resp stuff

Question 1

what is chronic bronchitis

Answer 1

long term symptoms of a cough and sputum production due to inflammation in the bronchi

Question 2

what is emphysema

Answer 2

damage and dilatation of the alveolar sacs and alveoli, decreasing the surface area for gas exchange

Question 3

investigations for COPD

Answer 3

-post bronchodilator spirometry (less than 70%)
-chest x-ray

Question 4

first line investigations for asthma in adults

Answer 4

eosinophil count OR fractional nitric oxide

Question 5

severe COPD

Answer 5

FEV1 30-49%

Question 6

mild COPD

Answer 6

FEV1 > 80%

Question 7

moderate COPD

Answer 7

50-79%

Question 8

very severe COPD

Answer 8

< 30%

Question 9

moderate asthma attack

Answer 9

-PEFR 50-75%
-speech normal
-RR < 25
-pulse < 110

Question 10

severe asthma attack

Answer 10

-PEFR 33-50%
-can’t complete sentences
-RR > 25
-pulse >110

Question 11

life threatening

Answer 11

-PEFR < 33%
-oxygen sats < 92%
-normal pCO2
-silent chest, cyanosis or feeble resp effort
-bradycardia, dysrhythmia or hypotension
-exhaustion, confusion or coma

Question 12

indication for surgery in bronchiectasis

Answer 12

localised disease

Question 13

whats the threshold for a Wells PE score to get a CTPA

Answer 13

4 or more

Question 14

what investigation if wells score is less than 4

Answer 14

D-dimer

Question 15

dry cough and erythema multiform?

Answer 15

MYCOPLASMA pneumonia
- can present in young people

Question 16

within what time frame can you do a d-dimer

Answer 16

4 hours

Question 17

if you suspect a PE, then CTPA is negative, what is the next step

Answer 17

do a proximal leg vein USS

Question 18

PE + hypotension treatment

Answer 18

thrombolysis (they have haemodynamic instability!!!)

Question 19

minimal symptom pneumothorax treatment

Answer 19

conservative treatment regardless of size

Question 20

what does reduces transfer factor mean (TLCO)

Answer 20

impaired gas exchange

Question 21

investigation for legionella pneumonia

Answer 21

urinary antigen test

Question 23

most common cause of occupational asthma (chemical)

Answer 23

isocyanates

Question 24

what are the high risk features that indicate chest drain in pneumothorax

Answer 24

->55 with smoking hisotry -bilateral pneumothorax -haemodynamic instability -significant hypoxia -underlying lung disease -haemothorax

Question 25

which lung cancer produces ACTH and ADH

Answer 25

small cell lung cancer

Question 26

indication for steroids in sarcoidosis

Answer 26

-patients with CXR stage 2 or 3 who are symptomatic -hypercalcaemia -eye, heart or neuro involvement

Question 27

bilateral coarse crackles and widespread polyphonic wheeze in young person

Answer 27

bronchiectasis

Question 28

most common organism in bronchiectasis infections

Answer 28

haemophilus influenza