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1
Q

what does amiodarone do to the lunges

A

lower zones lung fibrosis

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2
Q

mast cell tryptase

A
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3
Q

discharge post anaphylaxis attack

A

2 epipens

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4
Q

steroid dose kids asthma attack

A

10mg oral pred <2
20mg 2-5yo
30-40mg >5yo

3 days

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5
Q

silicosis CXR

A

mining occupation

upper zone fibrosis
egg shell calcification of hilar nodes

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6
Q

acute bronchitis tx

A

usually self resvolves

consider abx if
systemically super unwell
pre existing comorn
CRP 20 -100 = delayed prescripti
CRP>100 = doxycycline

if preg or child = amox

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7
Q

CF contraindication to lung transplant

A

burkholderia cepacia

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8
Q

pharm tx CF

A

if homozygous for delta F508 mutation =

lumacaftor/ivacaftor (Orkambi)

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9
Q

SAMA example

A

ipratropium

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10
Q

atypical pneumonia causes

A

legions of psittaci MCQs

legionella
chlamydia psittaci
mycoplasma pneumoniae
chlamydophilia pneum
q fever - coxiella burnetii

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11
Q

indications for surgery in bronchiectasis

A

localised disease
uncontrollable haemptysis

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12
Q

life threa attack

A

PEFR <33%
spO2<92%
‘normal’ CO2

CHEST

Cynaosis
hypotenson
exhaustion/confusion
silent chest/poor resp effort
tachy/brady/arthythmia

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13
Q

occupational asthma is
mc cause

A

exposure following chemicals at work

mc: isocyanates ie spray painting and foam moulding using adhesives

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14
Q

pattern of asthma on spirometry

A

obstructive

reduced FEV1:FVC

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15
Q

asthma diagnosis on spirotmetry

A

15% improvement post bronchodilatir

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16
Q

how does salbutamol work

A

b2 receptors in resp tract stimulated
= inc sympathetic activity
= relaxes bronchial smooth muscle

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17
Q

physiological measurement to determine COPD severity

A

FEV1

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18
Q

when is LTOT Ci in copd

A

if still smokes

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19
Q

bronchiectasis mc organism

A

haam . influenxa

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20
Q

pneumonia cx

A

resp failure
af
empyema
effusion
lung abcess
pericarditis

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21
Q

empyema tap and mx

A

turbid
ph<7.2
reduced glucose
inc LDH

US guided chestdrain/asp

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22
Q

legionella sx

A

lymphopenia
siadh-> low na
deranged LFTs

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23
Q

klebsiella who

and fx

A

pneum in alcholic

cavitating pneumonia
esp upper lobes

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24
Q

parrots pneumonia

extra pulm fx

A

chlamydia pstacci

horders spots - rose spots
splenomegaly
epistaxis
hep nephritus
meningoenceph

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25
Q

bronchectasis cxr

A

thickened bronchial walls
tramlines n rings

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26
Q

bronchiescasis spiro

A

obstructive

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27
Q

bronchiectasis ix

A

initial
sputum, cxr, post brochodil spirometry

gold
high res CT

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28
Q

allergic bronchopulm aspergillous

A

T1HS reaction

cxr= bronchiectasis
sputum = black on silver stain
skin test = aspergillous or IgR RAST

inc IgE and eosinophills

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29
Q

consolidation

percussion
breath sounds
vocal resonance

chest expansion

A

dull

bronchial

increased

reduced

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30
Q

effusion

percussion
breath sounds
vocal resonance

A

stony dull

reduced
reduced

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31
Q

pembertons sign

A

hold arm over head =

facial plethora
insp stridor
inc jvp

SVC obstruction

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32
Q

local cx llung ca

A

recurrent laryngeal palsy
phrenuc palsy
SVC obstruction
horners
af

33
Q

endo cx lung ca

A

ADH -> SIADH (euvol low na)
ACTH -> cushings syndrome
serotonin -> carcinoid (flushing, diarrhoa)
PTHrP -> primary HPT (incca, bone pain) -SCC

34
Q

transudate (low protein)
inc capillary hydrostatic pressure causes

A

ccf
iatrogenic fluid overload
renal failure

35
Q

transudate
reduced cap oncotic pressure

A

liver failure
nephrotic syndrome
malnut,malabsorb

36
Q

MRC dysponia scale

A

1 sob on vigorous exertion
2 SOB hurrying/ stairs
3 walk slowly or stop for breath
4 stops for beath <100m/few mins
5 too breathless to leave house or SOB ondressing

37
Q

transudate conten

A

<25 protein

38
Q

exudate

A

> 35 protein

39
Q

effusion fluid protein between 25-35

A

LIGHTS criteria

40
Q

lights criteria

A

Light’s Criteria
An exudate has one of:
1 .Effusion : serum protein ratio >0.5
Effusion : serum LDH ratio >0.6
Effusion LDH is 0.6 × ULN

