Respiratory

Question 1

Late line drug used in asthma

Answer 1

Theothyline

Question 2

Asthma chronic treatment

Answer 2

1) SABA
2) + low ICS
3) + LTRA
4) + LABA, take away LTRA if no effect
5) SABA + medium dose MART + LTRA if effect
6) High dose ICS or LAMA or theothyline

Question 3

MART

Answer 3

LABA and ICS

Question 4

Most common cause occupation asthma

Answer 4

Isocyanates - spray paint

Question 5

Moderate asthma

Answer 5

PEFR 50-70%
RR < 25
Pulse <110

Question 6

Severe asthma

Answer 6

PEFR 33-50%
RR > 25
Pulse > 110
Cannot complete sentences

Question 7

Life threatening asthma

Answer 7

PEFT <33%
Oxygen <92%
Silent chest
Bradycardia or hypotension
Confusion or coma
Normal PCO2

Question 8

Acute asthma treatment

Answer 8

1) SABA and oral corticosteroid 5d
2) SAMA - ipratropium
3) IV magnesium or aminophyline

Question 9

COPD severity

Answer 9

1 - FEV1 >80% plus symptoms
2 - 50-79%
3 - 30-49%
4 - <30%

Question 10

COPD treatment

Answer 10

1) SABA or SAMA
2) Asthma features - combined LABA and ICS
3) No asthma features - combined LABA and LAMA
4) Theophyline, consider azithromycin

Question 11

LTOT indication

Answer 11

pO2 < 7.3 or <8 and oedema or pulmonary hypertension

Question 12

COPD infective cause

Answer 12

Haemophilus influenzae

Question 13

Most common lung cancer

Answer 13

Adenocarcinoma

Question 14

Hypercalcaemia or hyperthyroidism in lung cancer

Answer 14

Squamous cell

Question 15

CURB 65

Answer 15

Confusion
Urea > 7
RR >30
BP < 90 systolic, 60 diastolic
Age > 65

Question 16

Xray post pneumonia

Answer 16

6 weeks

Question 17

Identify legionella

Answer 17

Hyponatraemia

Question 18

Legionella and mycoplasma antibiotic

Answer 18

Clarithrymycin or azithromycin

Question 19

Identify mycoplasma

Answer 19

Erythema multiforme

Pericarditis

Question 20

Delay for CTPA in PE

Answer 20

Start low molecular weight heparin

Question 21

Treatment PE

Answer 21

DOAC if stable, thrombolysis if not

Question 22

Exudative pleural effusion

Answer 22

> 30g/L protein

Question 23

Causes exudative pleural effusion

Answer 23

Infection or conective tissue disorder

Question 24

Transduate pleural effusion

Answer 24

<30g/L

Question 25

Causes transduate pleural effusion

Answer 25

Congetive heart failure | Hypoalbuminaemia - liver disease

Question 26

25-35g pleural effusion

Answer 26

Lights criteria: - pleural fluid protein/serum protein 0.5 - pleural fluid LDH/serum LDH 0.6

Question 27

Pleural effusion treatment

Answer 27

Small - supportive | Large - aspiration/drainage

Question 28

Aspiration in empyema

Answer 28

pH<7.2 Low glucose High LDH

Question 29

Pneumothorax investigation

Answer 29

CXR

Question 30

Primary pneumothorax treatment

Answer 30

<2cm and not SOB - discharge | Otherwise - aspiration, chest drain if fails

Question 31

Secondary pneumothorax treatment

Answer 31

<1cm - oxygen and admit 1-2cm - aspiration, chest drain if fails >2cm - chest drain

Question 32

Tension pneumothorax treatment

Answer 32

Needle decompression and chest tube

Question 33

Mesothelioma diagnosis

Answer 33

Thoracoscopy

Question 34

Bronchiectasis common organism

Answer 34

Haemophilus influenza

Question 35

Upper zone fibrosis

Answer 35

CHARTS - coal workers pneumocomiosis - hypersensitive pneumonitis - ankylosing spondylitis - radiation - TB - sarcoidosis

Question 36

Lower zone fibrosis

Answer 36

IPF Drug induced Asbestos

Question 37

Fibrosis diagnosis

Answer 37

CT scan

Question 38

Calculate anion gap

Answer 38

(Na +K) - (Cl + bicarbonate)

Question 39

Metabolic acidosis normal anion gap

Answer 39

Diarrhoea Addisons Renal tubular acidosis

Question 40

Metaboic acidosis raised anion gap

Answer 40

Lactate - shock Ketones - DKA, alcohol Urate - renal failure Acid poisoning - salicylates, methanol

Question 41

Metabolic alkalosis

Answer 41

Vomiting | Hyperaldosteronism

Question 42

Respiratory acidosis

Answer 42

COPD | Sedative drugs

Question 43

Respiratory alkalosis

Answer 43

Anxiety PE Pregnancy

Question 44

Identify granulomatosis with polyangitis (Wegeners)

Answer 44

Epistaxis, sinusitis Haemoptysis Renal disease

Question 45

Antibody in Wegeners

Answer 45

cANCA

Question 46

Identify eosinophilia granulomatosis with polangitis (Churg Strauss)

Answer 46

Asthma Eosinophilia Renal disease

Question 47

Antibody in Churg strauss

Answer 47

pANCA

Question 48

Oxygen targets

Answer 48

94-98 normally | 88-92 in COPD

Question 49

Restrictive spirometry causes

Answer 49

Fibrosis Asbestosis Sarcoidosis Obesity

Question 50

Centor criteria

Answer 50

Tonsillar exudate Cervical lymphadenopathy Fever Absence of cough

Question 51

Causes raised transfer factor

Answer 51

Asthma Polycythaemia Pulmonary haemorrhage

Question 52

Location canula in tension pneumothorax

Answer 52

2nd intercostal space