RESP 3

Question 1

small cell lung cancer arises from what 
where
mets
stuff
treatmet

Answer 1

neuroendocrine cells (APUD)
centrally located
rapidly metastasis
ADH -> hyponatraemia, ACTH cushings, Lambar Eaton syndrome. hypokalaemia

limited then surgery or radio and chemo
excessive palliative chemo

Question 2

sqmaous cell carcinoma

Answer 2

commonest 
epithelial cells arise from 
calvitating central mass
slow mets
PTH - increased calcium hyperthyroid
central necrosis

Question 3

adenocarcinoma

Answer 3

non smokers
mucous secretin glandular cells 
peripheral 
mets early 
gyncamastia

Question 4

large cell

Answer 4

peripheral 
anasplatic - undifferntiated
poor prognosis 
mets early 
may secrete bHCG

Question 5

ix for lung cancer

what is a pan coast tumour

Answer 5

CXR, bronchoscopy, PET

cancer of apex of lung

Question 6

treatment for NSCLC

CI to surgery

Answer 6

poor response to chemo: curative/palliative radio
only 20% suitable for surgery

general health, star 3b/4 mets, FEV1 <1.5 litres, malignant pleural effusion, tumour near hilum, vocal cord paralysis, SVC obstruction

Question 7

resp failrue defined as what
type 1 causes
type 2 causes

Answer 7

O2 under 8
V/P mismatch, hypoventilation, pneumonia, abnormal diffusion, pulmonary edema, pneumonia, PE, asthma, fibrosis

PcO2 >6
alveolar hypoventilation, asthma, COPd, pneumonia, sedatives, trauma, GBC, MG, cord lesions

Question 8

symptoms of hyperaemia

symptoms of increased CO2

Answer 8

SOB, restlessness, agitation, confusion, central cyanosis

headache, vasodilatation, increases PR, bounding pulse, flap, papilloedema

Question 9

ix for resp failure

treatment

Answer 9

bloods CXR ABG spirometry

underlying

Question 10

ARDS causes
ix
rx

Answer 10

lung injury. infection, aspiration, trauma, shock, sepsis, DIC, haemorrhage, pancreatitis, head injury

CXR bilateral infiltration, PCWP <19mmHg or lack of CHF, hypoxaemia

ICU CPAP

Question 11

PE causes

WELLS Score

Answer 11

fat air endocarditis amniotic fluid

clinical sign of DVT 3
alternate dx unlikely 3
prev DVT/PE 5
HR>100 5
surgery/immobilisaition within 4 weeks 1.5
haemoptysis 1
active cancer 1

PE unlikely 4 or under D dimerd
likely >4 CTPA

Question 12

PE other ix

Answer 12

ECG
ABG
CXR wedge shaped infarcts

Question 13

treatment for PE if harm-dynamically unstable
if stable
what should be started

Answer 13

thrombolyse
LMWH for 5 days
Warfarin or reveroxaban

Question 14

pulmonary hypertension pulmonary artery pressure
cause
symp
ix
rx

Answer 14

> 25mmHg at rest >30 with exercise

secondary to COPD/lung disease - RVH

SOB, fatigue, oedema, increased JVP, ascites, RV heave, loud P2, tricuspid regurg

CXR. V/P scan. HRCT. PFTs. FBC (polycythaemia). ECG: RAD/RVH. ECHO: RA/RV enlargement

treat as right sided heart failure