Respiratory

Question 1

What is the function of the CFTR protein?

Answer 1

Enables movement of chloride from intracellular to extracellular space in the lungs

Question 2

What are the high risk determinants in pulmonary hypertension?

Answer 2

Systemic venous sats <58%
Echo shows RA/RV enlargement
Reduced LV size
Increased RV:LV ratio
Pericardial effusion
Systemic cardiac index - <2.5l/min/m2
mRAP >10mmHg
Acute vasoreactivity
6-minute walk test <350m

Question 3

What is the most common embryological aetiology of isolated cleft lip?

Answer 3

Failure of the fusion of the medial nasal and maxillary processes

Question 3

Until what age does alveolar development continue?

Answer 3

8 years

Question 4

In CF, what is the most primary mechanism acting to reduce mucociliary clearance?

Answer 4

Decreased volume of the periciliary layer - cilia become embedded and therefore their movement is impeded.

Question 4

What does a right shift in the oxygen dissociation curve indicate?

Answer 4

Decreased oxygen affinity for Hb, favouring oxygen release to the tissues?

Question 4

What does a left shift in the oxygen dissociation curve indicate?

Answer 4

Increased affinity for Hb, favouring less oxygen release to the tissues

Question 5

What can shift the oxygen dissociation curve to the left?

Answer 5

Alkalosis
CO poisoning
Low CO2
Fetal Hb

Question 6

What can shift the oxygen dissociation curve to the right?

Answer 6

Acidosis
Fever
Increased CO2
HbS

Question 6

What conditions lead to a low transfer factor (TLCO)?

Answer 6

Pneumonia
Smoking
Obesity

Question 7

What occurs in the first stage of lobar pneumonia?

Answer 7

Vascular congestion and alveolar oedema
High numbers of infecting organism

Question 7

What occurs in the second stage of lobar pneumonia?

Answer 7

Significant infiltration of RBCs, fibrin and neutrophils

Question 8

What occurs in the third stage of lobar pneumonia?

Answer 8

Breakdown of fibrin and RBCs create fibrinopurulent exudate

Question 9

What occurs in the fourth stage of lobar pneumonia?

Answer 9

Resolution caused by macrophage clearance

Question 10

ABCA3 protein mutations can lead to what respiratory condition?

Answer 10

Interstitial lung disease secondary to surfactant deficiency

Question 11

What would Weber’s test show in conductive hearing loss?

Answer 11

Localises to affected ear

Question 12

What is the classical triad of submucosal cleft palate?

Answer 12

Bifid uvula
Absent or notched posterior nasal spine
Translucent or blue area in the midline of the soft palate

Question 13

What would Weber’s test show in SN hearing loss?

Answer 13

Localises to unaffected ear

Question 13

What would Rinne’s test show in conductive hearing loss?

Answer 13

Bon conduction > air (-ve) on affected side

Question 14

What would Weber’s test show in severe SN hearing loss?

Answer 14

Localises to unaffected ear

Question 15

What is the most common GI manifestation of CF?

Answer 15

Rectal prolapse

Question 15

What is the physiological motor for cilia within the lungs?

Answer 15

Dynein

Question 15

What would Rinne’s test show in SN hearing loss?

Answer 15

Air conduction > bone (+ve)

Question 16

What would Rinne’s test show in severe SN hearing loss?

Answer 16

Bone conduction > air (-ve) on affected side

Question 17

In what syndrome is dynein absent?

Answer 17

Kartagener syndrome

Question 18

At what gestational age does the external ear begin to develop?

Answer 18

6 weeks

Question 19

What kind of staining is needed to diagnose Neuroendocrine cell hyperplasia of infancy (NEHI)?

Answer 19

Bombesin staining

Question 19

What is the monoclonal antibody treatment for asthma?

Answer 19

Omalizumab

Question 19

What type of bacteria is pseudomonas?

Answer 19

Gram negative rods

Question 19

What is the role of thromboxane in PE?

Answer 19

Pulmonary and systemic vasoconstrictor

Question 19

What has been found on the aryepiglottic folds in laryngomalacia?

Answer 19

Shortening

Question 20

Which soft palate muscle is innervated by the medial pterygoid nerve?

Answer 20

Tensor veli palatini

Question 20

What are the histopathological features of alveolar capillary dysplasia?

Answer 20

Reduced pulmonary capillaries unable to make contact with the epithelial bed Thickened alveolar septum Hypertrophy of arterioles Abnormal positioning of pulmonary vein branches Immature lobular development

Question 20

How does alveolar capillary dysplasia present?

Answer 20

Hypoxia PPHN - unresponsive to NO and ECMO

Question 21

What is total lung capacity?

Answer 21

Total volume of air in lungs following a maximal inspiration

Question 22

What is vital capacity?

Answer 22

Maximum volume of air that can be expired after a maximal inspiration

Question 23

What is inspiratory reserve volume?

Answer 23

Maximum volume of air that can be inspired at the end of a normal tidal inspiration

Question 24

What is functional residual capacity?

Answer 24

Volume of air that remains in the lung after a normal tidal expiration

Question 25

What is expiratory reserve volume?

Answer 25

Maximum volume of air that can be expired after a normal tidal expiration

Question 26

What is residual volume?

Answer 26

Volume of air remaining after maximal expiration

Question 27

What are the common symptoms of EVALI?

Answer 27

Cough Fever Chest pain Dyspnoea Vomiting Weight loss

Question 28

What is the most common chemical compound associated with EVALI?

Answer 28

Tetrahydrocannabinol

Question 29

What is the first histopathological process in AOM?

Answer 29

Oedema within the subepithelial space

Question 30

Is the LDH level high or low in exudative pleural fluid?

Answer 30

High

Question 31

What conditions can cause exudative pleural effusion?

Answer 31

Malignancy Pericarditis Autoimmune disease

Question 32

What does the Guthrie card read to diagnose CF?

Answer 32

IRT - immunoreactive trypsinogen

Question 33

What cells line the lingual surface of the epiglottis?

Answer 33

Stratified squamous epithelium