Respiratory

Question 1

Complications and Rx of amniotic fluid embolism

Answer 1

Obstructive shock, hypoxemic resp failure, DIC, coma, seizures
Resp and hemodynamic support, transfusion

Question 2

Causes of chronic dyspnea in sickle cell disease

Answer 2

Asthma , pulmonary hypertension, pulmonary fibrosis

Question 3

CXR, CT finding of interstitial lung disease confirmation?

Answer 3

Difffuse reticukar infiltrates, linear opacification.
Honeycombing pattern.
Confirm with CT and transbronchial biopsy

Question 4

How long does it take to develop of ARDS or fat embolism from inciting event?

Answer 4

24-72 hrs or longer

Question 5

Rx of AECOPD

Answer 5

Maximise expiratory air flow-inhaled bronchodilator
Reduce inflammation-systemic corticosteroids
Underlying triggers-antibiotics/ antivirals
Maintenance oxygen spo2 within 88-92%, NIPPV or invasive mechanical ventilation

Question 6

Antibiotics empirically used for AECOPD

Answer 6

FQ- moxi, levo or cephalosporins-ceftriaxone, cefpodoxime

Question 7

Drug for PPX for AECOPD in high risk patients

Answer 7

Roflumilast PDE4 inhibitor

Question 8

Findings in histoplasmosis

Answer 8

Hemoptysis, multifocal lung nodules, CXR- calcified lung nodules, hilar lymphadenopathy

Question 9

Cured Hodgkin lymphoma sequela

Answer 9

Cardiac disease, radiation induced hypothyroidism, secondary malignancy
Malignancy- Lung, breast, GI, haematological

Question 10

Rx of acute bronchitis

Answer 10

Supportive care-NSAIDS or bronchodilators

Question 11

Pathogenesis behind aspirin exacerbated respiratory disease

Answer 11

Leukotrienes

Question 12

Thoracocentesis location

Answer 12

Mid clavicular- 6 and 8 th ribs
Mid axillary-8 an 10 th ribs
Paravertebral- 10 and 12 th ribs

Question 13

Complication of RSV in newborns

Answer 13

Apnea-<8 months to get nirsevimab injection to prevent RSV

Question 14

What increases survival in COPD patients

Answer 14

Oxygen, smoking cessation

Question 15

Pathophysiology behind ARDS, diagnostic criteria

Answer 15

Decreased lung compliance, increased WOB, severe V/Q mismatch- severe hypoxemia through intrapulmonary shunting, increased hypoxia pulmonary vasoconstriction- RV afterload, acute PHTN.
DX- new b/l alveolar lung opacities within 1week, Deena not due to HF or volume overload, hypoxemia with PaO2/FiO2<300

Question 16

Child with pneumonia, not improving with antibiotics after 48-72 hrs. NBS?

Answer 16

Repeat CXR. Could have lead to complications- parapneumonic effusion, abscess, necrotising pneumonia

Question 17

What happens to FRC, RV, TLC in COPD?

Answer 17

Increased

Question 18

What happens to FVC, VC, FEV1/FVC in COPD?

Answer 18

Decreased

Question 19

Management of exercise induced asthma

Answer 19

Budesonide-formeterol 5-10 mins before exercise

Question 20

17 yr old noisy breathing, loud inspiratory stridor on exercise, not during rest. Diagnosis?

Answer 20

Paradoxical vocal cord motion

Question 21

CT chest findings in hypersensitive pneumonitis

Answer 21

Bilateral micronodular interstitial pattern

Question 22

Small cell lung cancer with SIADH. Next step?

Answer 22

Fluid restriction.

Question 23

Rx of IPF

Answer 23

Anti fibrotic therapy-Pirefnidone, nintedanib

Question 24

What’s to be done to prevent post op atelectasis

Answer 24

Deep breathing exercises

Question 25

Rx for invasive aspergillosis

Answer 25

IV voriconazole +echinocandin, then prolonged oral voriconazole.

Question 26

PPX for bronchiolitis

Answer 26

Nirsevimab

Question 27

Pathogenesis behind asthma exacerbation in pregnancy

Answer 27

Low epinephrine and glucocorticoid signalling

Question 28

Mx of asthma in pregnancy

Answer 28

ICS with beta agonist, systemic corticosteroids for acute exacerbation

Question 29

DLCO in good pasture syndrome

Answer 29

Increased