RESP

Question 1

What bacteria most commonly causes pneumonia?

Answer 1

Strep pneumoniae- 90%
Staph aureus
Legionella’s

Question 2

What are signs of a pneumonia infection?

Answer 2

A drop in BP
Fever
Fatigue
Pleuritic chest pain
SOB
Headache
Cough with sputum

Question 3

What is the gold standard test for pneumonia?

Answer 3

Chest X-ray

Question 4

What is used to assess he severity of pneumonia?

Answer 4

CURB-65

• confusion
• blood urea nitrogen
• resp rate
• blood pressure
• older than 65

Question 5

What are the antibiotic stages for community acquired pneumonia?

Answer 5

Mild- oral amoxicillin
Moderate- oral amoxicillin and clarithromycin
Severe- IV co-amoxiclav and clarithromycin

Question 6

What are the management of pneumonia steps?

Answer 6

Oxygen to maintain PaO2, IV fluids, Antibiotics, Analgesia

Question 7

What is the treatment for legionella pneumonia?

Answer 7

fluoroquinolone and clarithromycin

Question 8

What is mycobacterium tuberculosis?

Answer 8

An aerobic non-motile rod shaped bacteria

Question 9

What should you do when you have a case of TB?

Answer 9

It is a notifiable disease

Question 10

What are the signs and symptoms of TB?

Answer 10

Fever, night sweats, chills, chest pain, anorexia, weight loss, cough >3/52 in a year

Question 11

What tests do we do for TB?

Answer 11

3x sputum test, Manoux skin test, CXR, CT scan, interferon gama release assays

Question 12

What satin do you use for TB?

Answer 12

Ziehl-Neelson stain

Question 13

What is the treatment for TB?

Answer 13

RIPE
Rifampacin
Isoniazid
(2 months intense then 4 months continued)
Pyrazinamide 
Ethambutol 
(2 months intense)

Question 14

What can be an issue with diagnosing TB?

Answer 14

It takes 2-6 weeks to show up in labs

Question 15

What are the risk factors of TB?

Answer 15

HIV+, anorexia, IVDU, born in a high prevalence area, homeless, alcoholic,

Question 16

What are some examples of beta agonists?

Answer 16

Salbutamol and salemeterol

Question 17

What makes up COPD?

Answer 17

Chronic bronchitis, emphysema and COAD

Question 18

What do you see in type 2 resp failure?

Answer 18

High CO2 and low O2

Question 19

What are signs of emphysema COPD?

Answer 19

Pink puffer- weight loss, breathless, maintained pO2

Question 20

What are the signs of chronic bronchitis COPD?

Answer 20

Cough, resp failure, lack of energy, low mood

Question 21

What are general signs of COPD?

Answer 21

Barrel chest, ankle swelling, sputum, chronic cough

Question 22

How do we diagnose COPD?

Answer 22

FEV1/FVC < 70%

CXR

Question 23

What is the drug pathway for COPD?

Answer 23

SABA
LABA
LABA +Corticosteroid
LABA + Corticosteroid+ LAMA

Question 24

What is the pathophysiology of COPD?

Answer 24

Parenchymal destruction meaning less alveolar attachments and less elastic recoil with fibrosis and inflammation

Question 25

What type of hypersensitivity is asthma?

Answer 25

Type 1 -IgE

Question 26

What are pathophysiological signs of asthma?

Answer 26

Bronchoconstriction | Mucus production

Question 27

When is asthma worse?

Answer 27

In the morning

Question 28

How do we test for asthma?

Answer 28

Spirometry FEV1/FVC< 70% and a peak flow diary

Question 29

What is the drug plan for asthma?

Answer 29

SABA, Corticosteroids, Corticosteroid and LABA, higher dose corticosteroid and biological therapy, then add prednisolone

Question 30

What is transudate?

Answer 30

Low protein fluid from heart failure, cirrhosis and nephrotic syndrome

Question 31

What is exudate?

Answer 31

High protein fluid from bacterial pneumonia, cancer, viral infection and pancreatitis

Question 32

What do you see on a chest X -ray of a pleural effusion?

Answer 32

White fluid

Question 33

What are signs and symptoms of pleural effusion?

Answer 33

Decreased chest movement , reduced breath sounds, dull percussion Symptoms- SOB, cough and chest pain

Question 34

What is the treatment for pleural effusion?

