Resp

Question 1

Most common cause of pneumonia

Answer 1

Strep. Pneumoniae

Question 2

Most common cause of pneumonia in COPD

Answer 2

H. influenzae

Question 3

Most common cause of pneumonia in alcoholics

Answer 3

Klebsiella pneumoniae

Question 4

Features of pneumococcal (s.pneumoniae) pneumonia

Answer 4

rapid onset
high fever
pleuritic chest pain
herpes labialis

Question 5

Urinary antigen tests for pneumonia

Answer 5

Legionella and pneumococcal urinary antigens

Question 6

When should you delay pneumonia pt discharge

Answer 6

Temp still >37.5C

Question 7

How long after pneumonia will pt feel back to normal?

Answer 7

May take up to 6m for fatigue, cough, breathlessness to go

Question 8

Common cause of bronchiolitis?

Answer 8

RSV

Question 9

Common cause of croup?

Answer 9

Parainfluenza

Question 10

Common cause of cold?

Answer 10

rhinovirus

Question 11

Huge white out of one lung field?

Answer 11

Unilateral pleural effusion = malignancy or infection (trachea pushed away)
Lung collapse - trachea pulled towards side of white out

Question 12

Transudate v exudate pulm eff?

Answer 12

Transudate protein <30g/L
Exudate protein >30g/L
Transudate is systemic disease whereas exudate indicates local disease

Question 13

Small cell paraneoplastic syndromes?

Answer 13

ADH - low Na
ACTH - cushings
Lambert Eaton syndrome

Question 14

Squamous cell paraneoplastic syndromes?

Answer 14

PTH-rp causing hypercalcaemia

Question 15

COPD symptoms in a young person

Answer 15

alpha-1 antitrypsin (A1AT) deficiency

Question 16

First line for COPD?

Answer 16

SABA or SAMA (ipratropium)

Question 17

Second line for COPD?

Answer 17

no asthmatic features = LABA + LAMA

asthmatic features = LABA + ICS

Question 18

Presentation of cor pulmonale?

Answer 18

Breathlessness
Peripheral oedema
Dizziness
chest pain 
Raised JVP
S3
Murmur
Hepatomegaly bc of back pressure into hepatic vein

Question 19

FEV1 and FVC findings?

Answer 19

FEV1 Reduced in obstructive lung

FVC reduced in restrictive lung

Question 20

What is FVC?

Answer 20

Total amount of air a person can exhale after full inhalation

Question 21

When is obstructive lung disease diagnosed?

Answer 21

When FEV1 is <75% of FVC

Question 22

When is restrictive lung disease diagnosed?

Answer 22

FEV1 and FVC are both reduced, FEV1 is >75%

Question 23

Examples of restrictive lung disease?

Answer 23

Pulm fibrosis
Sarcoidosis
Obesity
Scoliosis of the spine 
MND

Question 24

Types of lung cancer?

Answer 24

Small cell and non small cell

NSCLC: squamous and adenocarcinoma

Question 25

Lung cancer on CXR:

Answer 25

hilar englargement
peripheral opacities
pleural effusions
lung collapse

Question 26

Investigations for lung cancer?

Answer 26

CXR
CT/PET
Bronch
Biopsy

Question 27

Extra pulmonary symptoms of Lung cancer?

Answer 27

Hoarse voice - recurrent laryngeal nerve palsy
SVCO - distended neck veins, facial swelling, difficulty breathing (pembertons sign - raising hands above head causes facial swellking and cyanosis)
Horner’s syndrome - partial ptosis, anhydrosis, miosis (pupillary constriction)