41
Q

exudate causes

A

inc cap permeability

pneumonia, TB
bronchial ca lymphoma, mesothilioma
RA, SLE
infarction

42
Q

empyema causes

A

ca
TB
RA
SLE

43
Q

Interstitial lung disease upper zone causes

A

A PENT

Aspergillosis : ABPA
Pneumoconiosis: Coal, Silica
Extrinsic allergic alveolitis
Negative, sero-arthropathy,
TB

44
Q

interstitial lung disease lower zone causes

A

STAIR

Sarcoidosis (mid zone)
Toxins: BANS ME
Asbestosis
Idiopathic pulmonary fibrosis
Rheum: RA, SLE, Scleroderma, Sjogren’s, PM/DM

45
Q

interstitial lung disease dug causes

A

BANS ME

Bleomycin, Busulfan
Amiodarone
Nitrofurantoin
Sulfasalazine
MEthotrexate,

46
Q

complicaions idiopathic pul htn

A

inc risk ca lung
type 2 resp failure and core pulmonale

47
Q

pneumonia ix

A

Bloods
ABG
URine pneumoccocal and legionella ag
sputum MC&S
CXR

48
Q

MC HAP

A

pseudomonas aerunginosa
staph aureus

49
Q

statins and macrlides

A

macrolide inhib CYP3A4
= inc serum statin

= risk of myositosis/rhabdo

50
Q

pneumothorax

percussion
breath sounds

chest expansion

A

hyperesonant percuss
reduced breath sounds

reduced chest expan

51
Q

why might TB be on rise

A

HIV/AIDS prevelance
immunosupressive drugs
inc immig from areas of high prev
poor socioecon conditions and overcrowding

52
Q

TB Dx

A

RI 6 mths
PE 2 mths

53
Q

why 4 drugs in tb

A

combat multidrug resistance

54
Q

erthythema nodosum causes

A

idiopathic
RA
UC/Crohns
TB
sarcoidosis
strep infxn
chlamydia
oral contracept

55
Q

TB dx

pul
bone
meningeal

A

6 mths
9 mths
12 mths

56
Q

CF prev

A

1 in 2500 live births

57
Q

bronchiectasis path

A

chronic infxn and inflam of large airways causing their abnormal permenant dilitation

58
Q

bronchiectasis cause

A

idiopathic
recur ifxn , pertusiss Tb measles
RA
UC
alpha 1 antitripsin

59
Q

bronchiectasis cx

A

recurrent pneumonia
resp failure
massive haemoptysis
pneumothroax
cor pulmonale
septicaemia

60
Q

type 1 resp fail path

A

vq mismatch or diffusion failure

61
Q

type 2 respfail path

A

alveolat hypoventilation +/- vq mismatch

62
Q

PE Ix

A

2 level wells

CTPA or VQ scan

63
Q

Lung Ca ix

A

CXR
CT
PET
bronchoscopy

64
Q

non small cell lung ca staging

65
Q

lung ca types

A

small cell

non small cell =
- scc
- adenocarcinoma
- Large cell

66
Q

idio pulmonary fibrosis CXR

A

red lung vol
bilat lower zone reticnod shadowing
honeycomb lung

67
Q

restrictive spiro

A

low fev 1
low fvc

normal/high ratio

68
Q

causes extrinsic allergic alveolitis

A

bird fanciers lung
farmers lung
mushroom worker
winemakers

malt workers lung (aspergillus clavatus)

69
Q

extrinsic allerguc alveolitis

A

inhalation of allergerns that cause hypersensitv rxn

acute = Type 3 (4-6hrs fevecoughsob)

over time repeat exposure chronic = type 4 ie granuloma formation and obliterative bronchiolitis

70
Q

OSA tools

A

epworth sleepiness scale
multiple sleep latency test (MSLT)

71
Q

OSA RF

A

obesity
smoking
alochol
nasal polyps
enlarged tonsils/adenoids

72
Q

OSA dx

A

sleep studies
polysomnography

73
Q

OSA mx

A

stop smoking
wt loss
avoid alcohol
sleep upright
mandib advancement device
CPAP
surgery

74
Q

cor pulmonale cxr

A

enlarged r atrium n ventricle
prominent pul arteries

75
Q

cor pulmonale ecg

A

RAD p pulmonale

76
Q

sarcoidosis fx

A

GRANULOMAS

gen - fever wt loss lymphad
resp - BHL
arthralgia
neuropathy
urine - hypercalcaemia = renal stones
low hormones - pitdysfxn = amenorhea
optha - ant. uve
myocard - restrictive cardiomyop
pericardi effusion
abdo - hepsplemeg
skin = EN and lupus pernio

77
Q

BHL causes

A

sarcoidosis
TB
bronchial ca
extrinsic allerg alveo
lymphoma

78
Q

sarcoid granuloma

A

non caseating

finals (28 decks)

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