Ventilator

Question 1

Rise time

Answer 1

Time to reach the target inspiratory pressure and the adjustable inspiratory time.

Question 2

Muscle fatigue can be expected if pressure time index is

Answer 2

More than 0.15

Question 3

VILI can be seen at Transpulmonary pressures more than

Answer 3

30 to 35 CM h2o

Question 4

Safe fio2 values

Answer 4

40% safe for prolonged periods

Arterial po2 more than 120-130mm hg may produce systemic toxicity

Question 5

Two new modes of ventilation

Answer 5

Proportional assist ventilation - PAV

Neurally adjusted ventilator assistance - NAVA

Question 6

4 Pulmonary infectious complications in mech ventilator patients

Answer 6

1- compromised natural Glottic closure
2- ET tube impairs cough reflex portal for pathogens to enter lungs
3- Airways and parenchymal injury
4- ICU environment and use of antibiotics and many sick patients in close proximity

Question 7

Care bundles

Answer 7

Hand washing, elevated head end of bed, oral care with chlorhexidine, appropriate antibiotics

Question 8

3goals for ventilation setting

Answer 8

Enough PEEP to recruit alveoli
Avoidance of peep -TV combination that causes over distension
Limiting TV to physiological range

Question 9

Most common etiology of SVC syndrome

Answer 9

bronchogenic carcinoma and lymphoma

Question 10

Agents used for pleurodesis

Answer 10

Talc most common

Tetracycline, bleomycin, iodine povidone, nitrogen mustard, corynebacterium parvum, silver nitrate

Question 11

Young’s syndrome

Answer 11

Bronchiectasis, sinusitis, infertility(azoospermia)

Question 12

Kartagener syndrome

Answer 12

Primary culinary dyskinesia, situs inversus totalis

Question 13

Primary ciliary dyskinesia

Answer 13

HrCt shows lower lobe involvement more and sparing of upper lobe

Question 14

Lady windermere syndrome

Answer 14

Women suppress cough voluntarily causing retention of secretions. M/C a/w MAC infections.

Question 15

Thoracoscopy was introduced by

Answer 15

Hans-Christian Jacobaeus

Question 16

Semirigid pleuroscope dimensions

Answer 16

Proximal 22 cm is stiff, distal 5 cm bendable, angulation of 160 and 130 degrees, outer diameter of shaft is 7mm and working channel diameter of 2.8 mm

Question 17

Schramel and co workers pneumothorax grade

Answer 17

1-normal lung
2-pleuropulmonary adhesions
3-bullae and blebs <2cm in diameter
4-numerous large bullae >2cm in diameter

Question 18

Will Rogers Phenomenon

Answer 18

Seen in PET CT, patients that move from one stage to another can improve survival rates in both the stages

Question 19

RPGN identified D/D

Answer 19

Anca associated vasculitis, idiopathic Pauci immune glomerulonephritis, SLE, good pasture syndrome, post infectious glomerulonephritis, IgA nephropathy, Henoch -schonlein purpura, essential cryoglobulinemia, MPGN

Question 20

Deoxyspergualin

Answer 20

Antitumour and Immunosupressant used in refractory ANCA associated vasculitis

Question 21

Clinical antisynthetase syndrome

Answer 21

AB to aminoacyl transferase RNA synthetases
Co existence of myositis, diffuse lung disease and arthritis.
M/c is jo 1

Question 22

Csf ZN stain

Answer 22

4-40%

Question 23

CSF L/J C/S

Answer 23

25-70%

Question 24

CSF gene xpert sensitivity specificity

Answer 24

80.5%, 97.8% respectively

Question 25

Ortners syndrome

Answer 25

Hoarseness of voice due to compression of left recurrent laryngeal nerve due to enlarged left atrium seen in mitral stenosis

Question 26

Differentials of aspergilloma on CT

Answer 26

Organised hematoma, pus in cavity, neoplasm, abscess, wegener granulomatosis, ruptured hydatid cyst.

