Ash

Question 1

Types

Answer 1

Cystic
Saccular
Cylindrical
Fusiform
Tractional

Question 2

Congenital causes

Answer 2

Cf
Kartaneger
Pcd
Yellow nail
Young syndrome
LUNG SEQUESTRATION

Question 3

Infective

Obstruction

Answer 3

Post infectious- aspiration, tb. Pneumonia

Fb, mucous impaction,bronchial adenoma

Question 4

Syndromes ass

Answer 4

Kartaneger
Pcd
Yellow nail
Young 
Lady windermere
Mounier khun

Question 5

Stabdard tests

Answer 5

Cbc
Ige and specific ige
Ig g , igm
Soecific ab levels against pneumococcus- if less vaccine
Cf- early onset,  male infertility,  abd symptoms 
Pcd- neonatal distress,  childhood , infertility, otitus media
Sputum culture
Ctd
Aat - basal panacinar emphysema 
Bronch
Serum electrophoresis
Hiv1
Aspiration- flouroscopr, endoscopy

Question 6

What are the tests you fo in cf

Answer 6

Staph aureus 
Sweat nacl 60
30-60 - border line 
Chromosme 7 , delta 508
Cftr mutation

Question 7

What are the symptoms u see in pcd

Answer 7

Ultrastructural defects in cilia affecting normal motility
Recurrent urti and lrti
Otitis media
Sinusuistis
Bronchiecrasis
Male infertility
Situs incersus
Kartengere syndrome- sinusitis , infertility , situs

Question 8

Investigations in pcd

Answer 8

Nasal bitric oxide- low
Daccharin taste test
High speed video microscopy analysis
Transmission electron microscopy

Question 9

Young syndrome

Answer 9

Primary azoospermia
Bronchiectasis
Sinsusits

Question 10

Severity scoring

Answer 10

Faced

Question 11

Stable state treat

Answer 11

Twice daily acapella

Bronchopulmonary hygiene od- imrpoves cough related qol.airway clearance technoque- teached by physio

Question 12

Airway clearnace techniques

Answer 12

Acbt- active cycle of reathing technique
Postural/ modified pos/

Manual tech- percussion, vibration

Postural drainage- by gravity
Modified- dec symptoms of gerd

Pep

Oscillatiry pep- acapella
Insp muscle training-
High frequency chest wall oscillation- vest
Intrapulmknary percussive ventilation 
I/m bipap

Question 13

Recommend physio

Answer 13

Acbt/ acapella
Pd - modified pd- sitting
Rest if these are not working
Exercise plus fet huff for airway clearance

Question 14

During exacerbation

Fatigue

Answer 14

Acapella,+ pd are safe
Manual
Niv safe durimg exacerbation

Question 15

How often

Answer 15

Min 10 min , max 30

After this 2 huff or cough or until pt is fatigued

Question 16

Long term anti inflammatory

Answer 16

Ics proven role in asthma/copd

Abpa , ibd also
Decreases sputum volume , increases exacerbation

Indometgacin

Question 17

Long term abx ix

Pseudo rx

Answer 17

3 or more exacerbation per year
1st- colistin- ectasis and pseudo
2nd- genta
3rd- azee ir erythro
If high exacerbation- inhaled to oral

Question 18

Non pseudomonas

Answer 18

1st- azee
2nd- genta
3rd- doxy if macro intolerant

Question 19

When do u do tx

Answer 19

Less than 65
Fev1ess than 30 with significant clinical instability
Rapid progression/ detoriation drspite optimal treatment
Earler- massive hemo , phtn, icu need , rf needing niv

Question 20

Hiw do u treat respiratory failure

Answer 20

Long term o2 therapy
Same as copd.
Niv with Humidifier

Question 21

When do u do eradication therapy

Answer 21

1st isolation or regrowth in followup
1st-ciplox for 2 weeks
Iv antipseud bl+_ ag for 2 wks
F/b 3 months Neb Colistin, genta, tobra

Question 22

Before starting rx
Dose of azee
Choice
Review

Answer 22

Ntm, hearing loss- azee
Crcl , heaing - ag
Challenge test before inhaled abx
As per sens, tolerance.
Regular c/s

Question 23

Bd

Answer 23

In copd , asthma

Question 24

Rehab

Answer 24

Mmrc more than 1
6mwt/iswt- evaluate pre and post capacity
Insp muscle training in conjunction with conventional pulmonary rehab

Question 25

Ig g therapy

Answer 25

Cvid and xlinked agammaglobulinemia
In iga/ig g subclass def 

Lack of Pneumococcal ab
Sinopulmonary infection and progressive disease despite apo mx