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Question 1

what might be seen on CXR in a patient with atelectasis:

Answer 1

• complete whiteout of the hemithorax

- tracheal deviation toward affected lung

Question 2

which is the most appropriate surface landmark to mark boundary between right middle and lower lobes:

Answer 2

sixth rib

Question 3

air crescent sign on CXR found in:

Answer 3

aspergillosis

Question 4

describe tracheal deviation in pneumothorax?

Answer 4

tracheal deviation away from pneumothorax

Question 5

unilateral vs bilateral pleural effusion causes

Answer 5

unilateral pleural effusion
- trauma, tumour or infection

bilateral

• hypoalbuminaemia
• cardiac failure
• renal causes

Question 6

farmer with

1. inflammation
2. chronic bronchiolitis
3. non-necrotizing granuloma

likely clinical diagnosis :

Answer 6

hypersensitivity pneumonitis

Question 7

Histiocytosis X presents with

Answer 7

scattered nodules of langerhans cells.

contain racket shaped birbeck granules

Question 8

gold standard investigation for TB

Answer 8

send atleast 3 spontaneous sputum samples for culture and microscopy

one early morning sample!

Question 9

20 y/o DKA , has deep laboured breathing - this is known as:

Answer 9

respiratory pattern of breathing is known as Kussmaul breathing.

Question 10

this is a sign found in CXR in bronchiectasis:

Answer 10

signet ring sign

Question 11

radiologist reports ‘region of ground glass opacity surrounded by denser lung tissue’

this sign is known as:

Answer 11

atoll sign

relatively specific for cryptogenic organising pneumonia (COP)

Question 12

Which CXR finding is consistent with PE:

Answer 12

wedge-shaped opacity in the right middle lobe

Pulmonary embolism notes

• acute onset chest pain
• SOB
• factor V leiden mutation
• erythematous, swollen lower extremity

Question 13

28 y/o M

pc: chronic non productive cough
sh: non-smoker
ix: normal FBC, CRP, CXR + spirometry

what is the next appropriate investigation?

Answer 13

bronchial provocation testing

ddx

• cough variant asthma
• GORD
• post nasal drop

investigate bronchial hyper-reactivity

Question 14

how is bronchial provocation testing performed?

Answer 14

methacholine or histamine

increasing doses given until FEV1 drops by 20%

Question 15

76 y/o M

pc: alcoholic, productive cough, weight loss, fever, haemoptysis. smoker

multiple nodules in lung

indicative of:

Answer 15

TB strong risk factors
- smoking, alcohol

classic hx
- fever, productive cough, weight loss, haemoptysis

Question 16

first line therapy for a patient with type 2 respiratory failure on room air

Answer 16

28% venturi mask

Question 17

desaturation on exercise is a classical feature of:

Answer 17

pneumocystis jirovecii pneumonia

Question 18

treatment for klebsiella infection

Answer 18

meropenem