Question 27

Modified Ravitch procedure

Answer 27

Thoracic surgery - resection of Costal cartilage, sternal osteotomy, with or without fixation of the sternum with internal/external supports

Question 28

Nuss procedure

Answer 28

Thoracic surgery- placing a curve metal rod under the sternum through small incision on each side of the rib cage

Question 29

Blau syndrome

Answer 29

Granulomatous iritis, arthritis, skin rash | Sarcoidosis

Question 30

Dry skin common problem with

Answer 30

Cfz

Question 31

Order if reintroduction for skin rash for mdr tb

Answer 31

H ,R ,Z, ETO, CS, E, PAS, FQ ,KM

Question 32

Pancreatitis

Answer 32

Lzd, BDQ

Question 33

Antacids

Answer 33

Decrease absorption of FQ

Question 34

Ondensetron

Answer 34

Prolongs QT interval

Question 35

Pseudomembranous colitis

Answer 35

FQ

Question 36

When to stop all hepatotoxic drugs

Answer 36

Enzymes 5 times ULN

Question 37

Short MDR Tb hepatotoxicity drugs to with hold

Answer 37

H, ETO, Z

Question 38

Short mdr tb drugs to re introduce order

Answer 38

ETO, H, Z

Question 39

Monitor AST ALT for every

Answer 39

3 days after reintroduction

Question 40

Longer MDR TB hepatotoxicity drugs to with hold

Answer 40

ETO, Z, BDQ

Question 41

Longer MDR TB hepatotoxicity drugs to reintroduce order

Answer 41

BDQ, ETO, Z

Question 42

Shorter MDR TB regimen

Answer 42

Mfx, Kn/Am, ETO, Cfz, H, Z, E

Question 43

Giddiness in MDR TB

Answer 43

Aminoglycosides, ETO, FQ, Z

Question 44

Hypothyroidism

Answer 44

Eto/pto, pas

Question 45

Arthralgia

Answer 45

Z, FQ , BDQ

Question 46

Peripheral neuropathy

Answer 46

Lzd, CS, H, S, Km, Cm, Am, FQ, rarely pto /eto, E

Question 47

Depression

Answer 47

Cs, FQ, H, ETO /PTO

Question 48

Psychosis

Answer 48

Cs, FQ, H

Question 49

Seizures

Answer 49

Cs, H, FQ

Question 50

Superficial fungal infection and thrush

Answer 50

FQ

Question 51

Dysglycemia and hyperglycemia

Answer 51

Gtx, ETO /PTO

Question 52

DR TB follow up after treatment completion

Answer 52

6,12,18,24 months after treatment completion

Question 53

Non lactose fermenting gram negative bacilli

Answer 53

Acinetobacter, pseudomonas, burkholderia | Important cause of health care associated pneumonia

Question 54

Discharge of CAP patient

Answer 54

Hemodynamically stable, afebrile, accepting oral feeds for at least 48 hrs

Question 55

Bradycardia with fever

Answer 55

Legionella, C. Psitassi, Mycoplasma , F. Tularensis

Question 56

Ecthyma gangrenosum

Answer 56

Pseudomonas. aeruginosa

Question 57

Nitinol coils

Answer 57

Sx management of copd

Question 58

Interventional therapy in stable COPD

Answer 58

LVRS, bullectomy, transplantation, bronchoscopic interventions - endobronchial valves, lung coils, vapour ablation.

Question 59

Copd anxiety questionnaires

Answer 59

The hospital anxiety and depression scale(HADS) and primary care evaluation of mental disorders. (PRIME - MD)

Question 60

Lung transplant criteria for referral COPD

Answer 60

Bode index 5-6, pco2 >50 mm hg, | Pao2 <60 and fev1 <25%

Question 61

Recommended criteria for listing for lung transplant

Answer 61

Bode index >7, fev1 15-20%, Three or more severe exacerbation in 1 year, One severe exacerbation with acute hypercapnic failure or moderate to severe pulmonary hypertension

Question 62

COPD EXACERBATION 1) No respiratory failure 2) Acute respiratory failure non life threatening 3) Acute respiratory failure life threatening

Answer 62

1) RR 25-30, no accessory muscles use, good mental status, Hypoxic improved with supplemental oxygen via venturi mask 28-35%, no increase in paco2 2) RR >30 ,use if accessory muscles,good mental status, Hypoxic improved with venturi mask 28-35%,paco2 50-60 or elevated from baseline. 3) RR > 30, use of accessory muscle, MENTAL STATUS ALTERED, Hypoxic not improved with venturi or fio2 >40%, paco2 > 60 or elevated from baseline and PH <7.25.

Question 63

Crazy paving on CT

Answer 63

HP, pcp, minimally invasive adeno CA, lymphangitic carcinomatosis, cardiogenic pulm edema, lipiod pneumonia.