1st year resp

Question 1

asthma- restrictive or obstructive pattern?

Answer 1

obstructive

Question 2

how is asthma diagnosed?

Answer 2

History
Peak flow: PEFR <80%
Spirometry: FEC1/FVC < 70%

-once beta agonist is administered there’s a rise of 15%

Question 3

signs of severe asthma?

Answer 3

PEFR 33- 50%

• unable to complete full sentences
• RR >25
• pulse >110b/m

Question 4

signs of life threatening asthma attack?

Answer 4

• silent chest, cyanosis, bradycardia, dysrhythmia or hypotension
• exhaustion, confusion or coma
• normal pC02 (indicated exhaustion)
• acidosis
• PEFR <33%

Question 5

management of asthma?

Answer 5

1. SABA (salbutamol) + low dose ICS (beclometasone)
2. • LABA (salmeterol) + increase ICS
3. • LTRA (montelukast)
4. specialist therapy (e.g. theophylline, tiotropium)

Question 6

acute asthma management?

Answer 6

O SHIT ME

Oxygen (high flow)
Salbutamol (nebuliser)
Hydrocortisone (oral)
Ipratropium (nebulised)
Theophylline
Magnesium
Escalate care (get help)

Question 7

patient with COPD but nerve smoked

-what?

Answer 7

alpha1- antitrypsin deficiency

• this is a liver enzyme which inhibits proteolytic neutrophil enzymes
• protects against neutrophilic inflammation causing emphysema
• genetic deficiency that can cause COPD

Question 8

what is COPD?

Answer 8

• a common obstructive productive progressive disorder characterised by airway obstruction with little or no reversibility
• emphysema (enlargement of alveolar spaces due to destruction of walls)
• chronic bronchitis

Question 9

COPD treatment

Answer 9

• LABA/ LAMA + SABA

2. LABA/LAMA/ICS for frequent exacerbated with high eosinophilic count (>300)

Question 10

type 1 and type 2 rest failure?

Answer 10

type 1= low O2 without increased CO2

Type 2= low O2 with increased CO2 (COPD patients have this)

Question 11

examples non small cell lung cancer?

Answer 11

• adenocarcinoma (40%)
• squamous cell carcinoma (20%)
• large cell carcinoma (10%)

Question 12

types of lung cancer

Answer 12

small cell

non small cell (adenocarcinoma, large cell, squamous)

Question 13

lung cancer most associated with non smokers

Answer 13

adenocarcinoma

Question 14

lung cancers that are peripheral

Answer 14

• large cell

- adenocarcinoma

Question 15

lung cancers that are central

Answer 15

• small cell

- squamous

Question 16

lung cancers with worst prognosis

Answer 16

• small cell (rapidly metastasised)

- large cell (metastasises early)

Question 17

small cell cancer secrete?

Answer 17

ACTH- can cause cushings

Question 18

squamous cell cancer secrete?

Answer 18

PTHrP (can cause hypercalcaemia)

Question 19

large cell cancers secrete?

Answer 19

B- hCG

Question 20

treatment small cell cancer?

Answer 20

-chemo