Resp

Question 1

What is the most common organism causing IECOPD?

Answer 1

Haemophilus influenzae

Question 2

What pathogen causing pneumonia often also causes hyponatraemia?

Answer 2

Legionella (diagnosed by urinary antigen test, often also deranges LFTs too)

Question 3

What is the spirometer pattern that would be shown in a patient with COPD?

Answer 3

Obstructive
FEV1 reduced
FVC normal
Therefore ratio FEV1/FVC reduced

Question 4

What is the most common radiological finding in sarcoidosis?

Answer 4

Bilateral hilar lymphadenopathy
(Also interstitial lung disease)

Question 5

Which type of lung Ca is most associated with hypercalcaemia?

Answer 5

Squamous cell carcinoma
(Due to PTHrp)

Question 6

What is the most common cause of IECOPD?

Answer 6

Haemophilus influenzae

Question 7

A centor score of >3 or FEVERpain score of >4 would indicate treatment with which antibiotic?

Answer 7

Phenoxymethylpenicllin for 7-10days

Question 8

What is the anatomical location of chest drain insertion?

Answer 8

5th ICS
Mid axillary line

Question 9

What are some features of a life threatening asthma attack?

Answer 9

PEF <33%
Sats <92%
Silent chest
Normal pCO2
Cyanosis
Drowsy

Question 10

How is an asthma attack managed in hospital?

Answer 10

O SHIT
Oxygen
Salbutamol nebuliser back to back
Hydrocortisone 100mg IV or prednisone 40-50mg 5/7days
Ipatropium bromide nebulisers QDS
Mg sulphate

Question 11

What is the difference between a primary and secondary pneumothorax?

Answer 11

Primary no underlying lung pathology
Secondary there is underlying lung pathology

Question 12

A secondary pneumothorax of 1.5cm should be managed by what?

Answer 12

If 1-2cm aspiration
If >2cm then chest drain insertion

If primary pneumothorax <2cm and not breathless, manage conservatively

Question 13

What antibiotic can be used in COPD patients with frequent exacerbations?

Answer 13

Azithromycin

Question 14

Which type of NIV is most effective in type 2 respiratory failure?

Answer 14

BIPAP

Question 15

Which type of NIV is used in pulmonary oedema?

Answer 15

CPAP

Question 16

How does the second line management for COPD differ depending on whether there is asthmatic features/ steroid response?

Answer 16

1st line: SABA or SAMA prn
2nd line if asthmatic features: LABA + ICS
if no asthma features: LABA + LAMA
3rd line is LABA + LAMA + ICS (and prn SABA)
Theophylline if above doesn’t work / can’t use inhalers

Question 17

Which organism causing pneumonia is associated with erythema multiforme?

Answer 17

Mycoplasma pneumoniae

Question 18

Legionella pneumonia is associated with which electrolyte disturbance?

Answer 18

Hyponatraemia

Question 19

What is an example of a short acting muscarinic antagonist?

Answer 19

Ipatropium

Question 20

What is the treatment for latent tuberculosis?

Answer 20

Either
3 months of rifampicin + isoniazid (+ pyridoxine)
Or
6 months isoniazid (+ pyridoxine)

Question 21

CXRVwith pleural plaques and bilateral lower lobe changes is suggestive of what?

Answer 21

Asbestosis

Question 22

What are the classical CXR findings in silicosis?

Answer 22

Upper lobe ground glass opacities
Egg shell calcification of lymph nodes