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Question 1

COPD diagnostic criteria

Answer 1

FEV1:FVC <0.7 and symptomatic

Question 2

Airflow limitation grades COPD

Answer 2

Mild: FEV1 >80%
Moderate: FEV1 50-79%
Severe: FEV1 30-49%
Very severe: FEV1 <30%

Question 3

mMRC dyspnoea score

Answer 3

1. SOB on vigorous exertion
2. SOB on hurrying or climbing stairs
3. Walks slowly or has to stop for breath
4. Stops for breath after <100m / few min
5. Too breathless to leave house / SOB on dressing

Question 4

Tool to predict mortality in COPD

Answer 4

BODE index

Question 5

BODE index components

Answer 5

BMI
Obstruction: FEV1
Dyspnoea: MRC score
Exercise capacity: 6 min walk

Question 6

Severe asthma criteria

Answer 6

PEFR <50%
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RR >25
Tachycardia >110

Question 7

Life threatening asthma criteria

Answer 7

PEFR <33%
SpO2 <92%, PCO2 >4.6kPa, PO2 <8kPa
Cyanosis
Hypotension
Exhaustion / confusion
Silent chest / poor respiratory effort
Tachy/brady/arrhythmias

Question 8

Causes of fibrosis

Answer 8

Upper: aspergillosis, pneumoconiosis (coal and silica), extrinsic allergic alveolitis, TB
Lower: sarcoidosis, toxins (bleomycin, busulfan, amiodarone, nitrofurantoin, sulfasalazine, methotrexate), asbetosis, idiopathic pulmonary fibrosis, rheum (RA, SLE, SS, Sjogren’s, PM/DM)

Question 9

Causes of bronchiectasis

Answer 9

Congenital
 - CF, PCD, Young's, yellow nail syndrome
Immunological
 - hypogammaglobulinaemia
Post-infectious
 - TB, pertussis, measles
Obstruction
 - foreign body, tumour

Question 10

Indications for lobectomy / pneumonectomy

Answer 10

Bronchial carcinoma
Bronchiectasis
COPD - lung reduction surgery
Old TB

Question 11

Differential for lobectomy scar but normal lung

Answer 11

Thoracotomy: abscess, empyema, biopsy, wedge

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