important!

Question 1

Why will we hear crackles at the beginning of inspiration in patient with chronic bronchitis?

Answer 1

Due to opening of small collapsed airways

Question 2

Hypoxia effect on vessels

Answer 2

vasoconstriction

Question 3

Hypoxic vasoconstriction in lungs will lead to

Answer 3

Increase pulmonary vascular resistance and pulmonary HTN

Question 4

Types of emphysema

Answer 4

Centriacinar- Smoking
Panacinar- a1-AT deficiency
Paraseptal

Question 5

Chronic bronchitis definition

Answer 5

Productive cough on most days of the week for at least 3 months with total duration of 2 years

Question 6

mMRC measures

Answer 6

Breathless scale 0-4

Question 7

3 steps of combined COPD asessment

Answer 7

Spirometry to confirm diagnosis
Assessment of airflow limitation
Assessment of symp./risk of exacerbations

Question 8

COPD non-pharmacological treatment

Answer 8

Smokin cessation
Smoke prevention
Regular exercise
Rehabilitation
Oxygen therapy
NIV (CPAP)
Lung Volume Reduction Therapy
LuTx

Question 9

Oxygent therapy- How long per day and what is the indication?

Answer 9

minimum 15h/d

PaO2 < 60 mmHg and <88% O2 saturation

Question 10

COPD pharmacological treatment other than LABA LAMA ICS..

Answer 10

Influenza vaccine
Mucolytics
AB

Question 11

Define COPD exacerbation

Answer 11

Acute worsening of respiratory symp. that result in need of additional therapy

Question 12

How to assess the severity of an exacerbation?

Answer 12

Arterial blood gass
CXR (for alternative diagnosis)
ECG
WBC count

Question 13

Systemic corticosteroids- What will we give, how much and for how long?

Answer 13

Prednisone
40 mg
5 days

Question 14

Asthma severity classification

Answer 14

Mild intermittent
Mild persistent
Moderate persistent
Severe persistent

Question 15

Special feature of PEF?

Answer 15

Daily variability > 20%

Question 16

Anti IgE drug

Answer 16

Omalizumab

Question 17

Clinical features of asthma exacerbation

Answer 17

Too breathless
Respiratory rate > 25/min
HR > 110 BPM
PEF < 50% of predicted normal or best

Question 18

PEF value in life threatening situations

Answer 18

< 33%

Question 19

Immediate management of asthma exacerbation

Answer 19

Oxygen
High dose Albuterol+Ipratropium
High dose systemic steroids

Question 20

asthma exacerbation respiratory medicine lecture notes what to add

Answer 20

Nebulized ipratropium
IV MgSO4
IV bronchodilators

Question 21

Classification of pneumonia (pathology)

Answer 21

Bronchopneumonia
Lobar
Interstitial

Question 22

Stages of pneumonia (4)

Answer 22

1. Congestion
2. Red hepatization
3. Grey hepatization
4. Resolution

Question 23

Grey hepatization is due to

Answer 23

Break down of RBC

Question 24

Auscultation of pneumonia

Answer 24

Bronchial breathing sounds

Question 25

Tectile fermitus is pneumonia

Answer 25

Increased due to lungs being filled with fluids

Question 26

Bronchopneumonia on CXR

Answer 26

Patchy areas spread throughout the lung

Question 27

Interstitial pneumonia on CXR

Answer 27

Spread pattern throughout, especially concentrated in the perihilar regions

Question 28

Pneumonia specific pathogen - How can we recognise it?

Answer 28

``` Sputum culture Blood culture Pleural fluid Antigen detection Serological test ```

Question 29

Which AB can we start if we suspect interstitial pneumonia?

Answer 29

Macrolides - Clarythromicine

Question 30

Hospital Aquired Pneumonia definition

Answer 30

Pneumonia that developes 48h post hospital admission

Question 31

Lung abscess are caused mainly by which bacterias?

Answer 31

``` Fusobacterium Prevotella Strep Staph Klebsiella ```

Question 32

When can we say that a patient is free of TB infection?

Answer 32

3 sputum samples are negative

Question 33

Treatment for TB lasts

Answer 33

6-24 months

Question 34

ILD of known etiology caused by exposure is devided into 2

Answer 34

Organic- Hypersensitivity pneumonitis | Inorganic- Silicosis, Asbestosis

Question 35

Inorganic substances

Answer 35

Silicosis Asbestosis Berylliosis Coal worker's lung

Question 36

IIP is devided into

Answer 36

Idiopathic Pulmonary Fibrosis Usual Interstitial Pneumonia Acute Interstitial Pneumonia

Question 37

CXR in ILD

Answer 37

Reticular Diffuse / Nodular bronchovascular Reticulonodular or infiltrative pattern

Question 38

In IIP which is the most common?

Answer 38

IPF

Question 39

IPF drug

Answer 39

Nintedanib

Question 40

Sarcoidosis is most common in which populatons?

Answer 40

African american | Scandinevian

Question 41

Sarcoisosis symptoms

Answer 41

Hypoxemia Heart blocks Bells palsy Erythema nodosum

Question 42

Sarcoidosis on HRCT

Answer 42

Ground glass appearance

Question 43

OSA definition

Answer 43

Total cessation of airflow > 10 sec

Question 44

Hypopnea=

Answer 44

shallow breathing or an abnormally low respiratory rate

Question 45

Apnea-Hypopnea Index is used to

Answer 45

Indicate the severity of sleep apnea

Question 46

AHI values

Answer 46

Normal: AHI<5 Mild sleep apnea: 5≤AHI<15 Moderate sleep apnea: 15≤AHI<30 Severe sleep apnea: AHI≥30

Question 47

Causes for OSA

Answer 47

``` Obesity Short neck Alcohol Diabetes Tonsillitis Macroglossia Large uvula Chronic URI ```

Question 48

Name of an intra-oral device that is given to OSA patients

Answer 48

Mandibular Advancement Device

Question 49

Why give CPAP/BPAP in OSA?

Answer 49

Airflow can prevent pharyngeal collapse