Resp

Question 1

Type 1 respiratory failure?

Answer 1

Hypoxia associated with hyperventilation and low CO2

Question 2

Type 2 respiratory failure?

Answer 2

Hypoxia associated with hypoventilation, thus reduced clearance of CO2.
Acute states- respiratory acidosis

Question 3

Bronchiectasis Definition?

Answer 3

permanent irreversible dilatation of bronchi and bronchioles

Question 4

Aetiology of bronchiectasis?

Answer 4

Obstruction with severe infection or severe infection alone e.g. whooping cough
Genetics (CF, Kartagener’s syndrome)
Immunodeficiency (hypogammaglobulinemia)

Question 5

Clinical features of bronchiectasis?

Answer 5

Chronic cough
Purulent sputum, sometimes blood
Finger clubbing

Question 6

What part of the lung is most affected by bronchiectasis?

Answer 6

Lower lobes

Question 7

Manifestation of Cystic Fibrosis?

Answer 7

meconium ileus
recurrent and frequent infections w/ pseudomonas
Bronchiectasis
chronic pancreatitis
malabsorption

Question 8

Diagnosis of Cystic Fibrosis?

Answer 8

Prenatal screening

Measure chloride conc. in sweat

Question 9

Obstructive Airways on PFTs?

Answer 9

Dec. FEV1
Normal or Dec. FVC
Dec. FEV1/FVC ratio

Question 10

In what percentage of COPD is smoking implicated?

Answer 10

90%

Question 11

What do ‘blue bloater’ and ‘pink puffer’ indicate?

Answer 11

Chronic Bronchitis

Emphysema

Question 12

Chronic Bronchitis Definition?

Answer 12

persistent productive cough on most days for a minimum of 3 months of the year for no less than 2 consecutive years, which can’t be contriubted to any other cardiac or respiratory cause

Question 13

Emphysema Definition?

Answer 13

abnormal, permanent enlargement of the airspaces distal to the terminal bronchiole, due to destruction of their walls and with minimal fibrosis

Question 14

Chronic Bronchitis Pathology?

Answer 14

Irritants (most commonly cigarette smoking) cause:
Hypersecretion of mucous
Inflammation and fibrosis -> obstruction
Squamous metaplasia/dysplasia/SCC can occur

Question 15

The most common form of emphysema?

Answer 15

Centri-acinar

Question 15

The most common form of emphysema?

Answer 15

Centri-acinar

Question 16

Where does centri-acinar emphysema occur?

Answer 16

Upper lobes

Question 17

What is centri-acinar emphysema associated with?

Answer 17

Smoking, coal dust

Question 18

What is pan-acinar emphysema associated with?

Answer 18

Alpha 1 Antitrypsin deficiency

Question 19

Where does pan-acinar emphysema usually affect?

Answer 19

Lower lobes

Question 20

Types of bronchial asthma?

Answer 20

Atopic (most common)
Non-atopic
Drug-induced asthma (aspirin)
Occupational asthma

Question 21

What causes atopic asthma?

Answer 21

Type 1 IgE mediated Hypersensitivity reaction

Question 22

What causes non-atopic asthma?

Answer 22

No evidence of allergens

Viral causes/inhaled air pollutants

Question 23

What drug can induce asthma?

Answer 23

Aspirin

Question 24

What is allergic bronchopulmonary aspergillosis?

Answer 24

proximal bronchiectasis seen in patients with asthma | inhalation of aspergillus spores

Question 25

What is obliterative bronchiolitis?

Answer 25

rare | lumen of small bronchioles become obliterated by fibrous tissues

Question 26

What causes obliterative bronchiolitis?

Answer 26

CT disease, IBD, Transplant (Graft vs. Host Disease, Chronic lung allograft rejection)

Question 27

Causes of Pulmonary Embolism?

Answer 27

Thromboembolism!!!!! | Tissue embolism, tumour embolism, foreign body embolism, fat embolism, amniotic fluid, air/gas (Caisson's disease-bends)

Question 28

Virchow's Triad?

Answer 28

Stasis, Hypercoagulability, Injury

Question 29

Risk for PEs?

Answer 29

heart disease, increased age, bed rest & immobility, OCP, tissue injury, late pregnancy, previous PE

Question 30

Symptoms of Pulmonary Embolism?

Answer 30

dyspnoea, fever, haemoptysis, cough, signs of pleuritis, rales, tachycardia often can be silent

Question 31

Pulmonary Oedema definition?

Answer 31

accumulation of fluid within the interstitium and alveolar airspaces

Question 32

Pulmonary Oedema presentation?

Answer 32

Dyspnoea, orthopnoea, cough, fine crackles on auscultation

Question 33

Pulmonary Hypertension Definition?

Answer 33

elevated pulmonary arterial pressure

Question 34

Causes of pulmonary HTN?

Answer 34

primary/idiopathic- minority secondary- decrease in cross-sectional area of pulmonary vascular bed (emphysema secondary- increased vascular blood flow (mitral stenosis, LVF)

Question 35

Pulmonary HTN clinical features?

Answer 35

intense fatigue, dyspnoea, cor pulmonale/ RHF, pulmonary artery atheroma

Question 36

What is a hamartoma?

