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Question 1

Causes of chronic interstitial lung disease?

Answer 1

idiopathic
rheumatological (RA,SLE, Sjogrens, dermatomyositis, Ank Spond, psoriasis, systemic sclerosis)
drugs (methotrexate, trimethoprim, amiodarone, bleomycin)
inhaled (extrinsic allergic alveolitis, asbestosis, silicosis, beryliosis)
vasculitis (Wegner’s, polyarteritis nodosa, Churg-Strauss, Goodpasture’s)
TB, sarcoid

Question 2

Respiratory causes of clubbing

Answer 2

bronchiectasis
lung cancer
interstitial lung disease
CF
lung abscess
TB
mesothelioma

Question 3

Which conditions cause predominantly Apical fibrosis?

Answer 3

BREASTS CLAP
Berylliosis, radiation, extrinsic allergic alveolitis, aspergillosis, silicosis, TB, sarcoidosis, coal miner’s pneumoconiosis, langerhans cell histiocytisis, ank spond, psoriasis

Question 4

Causes of COPD

Answer 4

smoking
alpha 1 antitripsin deficiency
coal dust

Question 5

common pathogens of IECOPD

Answer 5

strep pneumonae
Haemophilus influenzae
moraxella catarrhalis

Question 6

indications for long term oxygen

Answer 6

stopped smoking

pO2

Question 7

What is Light’s criteria for an exudate?

Answer 7

pleural fluid protein:serum protein >0.5
pleural LDH:serum LDH >0.6
pleural LDH >2/3rds upper limit of normal serum value

Question 8

DDx for dullness and dull percussion at a lung base?

Answer 8

pleural effusion
consolidation
collapse
tumour
pleural thickening
raised hemidiaphragm
lobectomy (+scar)

Question 9

causes of a chylothorax (pleural fluid cholesterol >4g/l)

Answer 9

lymphatic obstruction (lymphoma or solid tumour)
lymphatic damage (post surgery)
nephrotic syn
cirrhosis

Question 10

causes of low pleural fluid glucose/pH

Answer 10

malignancy
TB
empyema
inflammation - RA, SLE
oesophageal rupture

Question 11

Organisms involved in an empyema

Answer 11

anaerobes
staph
gram neg organisms (legionella, moraxella, Haemophilus)

Question 12

Ddx of clubbing and crackles

Answer 12

bronchiectasis
fibrosing alveolitis
chronic lung abscess
bronchial carcinoma

Question 13

causes of bronchiectasis

Answer 13

congenital - Kartageners and CF
mechanical obstruction - bronchial carcinoma
childhood illness - TB and measles
immune OVER activity - allergic bronchopulmonary aspergillosis, IBD associated
immune UNDER activity - hypogammaglobulinaemia
aspiration - chronic alcoholics and GORD