RESPIRATORY

Question 1

management of pulmonary hypertension

Answer 1

diuretics to treat the peripheral oedema
supplemental oxygen
CCB e.g. dltiazem and verapamil
PED5i = sildenifil
endothelin A = bosentan and ambristen
prostacyclin analagoues = epoprostenol, iloprost and treprostinil

Question 2

non productive cough 
dyspnoea
chest pain 
dull to percuss
reduced breath sounds 
reduced chest expansion

Answer 2

pleural effusion 
(>30g/L protein = exudate, <30g/L protein = transudate)

Question 3

progressive exertional dyspnea
dry cough
bibasal fine crackles
clubbing

Answer 3

idiopathic pulmonary fibrosis

Question 4

pulmonary fibrosis management

Answer 4

pulmonary rehabilitation
pirfenidone can be useful
supplemental oxygen
eventual lung transplant

Question 5

pleuritic chest pain - worse on inspiration and coughing
dyspnoea
haemoptysis

Answer 5

pleurisy

Question 6

progressive exertional dyspnoea
cough
black/brown sputum

Answer 6

pneumoconiosis

Question 7

managment of pneumoconiosis

Answer 7

avoidance of coal dust exposure
smoking cessation
manage chronic bronchitis symptoms

Question 8

erythema nodosum 
lupus pernio (red/purple raised skin around the face)
malaise 
fever 
polyarthralgia
SOB 
dry cough 
hypercalcemia

Answer 8

sarcoidosis

Question 9

management for sarcoidosis

Answer 9

steroids for 6-24 months

immunosuppressants in severe cases
lung transplant

Question 10

cough (non/productive), sore throat, rhinorrhea, wheeze and sometimes a low-grade fever

Answer 10

acute bronchitis

Question 11

management of acute bronchitis

Answer 11

analgesia and fluids

Abx indicated in systemic illness, co-morbidities or CRP 20-100
= give doxycycline (alt is amoxicillin)

Question 12

coryzal symptoms 
dry cough
increasing breathlessness
sometimes wheeze/fine inspiratory crackles
feeding difficulties

Answer 12

bronchiolitis

Question 13

investigation for bronchiolitis

Answer 13

immunofluorescence of nasopharyngeal swabs

Question 14

mx for bronchiolitis

Answer 14

supportive = humidified oxygen, NG feeding

Question 15

preceding coryza 
coughing bouts 
inspiratory whoops
spells of apneoa 
post-tussive vomiting

Answer 15

pertussis/whooping cough

Question 16

investigation for pertusis

Answer 16

nasal swab

Question 17

management of pertussis

Answer 17

oral macrolide 21 days
offer Abx household prophylaxis
school exclusion till 48hrs after Abx initiation

Question 18

red currant jelly sputum/ bloody mucous 
dyspnoea 
chest pain 
fever, night sweats 
productive cough

Answer 18

empyema

Question 19

management of empyema

Answer 19

IV antibiotics - cefotaxime children
amoxicillin, vancomycin or metronidazole in adults
analgesia
Chest drain/thoracentesis

Question 20

management of acute epiglossitis

Answer 20

secure airway - refer to anesthetist
(endotracheal intubation)
oxygen & IV antibiotics

Question 21

rapid onset
high temperature, generally unwell
stridor
drooling of saliva
'tripod' position'/ leaning forward provides some relief
thumb sign on X-ray

Answer 21

acute epiglossitis

Question 22

stridor
barking cough (worse at night)
fever
coryzal symptoms
steeple sign

Answer 22

croup

Question 23

management of croup

Answer 23

single dose of oral dexamethasone (0.15mg/kg) to all children regardless of severity
prednisolone alternative

emergencies = high flow oxygen & nebulized adrenaline

Question 24

pneumonia as a result of contaminated air conditioning

Answer 24

legionella

Question 25

pneumonia as a result of HIV

Answer 25

pneumocystis

Question 26

pneumonia in alcoholics

Answer 26

klebsiella

Question 27

Most common cause of infective COPD exacerbation

Answer 27

haemophilus influenzas

Question 28

tuberculosis management

Answer 28

2/12: RIPE

R = red/orange pee
I = paresthesia/weakness 
P = pain 
E = eyes 

4/12: RI

Question 29

Pneumocystis management

Answer 29

clotrimazole