MRCP Respiratory

Question 1

Which occupational lung disease is most likely to predispose a patient to developing TB?

Answer 1

Silicosis

toxic to macrophages

Question 2

Benign ovarian tumour, ascites & pleural effusion

Answer 2

Meigs syndrome

Question 3

Criteria for LTOT

Answer 3

PaO2 <7.3 when stable
PaO2 between 7.3 - 8 when stable & concurrent 2ry polycythaemia, pulmonary hypertension, peripheral oedema or nocturnal hypoxaemia

Question 4

Features of SVC obstruction

Answer 4

Headache, distended neck veins, fixed elevated JVP, facial & periorbital swelling (&conjunctival)

Question 5

IECOPD commonest organisms

Answer 5

Haemophilus influenza (commonest) 
Also moraxella catarrhalis, strep pneumoniae

Question 6

Epworth sleepiness score above what indicates OSA?

Answer 6

Score of 11 or above

out of 24

Question 7

Commonest cause of occupational asthma

Answer 7

Isocyanates

Followed by flour/grain

Question 8

Haemoptysis, non-smoker, cherry red spot on bronchoscopy

Answer 8

Bronchial carcinoid

Question 9

Bi-hilar lymphadenopathy, erythema nodosum, fever, arthralgia

Answer 9

Lofgren syndrome

Question 10

Treatment for legionella pneumonia

Answer 10

Clarithromycin/erythromycin

Question 11

Antibiotic choice for mycoplasma pneumonia

Answer 11

erythromycin/clarithromycin

Question 12

Most common pathogen in CAP

Answer 12

Strep pneumoniae

Question 13

Pathogen causing flu-like illness, cough, raised LDH & cold haemolysis

Answer 13

Mycoplasma pneumoniae

Question 14

Which pathogen is a cause of LRTI associated with reactivation of herpes simplex virus?

Answer 14

Strep pneumoniae

Question 15

Definitive investigation of active TB?

Answer 15

Respiratory secretions (eg sputum) positive for mycobacterium tuberculosis

Question 16

What is the only treatment shown to prolong life in patients with COPD?

Answer 16

Long term oxygen (used in excess of 15h per day)

Question 17

Eosinophilic granulomatosis with polyangiitis autoantibody

Churg-strauss

Answer 17

p-ANCA

Question 18

‘crazy paving’ appearance on HRCT

Answer 18

Pulmonary alveolar proteinosis

Question 19

Pneumonia associated with cold sores

Answer 19

Streptococcus pneumoniae

Question 20

Antibiotic therapy for CF patients colonised with pseudomonas

Answer 20

6 months PO azithromycin

Question 21

Pleural fluid pH <7.2 is highly suggestive of what?

Answer 21

Empyema

Question 22

Most accurate test to diagnose sarcoidosis?

Answer 22

Transbronchial lung biopsy

Question 23

Investigation with the highest diagnostic yield in TB?

Answer 23

Pleural biopsy and culture

Question 24

Treatment of bronchial carcinoid

Answer 24

Surgical resection (lesions are vascular and obstructive)

Question 25

Threshold for mechanical ventilation in GBS (ml/kg FVC)

Answer 25

20ml/kg FVC

Question 26

Treatment of ABPA

Answer 26

PO steroids and itraconazole