RESP 1

Question 1

causes of common corzya

spread via what

Answer 1

rhinovirus
coranovirus
adenovirus
spread via droplets

Question 2

sinusitis proceeded by what 
what is it 
cause
RF for it 
symp
acute subacute chronic

Answer 2

corzya
inflam of mucous membrane of paranasal sinuses
pneumonia, HI, rhinovirus
nasal obstruction, rhinitis, swimming, smoking
frontal headache worse on leaning forward, nasal discharge, mouth breathing, post drip - chronic cough
1w-1m
1-3m
>3m

Question 3

ix for sinusitis 
acute viral treatment 
acute bacterial treatment and second line 
chronic 
polyps/oedema
allergic rhintiis

Answer 3

nasondoscopy sinus culture CT since if cx suspected

analgesia, decongestant (oxymetazoline), intranasal steroid memtasaone, nasal ipratropium

Amox 2g PO BD
wait 10d then clinamycin and cefaxime/cefpodoxine
analgesia, decongestant, corticosteroid, intra nasal saline

amox. nasal saline irrigation

decongestants

oral pred 60mg OD for 4 days

Question 4

what is croup
cause
who and when
symptoms

Answer 4

laryngotracheobronchtiis inflam oedema
parainfluenza
6m-3y
autumn
stridor, croup, worse at night, fever, corzyal symp

Question 5

mild croup and rx
mod
severe

Answer 5

mild: no stridor at rest
PO dex and supportive

mod: stridor at res and no agitation/lethargy
PO dex and neb adrenaline

severe: stridor at rest and agitation/lethargy
PO/IM/IV dec and neb adrenaline and humidified oxygen. consider intubation

if no dex consider pred

Question 6

acute epiglottis is what
cause and age
symtoms
ix

Answer 6

severe infection of glottis
HIB 2-6yo
rapid onset. unwell child. drooling of saliva
clinical diagnosis. laryngoscopy confirms dx and airway established

Question 7

treatment of croup

Answer 7

secure airway: laryngoscope and intubate
in emergency tracheostomy/cricothyrotomy
IV Abs cefotaxime plus minus dexamethasone
once patient stable PO ABs amox

Question 8

type A influenza

type B

Answer 8

pandemics

localised outbreaks

Question 9

common causes of pneumonia

Answer 9

pneumonia
HI COPD px
SA following influenza infection
influenza type A

Question 10

CURB65

Answer 10

confusion MSQ<=8
urea >7
RR>=30
SBP <=90 DBP<=60
>=65

Question 11

mycoplasma pneumonia symp

assoc with what

Answer 11

dry cough. rash

assoc AI cold agglutinins haemolytic anaemia and erythema multiform

Question 12

legionella
coexillar burnetiiy
chlamydia postacci
klebsiella
pneumococcal 
PCP
psuedomonas

Answer 12

low Na. stagnant water/air conditioning

sheep and cattle

infected birds (parrots)

aspiration. elderly. alcoholics. cavitating. upper lobes. red jelly sputum

immunocpmp post splenectomy rusty sputum

HIV exercise desaturated cotrimox

peristant

Question 13

what should be offered to px over the age of 50 after pneumonia and when

Answer 13

6w
CXR
ensure no lung cancer

Question 14

ix for asthma

treatment cascade

Answer 14

FEV down FVC normal %<70 decreased PEFR. FeNO. CXR if smoker

SABA (+ICS)
SABA and ICS and LRTA (or LABA)
add LABA (and check LRTA effectiveness)
MART (SABA and ICS comb)
oral steroids

Question 15

mod acute asthma

severe

life threatening

Answer 15

PEFR 50-70% of predicted. speech normal. worsening symptoms. RR<25. pulse <110

PEFR 33-50%RR>25 pulse >110 unable to complete sentences

PEFR <33% sats <92% silent chest cyanosis resp effor hypotension confusion brady

Question 16

treatment for acute asthma

Answer 16

oxygen maintain sats 94-98%
salbutamol 5mg neb every 15-30mins
PO prednisone 40-50mg/IV hydrocortisone 100mg 6 hourly
Neb ipratropium
theophylline
Mg sulphate 1.2-2g IV over 20 mins
anaesethists

Question 17

what is chronic bronchitis
what is emphysema - CXR see what
cx of COPD
management of COPD

Answer 17

cough and sputum for 3 months
dilatation of air sacs and destruction of walls - decreased SA. swiss cheese

hypertension - cor pulmonale. osteoperosis secondary to rx

smoking
annual flu vaccine
once off pneumococcal

Question 18

ix for COPD

treatment cascade

Answer 18

FEV1 low FVC low <70%. CXR: hyperinflation, flat hemidiaphragm, exclude cancer. FBC exclude secondary polycythaemia. BMI. ABG. PERF down

SABA/SAMA
FEV1 >50% LABA/LAMA (tiotropium)
FEV1 <50% LABA and ICS comb OR LAMA
if taking LABA then add ICS comb
oral steroids
long term O2 in some
if over 65 starts bisphosphonates

Question 19

exacerbation of COPD cause

treatment

Answer 19

HI commonest, pneumococcal, rhinovirus commonest viral

neb salbumatol 5mg 4 hourly and ipratropium 500mg 16hourly
oxygen aim 88-92
steroids Pred 30mg OD 7-14 days
ABs

Question 20

cause of bronchiectasis

Answer 20

CF commonest
post infective - TB, measles, pertussis, penuminia
bronchial obstruction - lung cancer, foreign body
immunoglobulin defic
kartagers dynrome - ciliary dysfunction

Question 21

ix for bronchiectasis

cx

Answer 21

CXR non specific 
HRCT diagnostic dilatation of bronchi
FBC
serum alpha 1 antitripsin
sputum C&S
serum immunoglobulim

haemoptysis, cerebral abscess

Question 22

treatment of bronchiectasis

Answer 22

pulmonary rehab
postural drainage to clear airways 
inhaled bronchodilators in some
ABs if HI, SA, pseudomonas
surgery for localised disease

Question 23

cystic fibrosis is what
neonates:
other symp
ix

Answer 23

AR defect in gene CFTR
meconium ileus. prolonged jaundice.
recurrent chest infections, malabsorption, liver dx
sweat chloride >60. new born testing IRT test. genetic

Question 24

chest infections in CF cause
treatment
general treatment

Answer 24

SA, pseudomonas, aspergillus
regular chest physio and postural drainage, amox +/- salbutamol
high calorie diet for steatorrhoea, vit supplements, pancreatic enzymes, heart and lung transplants