passmed year 5

Question 1

Which of the following options confirms that the chest drain is located in the pleural cavity?

Answer 1

Chest drain swinging: Rises in inspiration, falls in expiration

Question 2

reduced breath sounds and dullness to percussion

Answer 2

pleural effusion

Question 3

Auscultation reveals normal heart sounds, bilateral coarse crackles, and a widespread polyphonic wheeze. She has a past medical history of pertussis as a toddler and recurrent pneumonia as a teenager.

Answer 3

bronchiectasis

Question 4

penumonia caused by aspiration

Answer 4

klebsiella

Question 5

klebsiella normally in what zones of the lung

Answer 5

upper

Question 6

target O2 sats in asthma

Answer 6

94-98%

Question 7

mx of brochiectasis

Answer 7

hysical training (e.g. inspiratory muscle training) - has a good evidence base for patients with non-cystic fibrosis bronchiectasis
postural drainage
antibiotics for exacerbations + long-term rotating antibiotics in severe cases
bronchodilators in selected cases
immunisations
surgery in selected cases (e.g. Localised disease)

Question 8

tx in high altitude cerebral oedema

Answer 8

dexamethasone

acetazolamide in prevention

Question 9

COPD standby medication:

Answer 9

NICE recommend offering a short course of oral corticosteroids and oral antibiotics to keep at home

Question 10

30-40 year old with basal emphysema and abnormal LFTs

Answer 10

alpha 1 antitrypsin deficiency

Question 11

Infective exacerbation of COPD

Answer 11

first-line antibiotics are amoxicillin or clarithromycin or doxycycline

Question 12

Bibasal fine end-inspiratory crepitations

Answer 12

PF

Question 13

Decrease in pO2/FiO2 in poorly patient with non-cardiorespiratory presentation →

Answer 13

ARDS

Question 14

persistent mouth ulcer

Answer 14

think SCC

Question 15

ramsay hunt syndrome tx

Answer 15

Oral aciclovir and prednisolone

Question 16

dix hallpike manouvre reproduces what

Answer 16

rotatory nsytagmus