Resp

Question 1

rapid onset SOB and cough, tachypnoea, tachycardia, inspiratory crepitations, bilateral signs

Answer 1

ARDS

Question 2

episodic wheeze, breathlessness, cough (worse in morning/at night)

Answer 2

asthma

Question 3

productive cough with purulent sputum/haemoptysis, SOB chest pain, clubbing, crepitations at base

Answer 3

brochiectasis

Question 4

cough, SOB, wheeze, dec exercise tollerance, hyper resonance, prolonged expiration, dec break sounds, hyperinflation, bounding pulse

Answer 4

COPD

Question 5

SOBOE, dry cough, fever, clubbing

occupation - keeps pets, farmer, plumber, mushroom picker, malt worker

Answer 5

extrinsic allergic alveolitis

Question 6

cough, haemoptysis, SOB, clubbing, lymphadenopathy, crackles wheeze, inc vocal resonance

bone pain/fractures, headaches/blurry vision, hepatomeg

Answer 6

Lung cancer

from mets

Question 7

dry cough, SOB, dec appetite, night sweats, pleural friction rub, pleural thickening on CXR

Answer 7

mesothelioma

Question 8

chronic fatigue, snoring, unrefreshed post sleep, obese

Answer 8

obstructive sleep apnoea

Question 9

sudden onset breathlessness and pleuritic chest pain, signs of resp distress , dec expansion/breath sounds, hyperresonance

Answer 9

pneumothorax

Question 10

dry cough , progressive SOB, fatigue, arthralgia, lymphadenopathy, erythema nodosum, blurred vision, red eyes, photophobia

Answer 10

sarcoidosis

Question 11

fever, lethargy, cough with green sputum, night sweats, weight loss, haemoptysis, lymphadenopathy, recent travel

Answer 11

TB

Question 12

Treatment of an acute severe asthma attack

Answer 12

ABCDE, resus, O2 sats, PEFR, ABGs
high flow O2, Salbutamol nebuliser, Ipratropium bromide, IV hydrocortisone (then oral prednisolone for 5 days)

if above measures do not work - IV Mg Sulphate

Question 13

Indications of a life threatening asthma attack (7)

Answer 13

Silent chest
Hypotension
Bradycardia
Exhaustion/poor respiratory effort
PH <7.25
pCO2 of 6KPa
Cyanosis

Question 14

How do you assess the severity of Pneumonia

Answer 14

CURB65
Confusion, Urea >7, RR>30, BP<90/60, Age >65

0-1 = outpatient
2 = inpatient
3-5 = inpatient and consider ICU

Question 15

Common causes of CAP

Answer 15

Strep pneumonia, haemophillus influenzae B, pneumococcus, mycoplasma

Question 16

Common causes of HAP

Answer 16

staph aureus, klebsiella, psudonomas aureginosa

Question 17

Antibiotics for CAP

Answer 17

amoxicillin, co-amoxiclav if severe

Question 18

Antibiotic if HAP - staph aureus

Answer 18

flucoxacillin + gentamycin

Question 19

antibiotics for HAP, peudonomas aureg

Answer 19

vancomycin

Question 20

treatment of atypical pneumonia

Answer 20

metronidazole

Question 21

how would u classify a PE and then how would you investigate

Answer 21

Wells score
P - prev DVT/PE = +1.5
E - evidence of DVT = +3
Stasis = +1.5
Cancer = +1
Opinion is PE = +3
Raised Rhythm (>100bpm) = +1.5
Exsanguination (haemoptysis) = +1

<4 - D-dimer
>4 - CTPA

Question 22

What would you use to confirm TB

Answer 22

Sputum MCS w/ Ziehl neelson stain

Question 23

what inv helps distinguish ARDS from HF

Answer 23

BNP <100

Question 24

management for bronchiectasis

Answer 24

2x IV antibiotics (which cover psudonomas aureginos)

inhaled corticosteroids, bronchodilators, maintain hydration, flu vaccine, physiotherapy

Question 25

what are the occupational RF for extrinsic allergic alveolitis

Answer 25

keep pets (esp birds), plumber, mushroom picker, malt worker

Question 26

CXR findings for lung cancer

Answer 26

coin shaped lesions, bi-hilar lymphadenopathy, consolidation

Question 27

FLAWS, hoarse voice, horners syndrome

Answer 27

pancoast tumour - tumour at lung apex compressing nerves

Question 28

CXR findings for mesothelima

Answer 28

pleural thickening, Pleural effusion, pleural plaques

Question 29

management for tension pneumothorax

Answer 29

max O2
large bore needle into 2 ICS at MCL
CXR 2 hours and 2 weeks later

if aspiration fails or fluid in pleural cavity - chest drain