kidneys

Question 8

positive anti-glomerular basement membrane antibodies

Answer 8

goodpastures

Question 9

chest infection with parrot/pigeons

Answer 9

caused by chlamydia psittaci

Question 10

dry cough and diarrhoea after holiday abroad (spain)

Answer 10

legionella pneumophila (test urine for antigen)

Question 11

“tall thin man, indulges in weed”

Answer 11

pneumothorax = marfans

Question 12

bilateral hilar lymphadenopathy

Answer 12

sarcoidosis

Question 13

erythema nodosum, granulomas, fatigue, iveitis and weight loss

Answer 13

sarcoid

Question 14

signet ring sign

Answer 14

bronchiectasis (signet ring = bronchiole wider than neighbouring arteriole)

Question 15

D sign on x-ray

Answer 15

empyema

Question 16

‘steeple; sign on x-ray

Answer 16

laryngotracheobronchitis/croup

Question 17

child with barking cough

Answer 17

croup

Question 18

pneumocystis pneumonia

Answer 18

HIV (treat with co-trimoxazole [+/- prednisolone if severe])

Question 19

asthma + nasal polyps + salicylate sensitivity

Answer 19

samters triad

Question 20

alcoholic with pneumonia

Answer 20

aspiration pneumonia = klebsiella pneumonia

Question 21

red jelly sputum

Answer 21

klebsiella pneumonia

Question 22

mucoid sputum

Answer 22

chlamydia psittaci

Question 23

rusty sputum

Answer 23

pneumococcal pneumonia

Question 24

cannonball mets (weight loss and haematuria)

Answer 24

primary renal cell carcinoma

Question 25

morning headaches

Answer 25

hypercapnia or side effects of organic nitrates

Question 26

ACTH secreting lung tumour

Answer 26

small cell carcinoma in lung

Question 27

PTH secreting lung cancer

Answer 27

squamous cell carcinoma of lung

Question 28

smal cell carcinoma

Answer 28

neuroendocrine, highly malignant, and may be associated with ectopic endocrine syndrome

Question 29

increased serum ACE and Ca2+

Answer 29

sarcoid

Question 30

eggshell calcification at hilar region

Answer 30

silicosis

Question 31

ghon focus is

Answer 31

an area of inection

Question 32

ghon focus is

Answer 32

an area of infection and caseous necrosis at the periphery of the lung beneath the pleura - found in TB. If rupture through visceral pleura into pleural cavity will produce TB pleurisy

Question 33

assman focus

Answer 33

apical lesion of secondary TB infection

Question 34

'coin lession'

Answer 34

rounded solitary lesion on x-ray. primary bronchial or lung carcinoma. metastatic tumour (esp kidney), carcinoma, granuloma, lung abscess

Question 35

what can cause horners

Answer 35

pancoast tumour

Question 36

acute management of asthma

Answer 36

OSHITMAN Oxygen - 100% on non-rebreather

Question 37

acute management of asthma

Answer 37

OSHITMAN ``` Oxygen - 100% on non-rebreather salbutamol - nebulised back to back hydrocortisone IV or prednisolone PO Ipratropium bromide nebulised hourly Theophyline IV or aminophylline IV Magnesium and call ANasthetist ```

Question 38

thumbprint sign on head X-ray

Answer 38

epiglottitis

Question 39

inspiratory whoop/barking cough

Answer 39

pertiussis

Question 40

snow storm appearance on x-ray

Answer 40

silicosis

Question 41

managment of infective exacerbation of COPD

Answer 41

iSOAP ``` i - ipratropium S - salbutamol O - oxygen A - amoxicillin P - prednisolone ```

Question 42

non-smoker + lung cancer

Answer 42

(peripheral) adenocarcinoma

Question 43

squamous + small cell cancer =

Answer 43

central

Question 44

high D dimer

Answer 44

suspect (but not diagnose) PE, send for CTPA or V/Q scan

Question 45

low d-dimer

Answer 45

excludes PE

Question 46

large PE treatment

Answer 46

thrombolysis

Question 47

small PE treatment

Answer 47

low molecular weight heparin

Question 48

MONAC

Answer 48

``` Morphine - till pain stops Oxygen - 10L min Nitrates - 2 sprays sublingual Asprin - 300mg Clopidagrel - 600mg ```

Question 49

CURB 65

Answer 49

Confusion 7mmol Resp rate >30min BP (systolic 65yrs