Answer 34

Aspirate/ chest drain | Pleurodesis

Question 35

What is pneumothorax?

Answer 35

A build up of air in the pleural space

Question 36

What can cause pneumothorax?

Answer 36

Trauma (ie rib fracture, gunshot) | Damage from underlying lung pathology

Question 37

What are the signs of pneumothorax?

Answer 37

Low blood pressure, low oxygen levels, lose breathe sounds on the affected side

Question 38

What are the symptoms of pneumothorax?

Answer 38

SOB, sharp, ONE SIDED chest pain and altered consciuosness

Question 39

What is the gold standard test for pneumothroax?

Answer 39

CXR

Question 40

What is tension pneumothorax?

Answer 40

EMERGENCY where the trachea is deviated away from the lung and a chest drain must be inserted

Question 41

What causes meothelioma?

Answer 41

asbestos

Question 42

What type of cancer is non small cell lung cancer?

Answer 42

Squamous and adenocarcinoma (asbestos)

Question 43

What are the red flag signs for lung cancer?

Answer 43

Haemoptysis and weight loss

Question 44

What is the treatment for stage 1/2 lung cancer?

Answer 44

Surgical excision and radical deep x ray therapy

Question 45

What is the treatment of stage 3/4 lung cancer?

Answer 45

Palliative chemo and radio and palliative day

Question 46

What does CF affect?

Answer 46

CTFR channel protein

Question 47

Signs of CF in kids?

Answer 47

Finger clubbing, rectal prolapse, steatorrhea

Question 48

What is the test for CF?

Answer 48

Sweat test (NaCl) and genetic testing

Question 49

What gene is CF?

Answer 49

DF508

Question 50

How do we investigate bronchiectasis?

Answer 50

High resolution computed tomography and a sputum culture

Question 51

How do we treat brochiectasis?

Answer 51

Stop smoking, airway clearance exercise | Bronchodilators, steroids and antibiotics

Question 52

What is accute symptom relief for ocupational lung disorders?

Answer 52

corticosteroids

Question 53

What are some examples of hypersensitivity pneumonitis?

Answer 53

Farmer's lung, bird fancier's and wine makers

Question 54

Where does Wegener's granulomatosis affect?

Answer 54

Ears, nose, kidney and lungs and is from blood vessel inflammation

Question 55

How do we treat Wegener's granulomas?

Answer 55

Cyclophosphamide, steroid injections and plasma exchange

Question 56

What is the centor criteria?

Answer 56

Helps guide as to whether pharyngitis has a viral of bacterial cause. 0-2 viral infection 3-4 50% bacterial

Question 57

What are the chest x ray signs of COPD?

Answer 57

Hypertnflation flat hemi-diaphragms large pulmonary arteries

Question 58

What are the results of CT for COPD?

Answer 58

Bronchial wall thickening, enlarged space air spaces

Question 59

How does eosinophilic asthma occur?

Answer 59

Allergens activate Th2 leading to mast cell/basophil. | An influx of eosinophils/T cells into the lumen

Question 60

How does non eosinophilic asthma occur?

Answer 60

Irritants activate Th1 and NUETROPHOLS, MACROPHAGES and MAST CELLS leading to an allergic reaction

Question 61

Normal signs of asthma?

Answer 61

Tachypnoea, audible wheeze, widespread polyphonic wheeze

Question 62

Tests for acute asthma attack?

Answer 62

ABG, CXR, bloods

Question 63

Where do lung cancers metastasis to?

Answer 63

Lymph nodes, bone, brain, liver, adrenal gland

Question 64

What cells are seen in small cell carcinoma?

Answer 64

Kulchistky cells

Question 65

What is pneumonia?

Answer 65

Inflammation of the lung parenchyma

Question 66

What are community causes of pneumoniae?

Answer 66

S. Pneumoniae H. Influenzae Stah aureus Klebsiella pneumonia

Question 67

What are late onset causes of hospital pneumoniae?

Answer 67

M. pneumoniae Legionella pneumophila Chlamydophila pneumoniae

Question 68

What causes rusty sputum in pneumoniae?

Answer 68

S. Pneumoniae

Question 69

What CURB65 score indicates immediate transferal to ICU?

Answer 69

5

Question 70

What is the TB vaccine called?

Answer 70

BCG vaccine

Question 71

What can cause pulmonary hypertension?

Answer 71

SLE, sclerloderma, septal defects, HIV