pulmo

Question 1

Define Kartenger syndrome

Answer 1

Situs inversus, ciliary primary dysfunction , sterility in man

Question 2

causes of broncheoctasis

Answer 2

allergic bronchopulmonary aspergillosis , immunodeficiency , ciliary dysfunction , cystic fibrosis , foreign body .

Question 3

diagnosis methods in broncheoctasis

Answer 3

1. do HRCT \ CXR,
2. find underline cause - prick test aspergilosis , immunodeficiencies , sweat test , ciliary function , septum microbiology

Question 4

define reid index

Answer 4

thickness of mucous gland \ wall . high in COPD

Question 5

Emphsysema -

Answer 5

permanent enlargment of the distal air spaces in terminal bronchioles- classfied into panacinar and centroacinar
loss of elastic recoil - tendency of alveoli to collapse

Question 6

pink puffer vs blue bloater

Answer 6

poor ventilatory drive and easily drift into respiratory failure with hypercapnia and RHF .
in PINK puffers - still has preserved ventilatory drive .. less hypercapnia .

Question 7

COPD staging

Answer 7

A- tiffanue <70 ; FEV1- 50 -70 %
B- tiffanue < 70 ; FEV1= 30-50%
C-tiffanue < 70 ; FEV1=<30% OR less 50% with chronic respiratory failure .

Question 8

where does croup affect

Answer 8

larynx and trachea

Question 9

which test can differentiate croup and H flue

Answer 9

steeple sign on Xray - subglottis narrowing. wheres in H flu its supraglottic inflammation

Question 10

in which setting the AP diameter is normal ? pink pufferes or blue bloaters

Answer 10

blue bloaters

Question 11

reticulonodular pattern is mainly caused by…

Answer 11

sarcoidosis

Question 12

idiopathic pulmonary fibrosis deff

Answer 12

progressive irreversible fibrosis of lung , chest CT shows pattern of huneycombing . commonly >50 years man ..

Question 13

idiopathic pulmonary fibrosis sym

Answer 13

dyspnea on exrestion , nonproductive cough , late insp fine cracjkes , clubbing , lower lung predominance

Question 14

features of sarcoidosis

Answer 14

GRUELING- granuloma , arthritis, uveitis , erythema nodosum,lymph node enlargment , interstitial fibrosis , negative TB ,gammaglobnemia

Question 15

which crnial nerve palsy is sarcoidosis most likely to cause

Answer 15

cranial nerve 7

Question 16

what is the heerfordt syndrome

Answer 16

parotitis , uveitis , facial palsy

Question 17

labaratory tests in sarcoidosis

Answer 17

high ACE , IgG,ca , cd4 \cd8 in bronchoalveolar lavage ( cd4 is consumed in granuloma )

Question 18

Pel Ebstein fever is a cherectaristics of which disease ?

Answer 18

Hodgkin - intermittent fever

Question 19

clinical features of hypersensativity pneumonia

Answer 19

dyspnea without wheezing , flue like symptoms , diffused fine crackles . chronic - recurrent common cold with cough fever

Question 20

diagnosis of hypersensitivity pneumonia

Answer 20

BAL - lymphocytic predominance , function test - restrictive. IgG antibodies during allergic reaction. upper love reticulonodular pattern. can cause anorexia in chronic form .

Question 21

x ray cherectaristics of abestosis

Answer 21

grounf glass opacities in lung bases , calcified pleural plagues , effusion could be the first sign of mesothelioma , no productive paroxysmal cough. at the begining is reticular disease and only later can cause fibrosis . “ egg shell calcification”

Question 22

describe caplan syndrome

Answer 22

pneumoconiosis together with rheumatic arthritis .larger nodules

Question 23

which mutation is associated with SCLC

Answer 23

I myc

Question 24

which mutations are associated with adenocarcinoma

Answer 24

EGFR , ALK , KRAS

Question 25

What are the suspected signs of malignancy on CT lung

Answer 25

solid lesion > 8 mm , irregular margins , spicules, calcifications , age > 40

Question 26

what is the use of immunohistochemistry in lung cancer

Answer 26

differentiate bw primary and secondary lung cancer. TTF1 protein found pneumocytes. chromogranin indicative of SCLC.

Question 27

When would you exclude surgery in lung cancer

Answer 27

fev<50 % or hypoxemia

Question 28

define light criteria

Answer 28

• LDH Pleura > 0.6
  -PROTEIN > 0.5
  CHOLESTEORL > 0.3

EXUDATE !

Question 29

DEFINE PARAPNEUOMOTIC effusion

Answer 29

accumulation of exudative fluid in pleural space… can be complicated - invasion of bacteria into pleural space. uncomplicated- no invasion . complicated if : glucose is less than 60 mg \ dl , ph<7.2 , high LDH

Question 30

what is the management in effusion

Answer 30

chest tube - furosamide can treat transudate . criteria low glucose and ph>7.20