Respiratory

Question 1

The maximum volume of air that can be voluntarily exhaled following a maximum inspiration is called what?

Answer 1

Vital Capacity

Question 2

The volume of air that can be voluntarily forcibly exhaled after normal expiration is?

Answer 2

Expiratory reserve volume

Question 3

What is the functional residual capacity?

Answer 3

The volume left in lungs after normal expiration (ERV+RV)

Question 4

What is the residual volume?

Answer 4

The volume of air in the lungs that cannot be voluntarily expired

Question 5

What is the name of the air breathed in or out at rest?

Answer 5

Tidal volume

Question 6

What is the value of tidal volume?

Answer 6

500ml

Question 7

What is the value of residual volume?

Answer 7

1200ml

Question 8

What is the value of expiratory reserve volume?

Answer 8

1100ml

Question 9

What is the value of the inspiratory reserve volume?

Answer 9

3000ml

Question 10

What is the value of the inspiratory capacity?

Answer 10

3500ml (tidal volume + inspiratory reserve volume)

Question 11

What is the volumes make up the vital capacity?

Answer 11

Expiratory reserve volume
Tidal volume
Inspiratory reserve volume
OR
Expiratory reserve volume
Inspiratory capacity

Question 12

What is the value of the vital capacity

Answer 12

4600ml

Question 13

What makes up the functional residual capacity and what is its value?

Answer 13

Expiratory reserve volume (1100ml)
Residual volume (1200ml)

Question 14

Why does air flow into the lungs during inspiration?

Answer 14

The external intercostal and diaphragm muscles contract and thoracic volume increases.

Question 15

Mr Tickle has a respiratory rate of 10 breaths per minute and a tidal volume of 800ml. If his residual volume measures 1000ml and his dead space volume measures 200ml what is Mr Tickle’s alveolar ventilation?

Answer 15

6000ml/min

Question 16

The partial pressure of oxygen in mixed venous blood is typically around?

Answer 16

40mmHg (5.3kPa)

Question 17

True or False

Carbon Monoxide poisoning reduced the arterial partial pressure of oxygen

Answer 17

False

Oxygen concentration in solution is not affected

Question 18

Arterial PCO2 level are elevated in chronic lung disease? True or False

Answer 18

True

Due to poor alveolar ventilation

Question 19

Nitrous oxide is a safe sedative to use in chronic lung disease? True or False

Answer 19

False

Question 20

Chronic lung disease sufferers are said to be on what respiratory drive?

Answer 20

Hypoxic drive

Question 21

When perfusion exceeds ventilation in L/min the blood is referred to as what?

Answer 21

Shunt

Question 22

A 59 year old man with known squamous carcinoma of the lung is admitted to hospital as an emergency with abdominal pain, constipation and confusion
The most appropriate investigation would be:
a) Bronchoscopy
b) CXR
c) Mediastinoscopy
d) Sputum cytology
e) Serum calcium

Answer 22

E

Question 23

A 79 year old woman with a peripheral spiculated opacity on CXR and an enlarged supraclavicular lymph node.
The most appropriate investigation would be:
a) Bronchoscopy
b) CT thorax
c) Fine needle aspiration
d) Lung function tests
e) sputum cytology

Answer 23

C

Question 24

A 55 year old business man complains of daytime somnolence. He normally sleeps 5 hours per night except on holiday when he will sleep 9 hours per night. His sleep study shows an Apnoea Hypopnea Index of 5 per hour.
What is the diagnosis?

Answer 24

Poor sleep hygiene

Question 25

A 38 year old with exacerbation of asthma is too tired to do a peak flow. What will his pH, PaCO2 and PaO2 values be compared to normal?

Answer 25

``` pH = Lowered PaCO2 = Raised PaO2 = Lowered ```

Question 26

The British Thoracic Guidelines for the treatment of chronic asthma recommend that a patient with newly diagnosed asthma who is waking up at night because of asthma should be on: a) Inhaled Beta-2 agonist and leukotriene receptor antagonist b) Inhaled beta-2 agonist c) ICS and inhaled beta-2 agonist d) Inhaled leukotriene antagonist e) Inhaled sodium chromoglycate

Answer 26

C

Question 27

What is the clinical term for coughing up blood?

Answer 27

Haemoptosis

Question 28

A 62 year old male smoker has coughed up blood 4 times during the past 1 month. His appetite has been poor and he has lost 1 stone during this period. What is the most likely diagnosis?

Answer 28

Lung cancer

Question 29

What are the clinical signs of lung cancer?

Answer 29

``` Clubbing Hepatomegally Lymphadenopathy Tracheal deviation SVC obstruction ```

Question 30

Give two imaging techniques which can be used to determine the extent of lung cancer

Answer 30

CXR CT Scan MRI scan

Question 31

What are the 4 major histological types of lung cancer?

Answer 31

Squamous cell carcinoma Adenocarcinoma Large cell lung cancer Small cell lung cancer

Question 32

List 4 organs or tissues to which lung cancer spreads

Answer 32

``` Brain, Skin, Adrenal glands, Liver Lymph nodes Bone ```

Question 33

List 6 possible clinical signs in a patient with left lower lobe pneumonia/consolidation

Answer 33

``` Dull percussion Tachypnoea Tachycardia Fever Cyanosis Decreased lung expansion on that side Bronchial breathing ```

Question 34

name 3 micro-organisms which are most commonly responsible for pneumonia in a young healthy individual

Answer 34

Streptococcus pneumonia Mycoplasma pneumoniae, Legionella pneumophila, Coxiella burnetti Chlamydia psittaci

Question 35

What two classes of antibiotics should be used to treat pneumonia before a bacterial diagnosis is reached?

Answer 35

Beta-lactam and macrolide

Question 36

Apart from oxygen what do you use to treat a patient with pneumonia?

Answer 36

Oxygen IV fluids Analgesia

Question 37

Apart from imaging what other investigations would you perform on a suspected cancer patient?

Answer 37

Biopsy (Bronchoscopy or percutaneous), Pulmonary function test

Question 38

What are the investigations for pneumonia?

Answer 38

``` CXR Sputum Cytology FBC ESR/CRP Blood culture Serology ```