4th Year Other

Question 1

when is a chest drain needed in pleural effusion

Answer 1

pH <7.2
pleural fluid <2.2mmol/L
LDH >1000IU/L
+ve gram stain/ culture

Question 2

what does an aspirate of gross pus indicate?

Answer 2

empyema

Question 3

confusion assessment in CURB65

Answer 3

AMTS <8

Question 4

side effects of isoniazid

Answer 4

hepatitis and peripheral neuropathy

Question 5

management of SE in isoniazid

Answer 5

pyridoxine prevents peripheral neuropathy
monitor LFT (prior to starting too)

Question 6

sweat test result in CF

Answer 6

Cl- >60mmol/L

Question 7

sarcoidosis 4 grades on CXR

Answer 7

grade 1= lymphadenopathy
grade 2= lymphadenopathy + infiltrates
grade 3= infiltrates
grade 4= fibrosis

Question 8

what is used in a V/Q scan?

Answer 8

radiolabelled albumin

radiolabelled xenon gas

Question 9

what is riociguat?

Answer 9

guanylate cyclase inhibitor

Question 10

what is riociguat used in?

Answer 10

pulmonary hypertension to relax vessels

Question 11

what is Caplan’s syndrome?

Answer 11

RA + pneumoconiosis

Question 12

what is the PAS stain?

Answer 12

stains for carbohydrate components

Question 13

which condition has a +ve PAS stain?

Answer 13

alpha1 antitrypsin

Question 14

management of pseudomonas

Answer 14

ciprofloxacin

Question 15

small cell paraneoplastic syndromes

Answer 15

SiADH
ACTH
LEMS

Question 16

squamous cell paraneoplastic syndromes

Answer 16

PTH-rp

TSH

Question 17

adenocarcinoma paraneoplastic syndromes

Answer 17

gynaecomastia

HPOA

Question 18

what is varenicline (champix)?

Answer 18

nicotine receptor partial agonist

Question 19

what are the options for smoking cessation

Answer 19

behavioural therapy
nicotine replacement therapy
champix
bupropion

Question 20

action of bupropion

Answer 20

SNRI

Question 21

which smoking cessation techniques are CI in pregnancy?

Answer 21

champix + bupropion

Question 22

where do the neurovascular bundles run in the ribs?

Answer 22

inferior so needle should be inserted above rib, in the back due to less distress for patient and wider spaces.

Question 23

what does a chest drain contain?

Answer 23

water to prevent air flowing back into the chest

Question 24

what causes histoplasmosis?

Answer 24

pigeon droppings

Question 25

what is allergic bronchopulmonary aspergillosis? ABPA

Answer 25

hypersenstivity reaction 1 and 3 to the fungus aspergillus

Question 26

who gets ABPA?

Answer 26

asthmatics
CF
damp buildings
soil, compost, plants
air conditioning

Question 27

major and minor features of ABPA

Answer 27

major= hx of asthma, central bronchiectasis, pulmonary opacities, eosinophilia, immediate skin reactivity and increased IgE

Question 28

what can EVAR not be performed?

Answer 28

if aneurysm is above the renal arteries

Question 29

CI to lung cancer surgery

Answer 29

SVC obstruction
FEV1 <1.5L
malignant pleural effusion
vocal cord paralysis

Question 30

what is mikulicz syndrome?

Answer 30

enlargement of parotid and lacrimal glands due to sarcoid, TB or lymphoma

Question 31

what is Heerfordt’s syndrome?

Answer 31

parotid enlargement, fever and uveitis secondary to sarcoidosis

Question 32

what is used to guide antibiotics in acute bronchitis?

Answer 32

CRP >100mg/L (give immediately)

Question 33

when to consider atelectasis?

Answer 33

72 hours post-op

needs upright position and physio

Question 34

what is seen on ECG in PE

Answer 34

S1Q3T3

Question 35

what is the result of PFTs in neuromuscular disorders?

Answer 35

restrictive

Question 36

how to calculate pack years?

Answer 36

pack (20 cigs) / years

Question 37

how to tell the difference on CXR between collapse and effusion/ pneumothorax?

Answer 37

collapse trachea is pulled towards

effusion trachea is pushed away