Answer 36

mass of tissue formed of components normally present in adult lung

Question 37

What is the peak age for lung carcinomas?

Answer 37

65-75 years

Question 38

Symptoms of lung cancers?

Answer 38

asymptomatic cough, weight loss, dyspnoea, chest pain, haemoptysis, antibiotic resistant pneumonia, bronchiectasis, lung abscess paraneoplastic syndrome

Question 39

Spread of lung cancer?

Answer 39

Local invasion- hoarseness, dysphagia, obstruction of SVC, Horner's syndrome Lymphatic- SVC obstruction Distant spread- everywhere, bone, brain and liver most common

Question 40

Histology of Lung Carcinomas?

Answer 40

Small Cell Lung Carcinoma | Non-small cell Lung Carcinoma (SCC, adenocarcinoma, Large Cell Carcinoma)

Question 41

Which lung carcinoma has the worst prognosis?

Answer 41

Small Cell Lung Carcinoma

Question 42

What part of the lungs does SCLC occur in?

Answer 42

central lobes and peri-bronchial

Question 43

Defining features of SCC?

Answer 43

production of keratin | destruction of intercellular bridges

Question 44

What are carcinoid tumours?

Answer 44

group of neuroendocrine neoplasms

Question 45

What gene mutations are involved with lung cancers?

Answer 45

EGFR, KRAS, ALK

Question 46

Which mutation commonly occurs in smokers?

Answer 46

KRAS mutation

Question 47

What is a drug used to treat lung carcinomas?

Answer 47

Pembrolizumab

Question 48

What are pleural effusions like to percuss?

Answer 48

Dull

Question 49

What are pneumothoraxes like to percuss?

Answer 49

Hyper-resonant

Question 50

When is pleurisy pain worse?

Answer 50

On breathing

Question 51

What is malignant mesothelioma strongly associated with?

Answer 51

Asbestos exposure

Question 52

What neoplasm is strongly associated with asbestos exposure?

Answer 52

Malignant mesothelioma

Question 53

What is the prognosis for malignant mesothelioma?

Answer 53

Very poor, usually dead within 2 years

Question 54

What is Adult Respiratory Distress Syndrome (ARDS)?

Answer 54

clinical term for presence of diffuse alveolar damage with hyaline membranes fatal in 40% of cases

Question 55

How does ARDS present?

Answer 55

acute respiratory distress, tachypnoea, dyspnoea, arterial hypoxaemia

Question 56

What are pneumoconiosis?

Answer 56

a group of lung diseases caused by inhalation of dusts

Question 57

Examples of extrinsic allergic alveolitis?

Answer 57

farmer's lung, pigeon breeder's lung, air conditioner lung

Question 58

What is sarcoidosis distinguished by?

Answer 58

non-caseating granulomas

Question 59

Where does a SCC usually occur?

Answer 59

arising at the centre of the lung

Question 60

What is pneumonia?

Answer 60

an inflammatory condition affecting the lung parenchyma which is usually caused by an infective agent

Question 61

Classifications of pneumonia?

Answer 61

Bronchopneumonia, lobar pneumonia, non-infective special pneumonia

Question 62

Most common bacterial cause of pneumonia?

Answer 62

Strep. pneumoniae

Question 63

Treatment for community-acquired pneumonia? (strep. pneumoniae)

Answer 63

Amoxicillin | If v severe- +erythromycin or clarithromycin

Question 64

Treatment for pneumonia (Mycoplasma, Coxiella, chlamydia, legionella)?

Answer 64

erythromycin/ tetracycline

Question 65

Treatment for pneumonia (staph aureus)?

Answer 65

Flucloxallin | If MRSA- vancomycin

Question 65

Treatment for pneumonia (staph aureus)?

Answer 65

Flucloxallin | If MRSA- vancomycin

Question 66

Treatment for pneumonia (pseudomonas aeruginosa)?

Answer 66

aminoglycoside + beta lactam

Question 67

What is Legionnaire's Disease?

Answer 67

acute pneumatic illness | fever, chills, cough, confusion, chest pain, arthralgia, malaise, nausea, vomiting

Question 68

What causes Legionnaire's Disease?

Answer 68

Legionella Pneumophilia

Question 69

What percentage of Legionnaire's disease is fatal?

Answer 69

5-20%

Question 70

What common fungus infects the lungs of patients with AIDS?

Answer 70

Pneumocystis Jiroveci

Question 71

What distinguishing feature appears in cytomegalovirus?

Answer 71

Owl-eyes

Question 72

What is the leading cause of death in AIDS patients?

Answer 72

TB

Question 73

What is seen in TB?

Answer 73

Caseating granulomatous tissue

Question 74

When does primary TB usually occur?

Answer 74

In childhood | usually asymptomatic

Question 75

What part of the lungs does primary TB affect?

Answer 75

Ghon complex in the midzone

Question 76

What part of the lungs does secondary TB affect?

Answer 76

upper lobes, upper part of lower lobes

Question 77

What can aspiration of gastric contents cause?

Answer 77

Lung abscess

Question 78

What can distal acinar emphysema cause?

Answer 78

Spontaneous Pneumothorax