Mixed Lecture questions

Question 1

the common cold is usually caused by what virus

Answer 1

rhinovirus

Question 2

what bacteria is epiglottitis commonly caused by

Answer 2

H influenzae

Question 3

what are the clinical features of asthma

Answer 3

wheeze
chest tightness
breathlessness
cough

Question 4

what investigations can help confirm asthma

Answer 4

spirometry
challenge test
peak expiratory flow rate monitoring

Question 5

what is the treatment for acute asthma

Answer 5

O2
nebulised SABA
IV aminophylline
Antibiotics if there is infection

Question 6

what are the main pathological features of COPD

Answer 6

mucous hypersecretion
tissue destruction
small airway inflammation and fibrosis

Question 7

what are the clinical features of COPD

Answer 7

tightness 
wheeze SOB
hyperinflated chest
central cyanosis 
productive cough 
accessory muscle use 
prolonged expiration 
cor pulmonale

Question 8

what are investigations that can be done to diagnose COPD

Answer 8

spirometry 
ABG-arterial blood gas
FBC-look for hypoxia 
CXR
Echo-cor pulmonale

Question 9

what lifestyle factors can a patient change to improve their symptoms of COPD

Answer 9

if obese lose weight
stop smoking
pulmonary rehabilitation

Question 10

what is the management of COPD in general

Answer 10

patients offered vaccines for flu etc
pulmonary rehabilitation therapy 
SABA
LABA- if symptoms get worse
high does inhaled steroid if FEV1

Question 11

how are exacerbation’s of COPD managed

Answer 11

O2
nebulised bronchodilator
iv Aminophylline
antibiotics if there is infection

Question 12

what are the causative agents of pneumonia

Answer 12

strept pneumonia
staph aereus
haemophillus influenzae

Question 13

what are the investigations to diagnose TB

Answer 13

3 sputum specimens:

1. sputum smear with Ziehl Neilsen stain
2. sputum culture
3. sputum PCR

CXR
CT scan of thorax
bronchoscopy
pleural aspiration and biopsy

Question 14

what are the TB drugs used for 4 months

Answer 14

Rifampicin
Isoniazid
Ethambutol
Pyrazinamide

Question 15

what are the TB drugs used for 2 months

Answer 15

Rifampicin

Isoniazid

Question 16

what are the side effects of Rifampicin

Answer 16

Orange irn bru tears and urine
induces liver enzymes
OCP ineffective
Hepatitis

Question 17

what are the side effects of Isoniazid

Answer 17

hepatitis

peripheral neuropathy

Question 18

what are the side effects of Ethambutol

Answer 18

optic neuropathy

Question 19

what re the side effects of pyrazinamide

Answer 19

gout

Question 20

what are features a patient may present with that suggest lung cancer

Answer 20

heamoptysis
weight loss
poor appetite
breathless and cough

Question 21

what are extrapulmonary signs a patient may have lung cancer

Answer 21

finger clubbing
HTPA
cervical lymphadenopathy
superior vena cava obstruction

Question 22

Horners syndrome can be a sign of lung cancer, what is Horners syndrome

Answer 22

drooping of the upper eyelid
lack of sweating in the face
constricted pupil

Question 23

what is Horners syndrome caused by

Answer 23

damage to the sympathetic nerves in the neck possibly lung cancer metastasis

Question 24

what is Pancoasts syndrome

Answer 24

Wasting of the small muscles in the hand in apical lung cancer invading the brachial plexus

Question 25

where is lung cancer most likely to spread to

Answer 25

Brain Bones adrenal glands Liver

Question 26

what is the 5 year survival rate for lung cancer

Answer 26

fewer than 10% of patients with lung cancer still alive at 5 years

Question 27

how would you treat epiglottitis

Answer 27

``` avoid instrumentation monitor for respiratory failure O2 if needed iv antibiotics according to culture specimens may need steroids for pharyngeal oedema ```

Question 28

what antibiotics could you give for epiglottitis

Answer 28

augumentin and cephlasporin

Question 29

what are the symptoms of glandular fever

Answer 29

``` fever sore throat fine red rash puffy eyes lyphadenopathy inflammation of the liver ```

Question 30

what tests could be done to diagnose glandular fever

Answer 30

monospot test blood film look for Epstein Barr virus

Question 31

what are the likely pathogens to cause rhinosinsitis

Answer 31

haemophillus influenzae moraxella catarrhalis streptococcus pneumoniae

Question 32

what virus usually causes the common cold

Answer 32

rhinovirus

Question 33

why wouldn't you give penicillin like ester such as ampicillin in glandular fever

Answer 33

it can result in a rash

Question 34

what is one of the key driver mutations that occur in approx 35% of smoking induced lung cancer

Answer 34

KRAS

Question 35

apart from KRAS what are 4 other well known key driver mutations in the development of lung cancer

Answer 35

EGFR BRAF and HER2 ALK rearrangements