resp questions

Question 1

what is light’s criteria

Answer 1

to distinguish between transudate and exudate when protein between 25 and 35
exudate likely if:
- pleural protein/serum protein >0.5
- pleural LDH/serum LDH >0.6
- pleural LDH >2/3 upper limit of normal serum LDH

Question 2

acute asthma management in order

Answer 2

OSHIMA
oxygen
salbutamol
hydrocortisone IV (or oral pred)
ipratropium bromide
magnesium sulphate IV
aminophylinline
- transfer to ITU/HDU for ventilation

Question 3

bronchiectasis features

Answer 3

• persistent productive cough
• dyspnoea
• haemoptysis
• crackles and wheeze on auscultation
• history of resp problems

Question 4

features acute moderate asthma

Answer 4

peak flow 50-75% best or predicted
normal speech
RR < 25
HR < 110

Question 5

features acute severe asthma

Answer 5

peak flow 33-50%
can’t finish sentences
RR > 25
HR > 110

Question 6

features life threatening asthma

Answer 6

peak flow <33%
silent chest, cyanosis, feeble resp effort
sats <92
normal CO2
bradycardia, dysrhythmia, hypotension
exhaustion, confusion, coma

Question 7

complications mycoplasma pneumoniae

Answer 7

cold agglutinins cause haemolytic anaemia
erythema multiforme
steven johnson’s, guillan barre - other immune mediated neuro diseases

Question 8

what is seen on bloods in legionella

Answer 8

hyponatraemia
deranged LFTs

Question 9

management pneumocystis jiroveci

Answer 9

co-trimoxazole

Question 10

feature specific to pneumocystic jiroveci

Answer 10

exertional dyspnoea

Question 11

what is CURB65

Answer 11

c - confusion
u - urea > 7
r - resp rate > 30
b - blood pressure (systolic <90 - diastolic <60_
age > 65
score >2 - hospital

Question 12

cause of lower lobe emphysema

Answer 12

alpha-1 antitrypsin deficiency

Question 13

asthma diagnostic tests

Answer 13

spirometry with bronchodilator reversibility
FeNO

Question 14

most common cause of cannonball metastases

Answer 14

renal cell carcinoma