Resp

Question 1

Side effects of steroid inhaler

Answer 1

hyperglycaemia
thin skin
peptic ulcer dis
isomnia
wt gain

Question 2

if an asthmatic patient Is waking up at night with the asthma symptoms despite using steroid inhaler 800mcg,salmeterol and moteleukast

Answer 2

increase the dose of beclometasone inhaler unto 1000mcg or add a LAMA(Theophyline)

max dose for moteleukast is 10mg/day and for salmeterol is 200mcg/day

Question 3

increased ACE levels
Bilateral hilar lympadenopathy
age 20 -40 years
erythema nodosum
lupus pernio; red purple lesions on the nose/ears
Dx?

Answer 3

Sarcoidosis

Question 4

a patient tis treated for arrhythmia and was given medication for it.He developed rash over scalp and elbows+also wears gloves in hot weather.
Which medication can cause this?

Answer 4

beta blocker has exacerbated psoriasis and also raynuds phenomena

Question 5

best diagnostic test for a lung cancer will be?

Answer 5

bronchoscopy followed by biopsy if this is not in the options then select CT scan

Question 6

most useful test to diagnose COPD is?

Answer 6

Spirometry
FEV1/FVC ratio less than 70% indicates airflow abs

Question 7

recurrent chest infections
sputum sample; pseudomonas auruginosa
steatorrhea; smelly stools
failure to thrive; less centiles
meconium ileus
rectal prolapse
prolonged jaundice

Answer 7

CF

Question 8

cough
SOB
Wt loss
clubbing
b/l fine end exp crepts
ABG;type 1 HF

Answer 8

Idiopathic Pul Fibrosis

causes;
prolonged contact with pigeons, smoking,gerd

HRCT honeycombing and reticular pattern

Tx;Azathioprine,prednisolone and acetylcysteine.

Question 9

tx for proximal DVT and PE

Answer 9

Apixaban and Rivaroxaban

if not suitable then;
LMWH for 5 days followed by dabigatran or edoxaban

LMWH with warfarin for 5 days or until the INR is 2 for 2 consecutive readings after that warfarin only

Question 10

cough
fever
hemoptysis
mass in the upper lung lobe
dx
tx

Answer 10

aspergilloma

itraconazole

In questions like these they also give the history of immunocompromised,diebetics,alcoholics
where the differential of klebsiella also arises

Question 11

hemoptysis
hematuria
malaise

Answer 11

wagers granulomatosis

anca antibodies are present

tx; steroids and cyclophosphamide

Question 12

tachypnea
breathless
sweating
leg cramps
pin point pupils

Answer 12

ARDS caused by heroin misuse

Question 13

an elderly pt completed a course of amoxicillin
what could it be

Answer 13

pneumonia

CAP

Question 14

faltering growth
recurrent chest infections
nasal polyps
person is a greek
Dx

Answer 14

CF; autosomal recessive condition

Diagnosed; by sweat test

Question 15

using SABA more
what is the next step

Answer 15

LABA+LAMA

Question 16

TX of COPD when peak flow shows diurnal variation and peak flow is only 25%

Answer 16

LABA+ICS

Question 17

if LABA+LAMA Or LABA+ICS don’t work what is the next option

Answer 17

LABA+LAMA+ICS

Question 18

History of cig smoking
moon like facies
central obesity
wt loss
hemoptysis
dx

Answer 18

Small cell ca

they can develop paraneoplastic syndromes such as cushings synd

Question 19

retired miner
asbestos expo
cough,wheeze
hemoptyis
no smoking
dx(which CA)

Answer 19

MESOTHELIOMA

Question 20

most common cause of lung cancer in its who do not smoke

Answer 20

NSCLC;Adenocarcinomas
LOCATED PERIPHERALLY IN THE LUNG

Question 21

asthma is not a risk factor for ARDS

Question 22

SACCAROPOLYSPORA RECTIVIRGULA
causes

Answer 22

Farmers lungs

Question 23

aspergillus clavatus
working in brewery
cough, fever and malaise

Answer 23

malt workers lungs

Question 24

even in a young patient like 33
PE’s ‘gold standard test” would be CTPA

preferable is V/Q

Question 25

SOB
black sputum
small pul nodules
dx?

Answer 25

coal workers pneumoconiosis

Question 26

SOB
cough
pottery/ceramic industry

Answer 26

Silicosis

Question 27

exposure to mining dust
Rheumatoid arthritis

Answer 27

Caplan synd

Question 28

causes of allergic bronchogenic alveolitis

Answer 28

mushroom, bird fancier(from bird droppings), farmer,cheese workers lungs

not asbestos

Question 29

A COPD pt who is severely hypoxic <7.3
is a candidate for LTOT

Question 30

tx of OSA

Answer 30

life style;wt loss advice
refer routinely to sleep care centre to find tx
simple technique; not to sleep in supine position