Buzz words: Respiratory

Question 1

SOB on exertion
“Winter bronchitis”
Wheeze
Chronic productive cough
Inv: post-bronchodilator Spirometry

Answer 1

COPD

Question 2

Inv: post-bronchodilator Spirometry

Answer 2

COPD

Question 3

Fever
Chronic Cough
Weight loss
Asian
Lowenstein Jensen Medium
Red Ziehl-Nelson Stain
“Acid fast bacilli”
RIPE treatment

Answer 3

TB

Question 4

Lowenstein Jensen Medium

Answer 4

TB

Question 5

Red Ziehl-Nelson Stain

Answer 5

TB

Question 6

“Acid fast bacilli”

Answer 6

TB

Question 7

TB drug SE: orange tears

Answer 7

Rifampicin

Question 8

TB drug SE: peripheral neuropathy

Answer 8

Isoniazid

Question 9

Red-green colour blindness

Answer 9

Ethambutol

Question 10

Steatorrhoea, diabetes
Clubbing, Signet rings
Recurrent Infections
Bronchiectasis
Sodium >60mmol

Answer 10

Cystic Fibrosis

Question 11

Shipyard/power station worker
End-inspiratory crackles
Non-productive cough
Pleural effusion

Answer 11

Mesothelioma

Question 12

Mouldy hay

Answer 12

Farmer’s lung (EAA)

Question 13

Parakeets/Pigeons

Answer 13

Bird fancier’s lung (EAA)

Question 14

Lung Ca:
Horner’s syndrome
Arm pain

Answer 14

Pancoast’s tumour

Question 15

Lung Ca:
Hypercalcaemia (constipation, polyuria)
Ectopic PTHrP
Epithelial cells

Answer 15

Squamous cells carcinoma

Question 16

Lung Ca:
Neuroendocrine symptoms
Paraneoplastic syndomes:
ACTH: cushing’s
ADH: SIADH
Anti-Ca ABs: Lambert Eaton
Mets early

Answer 16

Small cell carcinoma

Question 17

Lung Ca:
Goblet cell origin
NON-smoker, woman

Answer 17

Adenocarcinoma

Question 18

Lung Ca:
Goblet cell origin
NON-smoker, woman
Mets

Answer 18

Adenocarcinoma

Question 19

Fever, SOB, productive cough
Bronchial breath sounds
Coarse creps
Assess with CURB-65
CRP, urea, RR, BP, >65yo
IV clarithromycin, oral amoxicillin

Answer 19

Pneumonia

Question 20

Pneumonia:

rusty sputum, younger pt

Answer 20

S. pneumoniae

Question 21

Pneumonia:
small segmental
infiltrates, sinusitis, pharyngitis, laryngitis

Answer 21

Chlamydia pneumonia

Question 22

Pneumonia:
adolescents,
erythema nodosum, pericarditis,
haemolytic anaemia

Answer 22

Mycoplasma pneumoniae

Question 23

Pneumonia:

Abscesess

Answer 23

S. aureus

Question 24

Pneumonia:

purulent dark sputum

Answer 24

Klebsiella

Question 25

Pneumonia:
AIDS, widespread
infiltrates, low O2 sats

Answer 25

Pneumocytitis jiroveci

Question 26

Pneumonia:
legionnaire’s, low
Na, low albumin, air conditioning

Answer 26

legionnaire’s, low

Na, low albumin, air conditioning

Question 27

Pneumonia:
birds,
hepatosplnomegaly, conjunctivitis,
arthralgia, lower lobe consolidation

Answer 27

Chlamydophila psittaci

Question 28

Child coughing up blood

Answer 28

Inhaled foreign body

Question 29

Night cough
Intermittent wheeze
Eczema/hayfever (atopy)
Stepwise Treatment
Diurnal variation

Answer 29

Stable asthma

Question 30

Nocturnal cough

Diurnal variation

Answer 30

Stable asthma

Question 31

Nocturnal cough

Diurnal variation

Answer 31

Stable asthma

Question 32

Silent chest, apparent improving O2,
fatigue, bradycardia
IV magnesium sulphate, intubate

Answer 32

Life-threatening exacerbation of asthma

Question 33

60% O2 via facemask
Back-to-back nebs
Systemic steroids

Answer 33

severe exacerbation of asthma

Question 34

60% O2 via facemask
Back-to-back nebs
Systemic steroids

Answer 34

severe exacerbation of asthma