Resp

Question 1

Chronic lung disease in electrical and aerospace industry workers?

Question 2

Chronic lung disease in coal miners?
Other occupations?

Answer 2

Silicosis

sandblasting

Question 3

Which type of lung ca is associated with hypercalcaemia? Why?

Answer 3

SqCC
- PTHrP

Question 4

Which type of lung ca is assoc with cushings? Why?

Answer 4

small cell
ectopic acth secretion

Question 5

Skin change in carbon monoxide poisoning?

Answer 5

cherry red

Question 6

Most common cause of lung abscess

Answer 6

aspiration pneumonia

Question 7

Reed stern berg cells

Answer 7

Hodgkins lymphoma

Question 8

4 options for abx therapy in low severity CAP

Answer 8

amox
doxy
erythromycin
clarithromycin

Question 9

site of chest tube insertion

Answer 9

5th ICS, mid axillary

Question 10

chest tube removal - should this happen during expiration/inspiration? why?

Answer 10

expiration
- risk of pneumothorax if removed on inspiration

Question 11

Lights criteria

Answer 11

pleural effusion is exudative if:

Pleural protein: serum protein >0.5
Pleural LDH:serum LDH >0.6
Pleural LDH >2/3 the upper limit of normal

Question 12

Steroid dose for exacerbation of COPD?

Answer 12

30mg OD for 5 days

Question 13

Options for abx in IECOPD?

Answer 13

amox
doxy
clari

Question 14

Contraindication for influenza vaccine?

Answer 14

egg protein allergy

Question 15

Abx used for TB meningitis?

Answer 15

STREPTOMYCIN instead of ethambutol
+ RIP

Question 16

Name of tuberculous skin lesion?
- describe the appearance

Answer 16

lupus vulgaris
- well demarcated brown nodules, jelly consistency

Question 17

Most common organisms to cause HAP - name 4

Answer 17

MRSA
Pseudomonas
Klebsiella
E Coli

Question 18

1st choice abx for HAP

Answer 18

co-amoxiclav

Question 19

Type of lung lesion seen in sarcoidosis?

Answer 19

non caseating granuloma

Question 20

GPA vs Goodpastures - what clinical fx differ?

Answer 20

GPA has URTI features!!

GPA - Upper resp tract, lower resp tract + glomerulonephritis +++

Goodpastures - pulmonarry haemorrhage + glomerulonephritis

Question 21

SCLC patient with proximal muscle weakness that improves with use + hyporeflexia

Answer 21

Lambert Eaton
- affects VGCC in ACh synapses.

Question 22

Coal miner
with rheumatoid arthritis
and new chronic dry cough
-diagnosis?

Answer 22

Caplans syndrome

pulmonary fibrosis in coal miners with RA

Question 23

Red currant jelly sputum

Answer 23

Klebsiella

Question 24

apple-green birefringence of Congo red stain under polarized light

Answer 24

amyloidosis

Question 25

SLE features

Answer 25

serositis
oral ulcers
arthritis
photosensitivity

blood (all low)
renal failure
ANA
Immunologic (dsDNA, smooth muscle)
Neuro

Malar rash
Discoid rash

Question 26

most common lung injury from blunt chest trauma

Answer 26

Pulmonary contusion

Question 27

1st choice abx in acute bronchitis vs mild CAP

Answer 27

bronchitis - doxycycline
CAP - amoxicillin

Question 28

1st choice abx in CAP for pregnancy?

Answer 28

erythromycin

Question 29

Antibodies which are frequently +ve in SLE?

Answer 29

• dsDNA
• antiphospholipid
• smooth muscle

Question 30

Early vs late onset HAP
- typical organisms causing each of the above?

Answer 30

early <5 days from admission
- Strep pneumoniae
- Haemophilus

late >5 days from admission
- Pseudomonas
- MRSA
- gram negatives: klebsiella, E coli

Question 31

COPD pt already using PRN saba with little relief.
what is the next step of treatment

Answer 31

as per NICE:
- LABA and LAMA

as per GOLD:
- LABA or LAMA