Resp

Question 1

S: Dyspnoea, pink frothy sputum, tachycardia
Sx: bi basal end inspiratory fine crackles , elevated jvp

Answer 1

Acute pulmonary oedema

Question 2

Paraneoplastic syndromes of small cell carcinoma (5)

Answer 2

Cushingoid Sx from ACTH 
Lambert-Eaton Syndrome 
SIADH (low Na high ADH)
Encephalitis 
Retinal blindness

Question 3

Paraneoplastic syndrome of adenocarcinoma

Answer 3

Hypertrophic pulmonary osteoarthropathy

Question 4

Paraneoplastic syndrome of squamous cell carcinoma

Answer 4

Hypercalcaemia - PTH like protein secretion
Hyponatraemia
Also associated with central cavitating lesions
Keratinised cells

Question 5

Most associated with smoking bronchial carcinoma

Answer 5

Squamous cell carcinoma

Small cell to lesser extent

Question 6

Most common bronchial carcinoma and seen commonly in female non smokers
Markers?

Answer 6

Adenocarcinomas

Tyrosine kinase inhibitors used to treat EGFR and KRAS receptors

Question 7

Type 1 vs Type 2 Respiratory failure difference

Answer 7

Both have low pO2, below 7.5.
Type 1: V/Q mismatch, hypoxia with normocapnia. Eg PE, pulmonary fibrosis, pneumonia, pulmonary oedema

Type 2: ventilation dysfunction, hypercapnia and hypoxia. Eg asthma attack, COPD, OSA
/ GBS, polio, diaphragmatic paralysis / thoracic wall disease/

Question 8

Sx and symptoms of hypoxia

Answer 8

Dyspnoea, restlessness, tachypnoea, tachycardia, cyanosis.

Headache, confusion, drowsiness, fatigue, pallor?

Question 9

Treatment of asthma vs COPD

Answer 9

Asthma: SABA, inhaled corticosteroid, LABA, oral prednisolone

COPD: SAMA/ SABA, LAMA/LABA, theophylline, corticosteroids

Question 10

Most common CAP pathogens

Answer 10

Streptococcus pneumoniae 50%
Haemophillus influenzae 20%
Chlamydophila pneumoniae 13%
Mycoplasma pneumoniae 3%

Question 11

Atypical pneumoniae x5

Answer 11

Mycoplasma pneumoniae: younger age group, neuro + systemic signs (rash), joint pain, otitis media, lymphadenopathy
Chlamydia pneumoniae: mild symptoms
Chlamydia psittacosis: parrots, psittacosis
Legionella pneumophila: high mortality rate Legionnaire’s Disease, abdo pain diarrhoea confusion
Coxiella Burnetti : Q fever

Question 12

Hospital acquires pneumonia : classification/ bugs

Answer 12

> 48 hours admission
Gram negative enterobacteria
Staph aureus
Also: pseudomonas, klebsiella, (ventilator associated) bacteriodes, clostridium

Question 13

Aspiration pneumonia bugs

Answer 13

Oropharyngeal anaerobes
Streptococcus pneumoniae
Klebsiella

Question 14

What is curb65 or corb score?

Answer 14

Confusion 
Urea >9
Respiratory >30
BP systolic <90,diastolic <60
65> age 

Corb used to decide hospital admission
Curb65 for hospital admission or ICU

Question 15

Treatment for mild CAP pneumonia

Answer 15

Amoxicillin with/out doxycycline

Question 16

Treatment for moderate CAP pneumonia

Answer 16

Benzo penicillin with/out doxycycline

Question 17

Treatment for severe CAP pneumonia

Answer 17

Ceftriaxone with/out ezithromycin

Question 18

Cystic fibrosis specific pneumonia causing bug:

Answer 18

Pseudomonas aeruginosa

An opportunistic infection, also associated with ventilator pneumonia, nosocomial sepsis