Respiratory

Question 1

What does it mean if in blood test you have C-ANCA positive?

Answer 1

C-ANCA is a type of autoantibdoy

cANCA Positive > 90% of patients with granulomatosis with polyangiitis (Wegener’s granulomatosis)

Question 2

What is the most common organism in patients with bronchiectasis?

Answer 2

Haemophilus infuenza

Question 3

What test is used to diagnose benign paroxysmal positional vertigo? (really bad vertigo- triggered by changes in head position e.g. rolling over in bed)

Answer 3

Dix-Hallpike Manoeuvre

Question 4

What test is used to treat benign paroxysmal positional vertigo? (really bad vertigo- triggered by changes in head position e.g. rolling over in bed)

Answer 4

Epley manoeuvre

Question 5

Examples of obstructive disease

Answer 5

COPD
Chronic Bronchitis
Emphysema inc alpha-1 antitrypsin deficiency
Asthma
Bronchiectasis

Question 6

Examples of restrictive disease

Answer 6

Idiopathic pulmonary fibrosis
Sarcoidosis
Drug induced fibrosis
Asbestosis
Neuromuscular disease: polio, myasthenia gravis
Obesity
Scoliosis

Question 7

Organisms which commonly cause respiratory tract infections in patients with CF

Answer 7

Staphylococcus aureus
Pseudomonas aeruginosa
Burkholderia Cepacia
Aspergillus

Question 8

How does hypercapnia affect intracranial pressure?

Answer 8

Hypercapnia can cause vasodilation of cerebral blood vessels so intracranial pressure increases
Important in ventilation in head injury patients

Question 9

What is a paraneoplasmic syndrome?

Answer 9

Group of rare disorders that are triggered by an abnormal immune response to a cancerous tumour known as a “neoplasm”

Question 10

What paraneoplastic phenomenon is associated with squamous cell carcinoma of the lung?

Answer 10

Parathyroid hormone-related protein (PTHrP) - similar function to PTH, when secreted by cancers it can cause hypercalcaemia

Question 11

What is a sternotomy?

Answer 11

A median sternotomy is the commonest incision utilised to access the heart and great vessels

Question 12

In the presence of hypoxia what happens to blood vessels?

Answer 12

Pulmonary arteries constrict in response to hypoxia, diverting blood away from poorly oxygenated lung regions. This maximises blood flow to well oxygenated regions of the lung.

Question 13

What causes the majority of bronchiolitis cases?

Answer 13

Haemophilus influenzae

Question 14

Symptoms of bronchiolitis

Answer 14

Dry cough
Preceding Coryza
Increasing breathlessness causing feeding difficulties
Wheeze

Question 15

Which nerve lies most posteriorly located at the lung root?

Answer 15

Vagus nerve

Question 16

What is alpha-1- antitrirypsin deficiency?

Answer 16

Co-dominant genetic disorders, presents with dyspnoea and chronic cough
Cause emphysema which esp affects lower lobes- bulla at left lung base
Get fam history of suffering breathing

Question 17

First line therapy for TB

Answer 17

Rifampicin
Isoniazid
Pyrazinamide
Ethambutol

Question 18

Respiratory causes of clubbing:

Answer 18

Asbestosis
Bronchiectasis
Cancer (lung)
Do not say COPD
Emphysema

Question 19

Characteristics of psychogenic dyspnoea:

Answer 19

Inability to take satisfying breath
No precipitating or relieving factors
Left submammary pains
Tingling in fingers (suggestive of intermittent episodes of hyperventilation)

Question 20

What is the CURB-65 score

Answer 20

Confusion (<8 on AMTS)
Urea (>8)
Respiratory rate (>30)
Blood pressure <90 systolic or <60 diastolic

Score of:
0-1 = home therapy with a clinic appointment
2= admission to hospital
3= ICU care