Respiratory

Question 1

most common bacterial organisms that cause infective exacerbations of COPD are:

Answer 1

Haemophilus influenzae (most common)
Streptococcus pneumoniae
Moraxella catarrhalis

Question 2

Adult asthma treatment

Answer 2

SABA
Low dose ICS
LTRA
LABA

Question 3

Acute asthma classification

Answer 3

Moderate>Severe>Lifethreatening>Near fatal

Question 4

Discharge criteria for acute asthma attach

Answer 4

• stable on their discharge medication (i.e. no nebulisers or oxygen) for 12–24 hours
• inhaler technique checked and recorded
• PEF >75% of best or predicted

Question 5

Guidelines to stepping down asthma treatment

Answer 5

-Consider step down every 3 months
-Reduce steroid dose by 25-50%

Question 6

Primary pneumothorax management

Answer 6

If not SOB and <2cm = do nothing
If SOB or >2cm = attempt aspiration
If unsuccessful = chest drain

Question 7

Secondary pneumothorax management

Answer 7

<1cm = admit and O2
1-2cm = aspirate
>50yo + >2cm or SOB = chest drain

Question 8

Obstructive vs Restrictive of PFTs

Answer 8

Obstructive - COPD, asthma, bronchiectasis
FEV1 reduced
FVC reduced or normal
FEV1/FVC reduced

Restrictive - PF, NMD, asbestosis, ARDS
FEV1 reduced
FVC significantly reduced
FEV1/FVC normal or increased

Question 9

Nicotine replacement therapy drugs

Answer 9

Nicotine partial agonists - Varenicline

Norepinephrine and dopamine reuptake inhibitor, and nicotinic antagonist - Bupropion

Question 10

Klebsiella pneumoniae

Answer 10

Gram negative
UTIs and atypical pneumonia
Cavitating legions. Upper lobe.
Alcoholics and diabetics.

Question 11

Mycoplasma pneumonia

Answer 11

Atypical pneumonia
Dry cough and coryza
Extra-pulmonary sx = haemolytic anaemia + erythema multiform

Question 12

Legionella pneumonia

Answer 12

Atypical pneumonia
Contaminated water
Bilateral signs
Fever, cough, myalgia
Extra-pulmonary sx = hepatitis + hyponatraemia