Respiratory

Question 1

CXR: Wedge shape opacification?

Answer 1

PE

Question 2

Common organism in aspiration pneumonia?

Answer 2

Klebsiella

Question 3

Examination finding in adenocarcinoma of the lung?

Answer 3

Gynocomastia

Question 4

Exudative pleural effusion (pleural fluid: serum protein)

Answer 4

> 0.5 or > 30g/L

Question 5

Transudative pleural effusion (pleural fluid: serum protein)

Answer 5

< 0.5 or < 30g/L

Question 6

Causes of exudative pleural effusion?
(PPP MCT)

Answer 6

Pneumonia (most common)
Pulmonary embolism
Pancreatitis
TB
Connective tissue disease
Mesothelioma

Question 7

Causes of transudative pleural effusion? (HHHM)

Answer 7

Heart failure (most common)
Hypoalbuminaemia (nephrotic syndrome, liver disease, malabsorption)
Hypothyroidism
Meige’s syndrome

Question 8

When should a chest tube be placed in pleural effusion?

Answer 8

ALL patients with pleural effusion associated with sepsis or pneumatic illness should receive diagnostic pleural fluid sampling, chest tube should be placed if:
1. Fluid is purulent, turbid/cloudy
2. Fluid is clear but pH is < 7.2

Question 9

Causes of lower zone fibrosis? (ICD-A)

Answer 9

Idiopathic
Connective tissue disease (RA, SLE but NOT and spond)
Drug induced (Amiodarone, bleomycin, methotrexate)
Asbestosis

Question 10

Causes of upper zone fibrosis? (CHARTS)

Answer 10

Coal workers pneumoconiosis
Histocytosis/ hypersensitivity pneumonitis
Ank Spond
Radiation
TB
Silicosis

Question 11

First line treatment of allergic bronchopulmonary aspergillosis?

Answer 11

Oral prednisolone
(2nd line agent is itraconazole)

Question 12

Major feature of allergic bronchopulmmonary aspergillosis?

Answer 12

Eosinophilia
(Positive RAST to aspergillus)

Question 13

Criteria for LTOT in COPD?

Answer 13

pO2 <7.3 or 7.3-8 AND one of:
1. Secondary polycythaemia
2. Peripheral oedema
3. Pulmonary hypertension

Question 14

2-level PE Wells test?

Answer 14

> 4 points - PE likely
< or = 4 points - PE unlikely

Question 15

Most common asbestos related lung change?

Answer 15

Pleural plaques (do not undergo malignant change)

Question 16

Diagnosis on mycoplasma pneumonia?

Answer 16

Serology

Question 17

Spirometry in restrictive lung disease?

Answer 17

FEV1: Reduced
FVC: Significantly reduced
FEV1:FVC ratio: Normal or increased

Question 18

Spirometry in obstructive lung disease?

Answer 18

FEV1: Significantly reduced
FVC: Reduced or normal
FEV1:FVC ratio: Reduced

Question 19

Aspiration of empyema?

Answer 19

Turbid effusion
pH < 7.2
Glucose: low
LDH: raised

Question 20

Diagnosis of mesothelioma?

Answer 20

Histology following thoracoscopy

Question 20

Type of lung cancer in which cavitating lesions are most common?

Answer 20

Squamous cell lung cancer

Question 21

Where are caveatting lesions in Klebsiella pneumonia?

Answer 21

Upper lobes

Question 22

Where are caveatting lesions in Klebsiella pneumonia?

Answer 22

Upper lobes

Question 23

Organism that can cause empyema formation?

Answer 23

Klebsiella

Question 24

Limitations following pneumothorax?

Answer 24

Lifelong ban from deep sea diving

Question 25

In bronchodilator reversibility testing, what is indicative of asthma?

Answer 25

Increase in FEV1 of 12% or more

Question 26

Which pneumonia does preceding influenza infection pre-dispose you to?

Answer 26

Staph Aureus

Question 27

Antibiotic in acute bronchitis?

Answer 27

Doxycycline

Question 28

Measurement of lung function in myasthenia gravis?

Answer 28

FVC

Question 29

Indication for mechanical ventilation in myasthenia gravis?

Answer 29

1. FVC 15 mL/kg or less
2. NIF (negative inspiratory force) of 20 cm H₂O or less

Question 30

CXR: Parallel line shadows?

Answer 30

Common in bronchiectasis
Indicate dilated bronchi due to peribronchial inflammation and fibrosis
Often called tram lines

Question 31

Most common organisms isolated in bronchiectasis?

Answer 31

Hame influenza (most common)
Pseudomonas Aerginosa
Klebsiella
Strep pneumoniae

Question 32

Bronchiectasis exam findings?

Answer 32

Coarse crackles
Wheeze

Question 33

Which pneumonia is associated with cold sores?

Answer 33

Strep pneumoniae

Question 34

Most common cause of occupational asthma?

Answer 34

Isocyanates

Question 35

Latenet TB CXR?

Answer 35

Calcified Gohn complex

Question 36

Discahrge in asthma?

Answer 36

After 24 hours medical management PEFR >75%
Diurnal variability < 25%

Question 37

Most common cause of bilateral hilar lynphadenopathy?

Answer 37

TB

Question 38

When is prophylactic azithromycin considered in COPD?

Answer 38

If patient does NOT smoke and:
1. Optimised pharmacological and inhaled therapies, have relevant vaccines and are referred for pulmonary rehab
And continue to have1 or more of:
1. Frequent (4x per year) exacerbations with sputum production
2. Prolonged exacerbations with sputum production
3. Exacerbations resulting in hospitalisation

Question 39

Test required before starting TB treatment?

Answer 39

FBC, U&Es, LFTs and visual acuity

Question 40

COPD and pneumothorax mimic?

Answer 40

Large emphysematous bull

Question 41

Difference in emphysema in COPD vs A1AT?

Answer 41

Emphysema is most prominent in the lower lobes in A1AT deficiency and the upper lobes in COPD

Question 42

Management of alpha 1 anti-trypsin deficiency?

Answer 42

Lung volume reduction surgery

Question 43

Which lung cancer is medial (near bronchus)

Answer 43

Squamous cell carcinoma